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clinical skills > Normal Fundus > Flashcards

Normal Fundus Flashcards

1
Q

What is the definition of the fundus?

A

The interior of the globe as sen with the ophthalmoscope

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2
Q

Where does the fundus extend?

A

All the way out to the ora serrata

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3
Q

What is the ora serrata?

A

Where the retina joins the ciliary body to the equator of the eye

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4
Q

With which technique can you see the ora serrata?

A

Direct ophthalmoscope

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5
Q

How does the fundus background appear?

A

Orange/red background

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6
Q

Why does the fundus look orange/ red?

A

Light directly reflected from choroidal blood vessels

light reflected from sclera and transmitted through choroidal blood vessels

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7
Q

What layers does the light pass through in the retina?

A

RPE/Bruchs membrane/Bruchs membrane then back from sclera to choroid 2nd time

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8
Q

What depends on amount of light directly reflecting from choroidal blood vessels and transmitting through choroidal blood vessels?

A

Degree of pigmentation on retina

Degree of pigmentation of choroid

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9
Q

What layers contribute to Fundus appearance ?

A

All retina layers?

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10
Q

What are the full retina appearances?

A

RPE/Photoreceptors/ External limiting membrane/ONL/OPL/INL/IPL/Ganglion cells/nerve fibre layer/internal limiting membrane

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11
Q

What types of fundus do you get ?

A

Uniform stippled

Tesselated (Tigroid)

Albinotic

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12
Q

What appearances do you get with uniform stippled fundus?

A
  • Stipple= paint with individual dots
  • Dark or negroid
  • Medium or caucasian
  • light or blond
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13
Q

What are dark negroid fundus?

A

Heavily pigmented RPE

heavily pigmented Choroid

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14
Q

What are light or blond fundus?

A

Lightly pigmented RPE

Lightly pigmented choroid

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15
Q

What is a tigroid fundus?

A

Lightly pigmented RPE and normal to heavy pigmented choroid

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16
Q

What is an Albinotic fundus?

A

Virtually no pigment in RPE or choroid

17
Q

Why are some fundi more pigmented than others?

A

Depends on :

  • Age
  • Race
  • Hereditary
  • Metabolic
18
Q

Do the retina and choroid pigmentation always run parallel?

A

No

19
Q

Define the OPTIC DISC?

A

The ophthalmoscopic view of the optic nerve head

20
Q

What are the features of OPtic disc?

A 
Size 
Shape
Colour
margins
level
vessels
surroundings
21
Q

What does the colour of optic disc depend on?

A

The white lamina cribrosa and myelinated nerve fibre behind the lamina
The red blood in capillaries supplying the disc

22
Q

What are the margins in optic disc?

A
  • -Sharp clear image of margins, especially on nasal side which can indicate optic atrophy
  • –Very blurred margins on temporal side can indicate oedema
  • –Distributions of nerve fible layer on healthy disc leads to relative blurring of margins on nasal 2/3rds of disc
23
Q

What does blurring of nasal side of optic disc indicate?

A

Optic atrophy

24
Q

What does blurring of temporal side of optic disc show?

A

Oedema of disc

25
Q

What levels of optic disc do you get?

A

Cupping and cup depth

26
Q

What is cupping in optic disc normal?

A

15% cant detect cup

  • Can be measured using Vertical CD ratio
  • > 0.6 suspicious to glaucoma
  • > 0.1 difference between eyes suspicious
27
Q

?What size of cup suggests glaucoma ?

A

> 0.6

28
Q

What is parallax?

A

When moving ophthalmoscope beam, areas at different levels move at different speeds

29
Q

What vessels are there in optic disc?

A

CRA- coronary retinal artery
CRA- coronary retinal vein
Cilio retinal arteries

30
Q

What is features of CRA?

A

Has all the characteristics of a true artery but after branching soon becomes a arteriole

31
Q

What is features of CRV?

A

Has all the characteristics of true vein but after branching soon becomes a venule

32
Q

What is the pressure of CRV?

A

Constant about 2mmHg than mean IOP

33
Q

What happens when IOP greater than CRV pressure?

A

Partial collapse of the vein, not recover until IOP falls back below of that of CRV

34
Q

What is the features of Cilio retina arteries?

A

Not branches of CRA but derived from blood vessels supplying the choroid

35
Q

What are the surroundings of optic disc?

A

Some layers stop short of the disc and cause

  • Scleral ring where RPE and choroid stop short of disc
  • Choroidal crescent where RPE stops short of disc
  • Pigment stops- build up of lot of pigment at edge of disc

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