Fundoscopy Flashcards
Positioning
Sitting in dark room
Tropicamide eye drops
R eye R hand R eye
Get patient to focus on object behind you
How to adjust the lens
Start on a low plus setting and turn ratchet anticlockwise until it is clear
Minus, anticlockwise, corrects for myopia (short sightedness)
What order do you examine in?
Red reflex, optic disc, macula, vessels, periphery
How do you check for red reflex?
From approximately 30cm at a 45º angle to the nose
No red reflex?
Cataracts, corneal opacities, tumours
How do you find the optic disc?
Find a large vessel and trace it towards the nose
What do you assess for the optic disk?
Colour (pale->atrophy)
Margin (blurred-> papilloedema)
Cup (increased cup:disc ratio-> glaucoma)
What do you look for at the macula?
Haemorrhages, exudates, pigmentation
What do you look for in the vessels?
4 main vessels
AV nipping at crossing points (hypertension)
Haemorrhages
Vessel tortuosity (diabetes/hypertension)
Microaneurysms (diabetes)
Silver wiring (hypertension)
Venous beading
Causes of gradual visual loss
Cataract, age related macular degeneration, optic neuropathy
Acute causes of visual loss
Uveitis, Keratitis (corneal ulcer) Optic neuritis Ischaemia optic neuropathy Retinal artery occlusion Retinal detachment Vitreous haemorrhage Stroke
What is involved in non-proliferative diabetic retinopathy?
Microaneurysms, dot and blot haemorrhages
Hard exudates
Cotton wool spots (local ischaemia)
Normal visual acuity
Severe non proliferative diabetic retinopathy involves?
Venous beading, dilation, tortuosity
Larger blot haemorrhages
Intraretinal microvascular abnormality
What is found in proliferative diabetic retinopathy
Neovascularisation
Vitreous haemorrhage
Tractional retinal detachment
Laser treatment scars are called:
Panretinal photocoagulation for proliferative diabetic retinopathy
