Opthalmoscopy Flashcards
What is a technique using a handheld instrument to look inside the eye?
Opthalmoscopy
How does Direct and indirect ophthalmoscopy differ?
Direct is using magnified monocular view inside the eye, limited field of view
Indirect can be monocular (MIO) or binocular (BIO) very wide field of view
What technique uses the slit lamp to view the fundus.
Fundus Biomicroscopy
What is the back part of your eye called?
Fundus
What are 3 different lenses used with fundus biomicroscopy?
Hruby lens
fundus contact lenses
non-contact condensing lenses
What is something that helps us see better in the eye?
Dilation
What is a pharmacological enlargement of pupil via eye drops? what does it allow?
Dilation
Allows much better view of the eye
What is an integral part of truly “comprehensive” eye care?
Dilation
What are some perceived disadvantages?
blurred vision (not usually true) light sensitivity (uncomfortable) long-duration
Is VA affected by dilation?
Generally doesn’t affect VA… Really??? (I think my eyes were blurry when I was dilated?)
What are the advantages of direct ophthalmoscopy?
Easier than indirect
Provides good magnification
Ability to adjust focus (cornea to retina)
What are the disadvantages of direct ophthalmoscopy?
Limited field of view
No stereoscopic view (no depth perception)
Dimmer image which limits resolution
True/False: Direct Ophthalmoscopy is done in well lit room.
False, lights are dimmed
What are the CLED’s of Ophthalmoscopy?
Correction: no, (unless highly myopic)
Lighting: dimmed
Eyes: monocularly
Distance: start at 40 cm and move in
What are you looking for with direct ophthalmoscopy?
Observe the retinal reflex and fundus looking for media opacities
How big is the optic nerve?
Optic nerve is about 1.5 mm.
How limited is the direct ophthalmoscope?
What is the magnification of it?
Only about 10% of field of view.
15x magnification
What do you do with ophthalmoscopy?
locate optic nerve head
check CUP, COLOR, CONTOUR
examine disc noting appearance
examine area adjacent to disc
examine area further out into quadrants checking blood vessels
lastly, move into line of sight to examine macula
switch hands and pt eye and repeat
Why do you check macula last?
because it is bright for the patient
What do you record?
Optic nerve: -cup to disc ratio (C/D) -color of rim -contour and margins -spontaneous venous pulsation (SVP) Blood Vessels: -arteriovenous (AV) ratio and any AV crossing changes Macula: -homognous color? -foveal reflex? Really anything that is ABNORMAL!!
What do you do if you find something abnormal?
identify
record
do something
Where is the cup in relation to the disc?
in the center of the disc
True/False: cups can be oval, or oblong, so you record the horizontal and vertical portions of the ratio.
True, C/D ratio: 0.3/0.2 (H/V)
A little longer horizontally…
True/False: In glaucoma if you lose ganglion cells you lose them at the cup first… so cup is larger.. (not important to remember right now)
True
What is the optic nerve margins?
the outside of the optic nerve, nice distinct margins. where end of nerve ends and where retina begins.
What is the name of the heart beat you can see by the optic nerve?
Spontaneous venous pulsation (SVP)
With blood vessels how can you tell the difference between arteries and veins?
Veins are darker, and generally arteries go over top off veins.
