Introduction

Ophthalmoscopy, also called funduscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or funduscope). It is done as part of an eye examination and may be done as part of a routine physical examination. It is crucial in determining the health of the retina, optic disc, and vitreous humor.

The pupil is a hole through which the eye's interior will be viewed. Opening the pupil wider (dilating it) is a simple and effective way to better see the structures behind it. Therefore, dilation of the pupil (mydriasis) is often accomplished with medicated eye drops before funduscopy. However, although dilated fundus examination is ideal, undilated examination is more convenient and is also helpful (albeit not as comprehensive), and it is the most common type in primary care.

When it is used?

Your eye doctor can use ophthalmoscopy to screen for eye diseases and conditions that can affect blood vessels. These conditions include: damage to your optic nerve, retinal tear or detachment, glaucoma, which is excessive pressure in your eye, macular degeneration, a loss of vision in the center of your visual field, cytomegalovirus (CMV) retinitis, an infection of your retina, melanoma, a type of skin cancer that can spread to your eye, hypertension, which is also known as high blood pressure and diabetes.

Types of ophthalmoscopy

There are different types of ophthalmoscopy. They are:

Direct ophthalmoscopy: You will be seated in a darkened room. The health care provider performs this exam by shining a beam of light through the pupil using an instrument called an ophthalmoscope. An ophthalmoscope is about the size of a flashlight. It has a light and different tiny lens that allows the provider to view the back of the eyeball.

Indirect ophthalmoscopy: You will either lie or sit in a semi-reclined position. The provider holds your eye open while shining a very bright light into the eye using an instrument worn on the head. (The instrument looks like a miner's light.) The provider views the back of the eye through a lens held close to your eye. Some pressure may be applied to the eye using a small, blunt probe. You will be asked to look in various directions. This exam is usually used to look for detached retina.

Slit-lamp ophthalmoscopy: You will sit in a chair with the instrument placed in front of you. You will be asked to rest your chin and forehead on a support to keep your head steady. The provider will use the microscope part of the slit lamp and a tiny lens placed close to the front of the eye. The provider can see about the same with this technique as with indirect ophthalmoscopy, but with higher magnification.

Risks involved in ophthalmoscopy

An ophthalmoscopy is sometimes uncomfortable, but it shouldn’t be painful. You may see afterimages after the light has been turned off. Those afterimages should go away after you blink several times. In rare cases, you may react to the eye drops. This may cause: dry mouth, flushing, dizziness, nausea and vomiting and narrow-angle glaucoma.

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The Ophthalmologist: Clinical and Therapeutic Journal
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