CLINICAL SKILLS - FUNDOSCOPY

Question 1

Introduction

Answer 1

Hello my name is Anjali Singh and I am a third year medical student - please can I confirm your name, age and DOB?

Nice to meet you. Today I have been asked to examine the back of your eye. In order to do this it will require me to shine a bright light into your eye and I will have to come quite close to your face in order to do this. Would that be ok?

remove glasses please.

Question 2

equipment

Answer 2

opthalmascope

Question 3

procedure (12)

Answer 3

1. please can you focus on a point behind my head for me
2. i am just going to check for red reflex
3. i am going to place my head on your forehead
4. look for disc
5. check the quadrants of the eye
6. look at the vessels
7. observe the spaces
8. look at the funds background
9. observe macula
10. do on other eye
11. explain findings
12. document

Question 4

What do you look for when you are looking at the optic disc?

Answer 4

1. contour - margin and shape
2. colour
3. cup (cup to disc ratio)

Question 5

How do you facilitate looking at the different quadrants of the eye?

Answer 5

ask the patient to look up, down and to the side

Question 6

What do you look for when you are looking at the vessels? (8)

Answer 6

1. how many - arteries and veins
2. any AV crossings or indentations
3. arterial light reflex
4. straight or tortuous
5. normal calibre
6. crossings
7. ratio between arteries and veins
8. copper or silver wiring

Question 7

What do you look for in the spaces? (4)

Answer 7

1. micro-aneurysms
2. dot, blot or flame haemorrhages
3. cotton wool spots
4. hard exudates

Question 8

What is the fundus background like? (3)

Answer 8

1. exudates
2. haemorrhages
3. colour