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The first ophthalmic speculum (ophthalmoscope) was invented in 1851 by Helmholz. Modern ophthalmologists use a variety of techniques to examine the fundus. These include direct and indirect ophthalmoscopy, fundus photography, autofluorescence, fluorescein angiography, indocyanine angiography, confocal laser scanning ophthalmoscopy (German: HRT, Heidelberg Retina Tomograph), optical coherence tomography (OCT, Optical Coherence Tomography), and ultrasonography of the eye. Some of these techniques do not require pupil dilation (mydriasis).

Methods of examining the fundus of the eye

The most commonly used testing methods include:

  • Direct ophthalmoscopy is performed using an ophthalmic speculum, or ophthalmoscope. The ophthalmoscope has built-in filters to reduce light intensity, as well as color filters: green – to facilitate observation of nerve fibers and small retinal vessels, and cobalt blue – to help with fluorescein examination. The resulting image of the fundus is simple and greatly magnified.
  • Indirect ophthalmoscopyis performed in a slit lamp (biomicroscope). The doctor can also use a special focusing lens, which the doctor holds in front of the patient’s eye under examination (non-contact) or with a special Goldmann triple mirror (a centrally placed focusing lens, surrounded by three mirrors), which is placed on the eye after a prior local anesthesia. This method allows a spatial (streoscopic) view of the inside of the eye.
  • Direct ophthalmoscopy is performed using an ophthalmic speculum, or ophthalmoscope. The ophthalmoscope has built-in filters to reduce light intensity, as well as color filters: green – to facilitate observation of nerve fibers and small retinal vessels, and cobalt blue – to help with fluorescein examination. The resulting image of the fundus is simple and greatly magnified.
  • Indirect ophthalmoscopyis performed in a slit lamp (biomicroscope). The doctor can also use a special focusing lens, which the doctor holds in front of the patient’s eye under examination (non-contact) or with a special Goldmann triple mirror (a centrally placed focusing lens, surrounded by three mirrors), which is placed on the eye after a prior local anesthesia. This method allows a spatial (streoscopic) view of the inside of the eye.

The Fison speculum is a device in the form of special glasses with a light source, which the ophthalmologist has attached to a helmet placed on the head. In addition, it uses a focusing lens held in front of the patient’s examining eye.

A funduscamera, on the other hand, is a device that takes a high-resolution color photograph of the eye. In this case, pupil dilation is unnecessary. Swiss Laser Clinic has a CLARUS 700 device from ZEISS. This is a versatile ultra-wide-field retinal camera for ophthalmic specialists to capture ultra-wide-field images (up to 210 degrees) of unparalleled quality and in addition in color.

Indications for fundus examination

Among the indications for fundus examination are:

  • The presence of diseases in the course of which changes occur on the ocular fundus: (hypertension, diabetes, blood diseases, collagenosis),
  • diseases of the central nervous system, with abnormal pupillary response to light,
  • Use of certain drugs (e.g., in cancer),
  • head injuries,
  • intracranial tumors,
  • imbalances,
  • Color vision disorders, visual acuity disorders, central or peripheral visual field defects,
  • recurrent headaches,
  • imbalances,
  • Myopia of more than 3.5 Diopters.
  • The presence of diseases in the course of which changes occur on the ocular fundus: (hypertension, diabetes, blood diseases, collagenosis),
  • diseases of the central nervous system, with abnormal pupillary response to light,
  • Use of certain drugs (e.g., in cancer),
  • head injuries,
  • intracranial tumors,
  • imbalances,
  • Color vision disorders, visual acuity disorders, central or peripheral visual field defects,
  • recurrent headaches,
  • imbalances,
  • Myopia of more than 3.5 Diopters.

It is worth remembering that every baby born prematurely, that is, every premature baby, should have a fundus examination. It is also good to conduct them in a person after a loss of consciousness. Regular checkups for all other at-risk individuals should take place at least once every 2-3 years,

CAUTION: after a fundus examination that requires the administration of pupil-dilating drops, do not drive, work at a computer or operate machinery until normal vision returns (usually improvement occurs 4 – 6 hours after application).

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