Fundoscopy

Question 1

Why is it important to approach the patient at 15 degrees?

Answer 1

You arrive at the fundus over the optic disc - patient’s blind spot - least discomfort and mimnimal pupil constriction.

Question 2

How do you prepare the patient?

Answer 2

Examine in a darkened room

Use instilling drops to dilate pupils

Make patient comfortable

Ask patient to fix their gaze on an object

Question 3

How do you observe the red reflex?

Answer 3

Lense to 0

30cm away

Presence of red reflex means that light is entering the eye and being reflected back from the fundus

Question 4

After focussing on the fundus, what are you looking for?

Answer 4

Optic disc (shape, colour, definition of edges/rim; note appearance of vessels as the cross the rim)

Vessels (appearance of arteries, veins -? tortuous, arterovenous nipping)

Retina (colour, haemorrhages, exudates, detatchment, tears)

macula (ask patient to look directly at the beam of light just before finishing looking at that eye)