and a burn on the sclera results. If the retina was not too highly detached, a retinal burn will also result, corresponding exactly to the scleral burn.

SUMMARY

Indirect viewing systems present an inverted image but enable high-resolution, wide-field binocular imaging extending into the far periphery of the retina. With appropriate techniques and equipment, excellent visualization may be possible, even with poor pupillary dilation or media opacities.

Mastery of the skill of binocular indirect ophthalmoscopy with scleral depression is essential for examining the peripheral retina, and diagnosing and treating retinal detachment. The dynamic technique of scleral depression, how to examine through a small pupil, and ways to ensure patient comfort and cooperation are presented.

SELECTED REFERENCES

Rosenthal ML, Fradin S: The technique of binocular indirect ophthalmoscopy. Highlights Ophthalmol 1966;9:179–257.

Rubin ML: The optics of indirect ophthalmoscopy. Surv Ophthalmol 1964;9:449–464. Schepens CL, Hartnett ME, Hirose T: Schepens’ Retinal Detachment and Allied Diseases,

Second Edition. Boston:Butterworth-Heinemann; 2000; pp. 99–102.

Wilkinson CP, Rice TA: Michels Retinal Detachment. St Louis: CV Mosby Co; 1997; pp. 335–374.

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