Fundus evaluation

BY
Renu Thakur

Direct ophthalmoscope
Indirect ophthalmoscope
Hruby lens
+60 Dsph lens
Fundus camera

Direct ophthalmoscope
To evaluate fundus
The main two parts are illumination
( tungsten lamp)& viewing system
Observing system :- sight hole ,
prism,focusing lens,filters.

Focusing lens
filters
Sight hole is having 3mm aperture
Magnification:-15X to 19X

Parameter affects reflex

The angle between illumination &
viewing axis
The distance between patient &
observer
Size of aperture & illumination

Clinical procedure
Instruction to patient(focusing)
Accommodation should be relaxed
Right eye(observer) with right eye
(patient)
Left eye (observer) with left eye
(patient)

Indirect ophthalmoscope
Monocular indirect
ophthalmoscope.
Binocular indirect ophthalmoscope.

Monocular indirect ophthalmoscope.

Hand held instrument
Light + patients pupil=image formed
by patient retina (illumination is
controlled by the iris diaphragm )
Condensing lens (plus aspheric lens)

Magnification:Total power of eye/condensing lens

power
Ex:- 60/20 = 3x (magnification)
Field of view
Procedure & indication &
contraindication

Indirect ophthalmoscope
1940 schepens

Head mounted binocular

Condensing lens(magnification
decreases with incensing power in
condensing lens)
Stereoscopic view & all quadrant of
the retina is visible

Light reflected patient eye =

image is formed at focal length of
condensing lens = image between
the condensing lens and eyepiece

Procedure
Patient instruction
Dilatation of pupil
IPD adjustment of binoculars
Position of condensing lens
Scleral indentator

Indication & contra indication

Advantage and disadvantage

Hruby lens
Colenbrander 1967
-60Dsph lens mounted on slit lamp
Distance between lens & patient eye is
less
-60.00 negate the human eye power

Magnification of
slit lamp is 16x or
more than that
It give binocular
view
Stereoscopic view

Procedure.
Advantage .
Disadvantage .

View through Hruby lens

+60 & +90 Dsph lens

EI Bayadi in 1953
Binocular view
Bispheric lens
Required long working distance

Procedure
Advantages & disadvantages

Undilated Pupil

Dilated Pupil

Interpretation
Aerial image is formed

Fundus camera

Stand mounted indirect

ophthalmoscope
Two light source are present
tungsten for retinal images & flash
light source for photograph
two light source combined by semi
reflecting surface

Light
F.M
,ophthalmoscope lens
At plane
patients pupil

Fundus image
between F.M
,ophthalmoscope lens

diaphragm

Illuminated patch on
patient retina

View
Compound
microscope

Film =
Flip mirror

G.G.S

Procedure.
Interpretation.