Ophthalmoscopy
Ophthalmoscopy
Definition
Purpose
Description
Preparation
Aftercare
Risks
Normal results
Abnormal results
Definition
Ophthalmoscopy involves the use of a lighted scope (ophthalmoscope) that has a very bright light and a number of magnifying lenses. The scope used may be a handheld scope that provides both light source and magnifying lenses (direct ophthalmoscope). Alternatively, the examiner may wear a binocular device and hold a lens to perform this examination (indirect ophthalmoscope). The ophthalmoscope is used to examine the back of the eye (called the fundus). The fundus is lined by the light-sensitive tissue of the retina, and also contains the optic disc, choroids, and blood vessels.
Purpose
Ophthalmoscopy is performed during the course of all routine physical examinations. Additionally, ophthalmoscopy can be performed when symptoms suggest the possible presence of a condition that could affect the eyes. For example, eye diseases such as macular degeneration, glaucoma, retinal detachment, or tumors on the optic nerve can be diagnosed or monitored through ophthalmoscopy. Opthalmoscopy may also be used to evaluate and monitor the deleterious effects of diseases of other body systems that may also affect the health of the eye, including such conditions as high blood pressure, atherosclerosis, vascular disease, diabetes, and brain tumors.
Description
Ophthalmosocopy is performed in a dark room. The bright light from the opthalmoscope will be shined into each of the patient’s eyes, and the examiner will change the internal lens of the scope to the power that provides the clearest image. The scope will be moved so that all quadrants of the eye can be examined. The individual undergoing the examination may be asked to move his or her eyes in various directions. An instrument to measure pressure in the eyeball may be briefly applied to each eyeball to test for glaucoma. The entire examination is usually completed in under five to ten minutes.
Preparation
There is no advance preparation required for opthalmoscopy. In some cases, such as indirect ophthalmoscopy, drops which can dilate the pupils may be put into the patient’s eyes several minutes prior to the examination. When the pupils are dilated, it can make the examination easier to perform, and the structures within the eye can be more clearly visualized by the examiner.
Aftercare
When patients have received dilating eyedrops prior to opthalmoscopy, they should wear sunglasses
KEY TERMS
Atherosclerosis— A disease in which plaques of material along the arterial walls cause the arteries to become abnormally hard and stiff. This disease puts people at higher risk for heart attack and stroke.
Choroid— Blood vessels which run between the white of the eye (sclera) and the retina, carrying nutrients and oxygen to the retina.
Glaucoma— A disease in which there is excessive fluid pressure within the eyeball.
Macular degeneration— A progressive disease in which the central portion of the retina (the macula) is gradually destroyed.
Optic disc— A visually inactive portion of the retina from which the optic nerve and blood vessels emerge.
Retina— The light-sensing tissue within the eye that sends signals to the brain in order to generate a visual image.
while outside for the next several hours to protect their eyes from sunlight. Some people find that their vision is affected by the dilatation of their pupils. In this case, they should be advised not to drive until they feel that their vision has returned to normal. Other than these precautions, there is no aftercare necessary following ophthalmoscopy. The patient can immediately return to a normal diet and normal activities.
Risks
Ophthalmoscopy poses no risk to the patient. Under rare circumstances, patients may have a reaction to the dilating eyedrops, such as nausea, vomiting, dry mouth, flushing, dizziness, or a glaucoma episode.
Normal results
Normal results of ophthalmoscope reveal normal anatomy of the back of the eye.
Abnormal results
Abnormalities in the opthalmoscopic examination may indicate a variety of eye disease, trauma to the eye, or other systemic diseases that have effects on the structure or functioning of structures within the eye.
Resources
BOOKS
Yanoff, M., et al. Ophthalmology. 2nd ed. St. Louis: Mosby, 2004.
Rosalyn Carson-DeWitt, MD
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Optional surgery seeElective surgery