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Ophthalmoscopy, also called fundoscopy, is a test that allows a healthcare professional to see the inside of the fundus and other structures using an ophthalmoscope (or fundoscope). This is done as part of an eye exam or as part of a routine physical examination. The procedure is important for determining the health of the retina, optic disc, and vitreous. The ophthalmoscope can reveal some eye conditions that cannot be identified with a normal examination.
What is an ophthalmoscope?
As already mentioned, ophthalmoscopy is a very important and complex test that allows the ophthalmologist or eye doctor to look at the back of the eye. Perhaps this is only with the help of a special device – an ophthalmoscope.
There is a special hole through which the eye will be viewed.
Opening the pupil wider (widens it) is a simple and effective way to better see the structure of the eye. Therefore, dilatation of the pupil is often achieved with medicated eye drops before the procedure.
However, while extended examination with an ophthalmoscope is ideal, further examination is more convenient and also useful (though not as comprehensive) – this is the most common type of primary health care.
An alternative or addition to ophthalmoscopy is to photograph the bottom of the eye for consultation with another doctor.
The ophthalmoscope helps to examine the part of the eye that is not accessible with the usual standard vision test, namely: the retina, optic disc, blood vessel.
This test is often included in a routine eye exam. Your optometrist may also refer you for this test if you have a condition that affects your blood vessels, such as high blood pressure or diabetes.
Often, the following procedures can be seen in the bypass sheet, namely: fluoroscopy or retinal examination (performed on the principle of ophthalmoscopy, which involves examining the eye).
When is an ophthalmoscope used?
Your eye doctor may use ophthalmoscopy to screen for eye diseases and conditions that can affect blood vessels. These conditions include:
- damage to the optic nerve;
- retinal detachment, vision loss (partial);
- glaucoma, which is excessive pressure in the eye
- macular degeneration;
- retinal infection;
- a type of skin cancer that can spread to the eye
- hypertension.
Types of ophthalmoscopy
The device has two main types. The first is direct ophthalmoscopy, which produces a vertical or unclaimed image at approximately 15x magnification.
Indirect ophthalmoscopy, which produces an inverted or reverse direct image that magnifies 2-5 times. Each type of ophthalmoscopy has a special kind of ophthalmoscope. A straight ophthalmoscope is an instrument the size of a small flashlight (torch) with multiple lenses that can expand up to about 15 times. This type of ophthalmoscope is more commonly used during a routine physical examination.
As for the indirect ophthalmoscope, it is a flashlight attached to the headband, in addition to a small portable lens. This creates a wider view of the inside of the eye. It also allows you to take a closer look at the eye, even if the lens is clouded by cataracts. An indirect ophthalmoscope can be monocular or binocular. It is used for peripheral viewing of the retina.
An ophthalmoscopy is done as part of a routine physical or complete eye examination. It is used to detect and evaluate the symptoms of various vascular and eye diseases such as glaucoma.
In patients with headaches, the detection of swollen optic discs on ophthalmoscopy is a key finding, as it indicates increased intracranial pressure, which may be associated with hydrocephalus, benign intracranial hypertension (otherwise called cerebral meninges), or a brain tumor, among other conditions. Cupped optic discs are seen in glaucoma.
In diabetic patients, regular ophthalmoscopic eye examinations (once every 6 months) are important for screening for diabetic retinopathy because vision loss due to diabetes can be prevented by retinal laser treatment if retinopathy is detected early.
In hypertension, retinal changes closely mimic those in the brain and may predict cerebrovascular accidents (strokes).
In order to provide better control through a pupil that is constricted by light from an ophthalmoscope, it is often desirable to dilute it by the use of a mydriatic agent such as tropicamide. First of all, it is considered an ophthalmic medicine.
Recent discoveries such as laser ophthalmoscopy scanning can produce good quality images. The procedure involves dilating the pupils up to 2 millimeters, so pupil dilatation drugs are no longer needed with these devices.
Efficacy and risks of ophthalmoscopy
The effectiveness of this device has been proven for a long time and according to the observations of many patients. However, there are some possible side effects of the procedure (which may not occur in all patients). What are the risks? Ophthalmoscopy is sometimes uncomfortable, but it should not be painful. At the end of the manipulation, you can see flashing spots, but after you blink a few times, they should disappear. In rare cases, the body reacts negatively to eye drops. This may lead to:
- dry mouth;
- tearing;
- dizziness;
- nausea and vomiting;
- glaucoma
Both the retinoscope and the ophthalmoscope allow you to observe the fundus and the red reflex. However, retinoscopy requires an efficient light source that can be quickly moved off the visual axis. An ophthalmoscope cannot provide this type of illumination. On the other hand, the retinoscope does not provide sufficient illumination of the retina. The red reflex seen with a retinoscope or ophthalmoscope may be clear or blurry. A clear reflex is more useful for ophthalmoscopy, while a blurry reflex is mainly used for retinoscopy.
An ophthalmoscope allows a doctor to look inside the eye to look for abnormalities or signs of disease in the retina and lens of the eye.
It does this by shining a tiny beam of light through the pupil. The modern ophthalmoscope is a hand tool. It contains a small lamp that directs a beam of light through a mirrored prism. The observer looks through a tiny hole in the prism. The tool magnifies the image and can focus on a range of rotating lenses. The lens needed to focus the image gives the clinician an approximate prescription for the lenses needed to correct the patient’s vision.
A new type of ophthalmoscope that can project a laser beam is being used in eye surgery to correct detached retinas. Another variety, called a binocular ophthalmoscope, is used in clinical research and provides an image of the eye that is magnified fifteen times. Timely application of this method will help to avoid serious diseases in the future.
The ophthalmoscope can detect an abnormality that is treatable at an early stage. Modern technologies make the procedure for checking the inside of the eye completely painless and safe. In addition, the patient does not need to undergo it twice when observed by different specialists. The new ophthalmoscopes are equipped with a photo function, which allows you to capture the inside of the eye and identify problems from the photo. This is quite comfortable if you need to seek treatment from several specialists.