Fundoscopy Made Easy

WONG YEE MING

Medical Student, 4th Year, 2009/2010

National University of Malaysia.

© 2009 by medicalpblukm.blogspot.com

1st edition, June 2009

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the author at kong1ming2@gmail.com. Credits should be given to medicalpblukm.blogspot.com.

This is a compilation effort from various sources, thus any contributions or comments are welcomed in the effort to improve this book. Therefore, feel free to e mail me at kong1ming2@gmail.com.

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Preface

This book is intended for medical students who are beginners in the use of direct ophthalmoscope. Over the years, basics in fundoscopy has form an essential part in the medical field, but little has been written to teach the younger generation of the fundoscopy techniques required to appreciate the findings where it is the only place where the blood vessels can be seen directly in our body without the need for any invasive procedure. Being one of those struggling medical students from such experience, this book is written to aid medical students in mastering the fundamentals before proceeding to appreciate the labnormalities and pathology in the eys which would never fail to mesmerize those who could see it. We are incredibly grateful to everyone who made this book a reality.

Wong Yee Ming

Kuala Lumpur, 2009

The Tool – Direct Ophthalmoscope

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Apertures and Filters

There are various apertures and filters in the indirect ophthalmoscope, but beginners may require only a certain few. However, here is a general breakdown of the use of each aperture and filter:

Small Aperture: For easy view of fundus through the undilated pupil. Always start with this while looking at the fundus.

Large Aperture: Standard aperture for dilated pupil and general examination of the eye, particularly the red reflex.

Sm Micro Spot Aperture: Allows easy entry into very small, undilated pupils.

Slit Aperture: Helpful in determining various elevations of lesions, particularly tumors and edematous discs.

Fixation Aperture: The pattern of an open center and thin lines permits easy observation of eccentric fixation without masking the macula.

Note from the Author

Before you conduct a direct fundoscopy, be realistic in your aims and know that practice makes perfect. Nothing beats experience in fundoscopy, even if you are a genius. But of course, do know your fundoscopy steps before you attempt to blind your volunteering patient with your initially wobbly techniques!

Now, I’m sure most of you medical students would have been too enthuasistic on looking at the fundus, having seen many pictures in the books. Do note that fundoscopy pictures in the books are taken with indirect ophthalmoscope which have a wider view. Therefore, tracing is required in direct fundoscopy before you get a full picture of the fundus.

A view of direct fundoscopy

A view of indirect fundoscopy of a normal fundus with the focus area of direct fundoscopy highlighted.

With this in mind, do not panic if you do not find the optic disc on your first try. All you need is a clear mind, and this book is here to guide you for an enjoyable experience in your use of fundoscopy.

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