basic fundoscopy
TRANSCRIPT
BASIC FUNDOSCOPY
DR. WILLARD BWALYA MUMBI (BSC.HB, MBCHB, PG. DIP. BA, MMED, FCO-ECSA)
CONSULTANT OPHTHALMOLOGISTKABWE GENERAL HOSPITAL EYE DEPARTMENTZAMBIA
26TH OCTOBER, 2016
NOTHING COMES EASILY, BUT WHEN IT ARRIVES IT STAYS WITH YOU. THEREFORE, THE IDEA OF PRACTICE DURING YOUR FREE
TIME MAY NOT BE OVER EMPHASISED.
DISCLOSURES:
No financial disclosures Sources of pictures:
American Academy series Kabwe General Hospital, Eye Department Eye rounds.ORG
WHAT TYPES DIESEASES REQUIRE FUNDOSCOPY
GENERAL INDICATIONS Diabetes LUMBER PUNCTURE Hypertension CVA RVD ( CD4 < 200) Kidney disease Cardiac disease ETC
EYE DISEASES All patients visiting the eye clinic Diabetic eye disease Glaucoma Age related macular degeneration Squint
FUNDUS
RETINAL VESSELS OPTIC DISC MACULAR
INSTRUMENTS USED IN FUNDOSCOPY
DIRECT OPHTHALMOSCOPE INDIRECT OPHTHALMOSCOPE SLIT LAMP WITH 90 D OR 78 D FUNDUS CAMERA
DIRECT OPHTHALMOSCOPE
PROCEEDURE
EXPLAIN WHAT YOU ARE ABOUT TO DO TO THE PATIENT DIM LIGHT ROOM CHECK FOR RED REFLEX: STAND 1 METER AWAY AND COMPARE
BOTH EYES THEN EXAMINE 1 EYE AT A TIME. YOUR RIGHT EYE TO EXAMINE THE RIGHT EYE OF THE PATIENT GET AS CLOSE TO THE PATIENT AS POSSIBLE
CONT’D EXAMINE FUNDUS IN ANY ORDER SUITABLE, BUT ALWAYS END
WITH MACULA
RETINA: DIVIDE IT IN 4 QUADRANTS AND THEN EXAMINE EACH QUADRANT AT A TIME
TO EXAMINE THE MACULA, ASK SUBJECT TO LOOK AT THE LIGHT
TO EXAMINE THE DISC, ASK PATIENT TO SLIGHTLY LOOK NASALLY. ANOTHER TRICK IS TO FIRST LOCATE THE VESSELS AND THEN FOLLOW THEM TO THEIR ORIGIN
RETINAL
COLOUR: RED/ORANGE
VESSELS
o A/V ratio 2 : 3
o Arteries are brighter red
o Veins are slightly purplish colour
OPTIC DISC
Colour; rich yellow different from rest of retina
Clarity of the Edges/margins
Depression in the middle: optic cup
Elevation
Shape: oval/round
MACULA
o Located temporal inferiorly
o Fovea reflex
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