Fundus Examination
Warsaw · Krakow · Vienna · Zurich
Fundus examination, also known as ophthalmoscopy, funduscopy, or fundoscopy, is performed to diagnose various systemic disorders, such as diabetes, atherosclerosis, arterial and intracranial hypertension, autoimmune diseases like lupus or rheumatoid arthritis, and to identify abnormalities in the structure and function of the retina, choroid, and optic nerve.
Modern Methods of Fundus Diagnostics
The first ophthalmic speculum (ophthalmoscope) was invented in 1851 by Helmholtz. Contemporary ophthalmologists utilize various techniques for fundus examination. These include: direct and indirect ophthalmoscopy, fundus photography using a fundus camera, autofluorescence, fluorescein angiography, indocyanine green angiography, scanning confocal laser ophthalmoscopy (German: HRT, Heidelberg Retina Tomograph), optical coherence tomography (English: OCT, Optical Coherence Tomography), and ocular ultrasonography. Some of these techniques do not require pupil dilation (mydriasis).
Methods of Fundus Examination
The most commonly used examination methods include:
Direct ophthalmoscopy is performed using an ophthalmic speculum, or ophthalmoscope. The ophthalmoscope has built-in filters that reduce light intensity and colored filters: green – facilitating the observation of nerve fibers and small retinal vessels, cobalt blue – useful for examination with fluorescein. The resulting image of the fundus is upright and significantly magnified.
Indirect ophthalmoscopy is performed with a slit lamp (biomicroscope). The physician may also use a special focusing lens, which the physician holds in front of the patient’s eye (non-contact), or a special Goldmann three-mirror lens (a centrally placed focusing lens surrounded by three mirrors), which is placed on the eye after local anesthesia. This method allows for a stereoscopic view of the eye’s interior.
Fison Speculum Examination
The Fison speculum is a device in the form of special glasses with a light source, which the ophthalmologist attaches to a helmet worn on the head. Additionally, they use a focusing lens held in front of the patient’s eye being examined.
Fundus Camera in Fundus Diagnostics
The fundus camera, in turn, is a device that captures high-resolution color images of the eye. In this case, pupil dilation is unnecessary. Swiss Laser Clinic is equipped with the CLARUS 700 device from ZEISS. This is a versatile, ultra-widefield retinal camera for ophthalmology specialists, enabling the capture of ultra-wide-angle images (up to 210 degrees) of unparalleled quality and in color.
Indications for Fundus Examination
Indications for fundus examination include:
- the presence of diseases that cause changes in the fundus: (arterial hypertension, diabetes, blood disorders, collagenosis),
- central nervous system diseases with abnormal pupillary light reflex,
- the use of certain medications (e.g., in oncological diseases),
- head injuries,
- intracranial tumors,
- balance disorders,
- color vision disturbances, visual acuity disturbances, central or peripheral visual field defects,
- recurrent headaches,
- balance disorders,
- myopia above 3.5 Diopters.
Who Should Undergo a Fundus Examination?
It is important to remember that every premature baby should undergo a fundus examination. It is also advisable for individuals who have lost consciousness. Regular check-ups for all other at-risk individuals should take place at least once every 2-3 years,
NOTE: After a fundus examination that requires the administration of pupil-dilating drops, one should not drive motor vehicles, work on a computer, or operate machinery until normal vision returns (improvement usually occurs 4-6 hours after the application of the preparation).
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