Fundoscopy

Question 1

How would you start this examination?

Answer 1

• Wash hands
• Your ID
• Patient ID
• Explanation
• Consent
• Pain

Quick end of bed examination and face examination

Question 2

What would you look for on inspection?

Answer 2

1. AVPU
2. Periorbital swelling
3. Redness of eye
4. Discharge
5. Ulcers
6. Any medications nearby

Question 3

I am short sighted. What should I set the lens to for my vision?

Answer 3

-ve 4/5ish area, play about with it

Question 4

How would you examine the patients right eye?

Answer 4

15 degrees to right of patient (my left) Tell patient to look over your right shoulder Hold scope in your right hand and use your right eye

Question 5

What is the first thing you should do?

Answer 5

Observe the red reflex - Shine light into patients eye at an angle at ~30cm distance - Should see shine of red fundus while looking through opthalmoscope

Can do this in both eyes before moving on to one eye

Question 6

What do you do after red reflex?

Answer 6

Get closer to patient and focus on the fundus, adjust dial so it is clear

Question 7

How would you view the optic disc?

Answer 7

Shine light nasally

Question 8

What would you look for in the optic disc?

Answer 8

Clear margins

Colour

Shape

Appearance of vessels as they cross the rim - are they toruous/conjested?

Question 9

What would you look for on the retina?

Answer 9

• Colour
• Haemorhages
• Exudates
• Tears

Question 10

How would you examine the maccula?

Answer 10

Ask patient to look directly into the light

Question 11

After assessing the maculla?

Answer 11

Repeat on other eye

Question 12

How would you close this examination?

Answer 12

• Thank patient
• Wash hands
• Requests a full neurological exam and testing of visual acuity, fields, reflexes, eye movements, urine dipstick and blood pressure