Fundoscopy

Question 1

What are steps of fundoscopy?

Answer 1

1. Introduction and prep
   
   1. Dark room
2. Red reflex
   
   1. Set to 0
   2. From 30cm
3. Fundoscopy
   
   1. 15 degrees from midline
   2. 0 on dial, adjust to make not fuzzy as required
4. Fundus
   
   1. 2-4cm

Question 2

What do you comment on for fundus?

Answer 2

• Optic disk
  
  • Shape, definition of edges, colour, appearance of vessels
• Vessels
  
  • Normal, tortuous, congested
• Retina
  
  • Colour, haemorrhages, exudates, detachments, tears
• Macula
  
  • Ask to look directly at beam of light

Question 3

What does absence of red reflex indicate?

Answer 3

Obstruction of light pathway such as in cataracts

Question 4

What are you checking for in anterior section of eye?

Answer 4

• White opacities (corneal ulcer)
• Abrasions (use fluorescein dye as eye drop then under blue light will appear yellow)

Question 5

For optic disc what is normal:

• colour
• contour
• cup

Answer 5

• Colour
  
  • Orange-pink doughnut with pale centre
• Contour
  
  • Well defined borders, if swollen indicates papilloedema (disc swelling)
• Cup
  
  • Is the pale centre of orange-pink doughnut, cup to disc ratio should be about 0.3
  • Increased in cup to disc ratio indicates glaucoma

Question 6

What are 4 quadrants of retina called?

Answer 6

• Superior temporal
• Superior nasal
• Inferior temporal
• Inferior nasal

Question 7

What are some macula pathologies?

Answer 7

• Hard exudates
  
  • Waxy yellow lesions, associated with diabetic retinopathy
• Drusen
  
  • Yellow-white flecks scattered around macular region, caused by age related macular degeneration
• Cherry-red spot
  
  • Central retinal artery occlusion

Question 8

What signs are seen in diabetic retinopathy?

Answer 8

• Microaneurysms
• Dot and blot haemorrhages
• Cotton wool spots

Question 9

What are signs of proliferative diabetic reintopathy?

Answer 9

New vessels at disc and elsewhere

Question 10

What are signs of hypertensive retinopathy?

Answer 10

• Narrowing of arteries in eyes (AV nipping)
• Features of diabetic eye disease later
• Optic disc swelling even later

Question 11

What are signs of glaucoma?

Answer 11

Increased cup-disc ratio

Question 12

What are signs of papilloedema?

Answer 12

Optic disc swelling

Question 13

What are signs of central retinal artery occlusion?

Answer 13

• Cherry red spot
• Pale retina

Question 14

What are signs of central retinal vein occlusion?

Answer 14

• Disc swelling
• Haemorrhages
• Cotton wool spot
• Tortous vein

Question 15

What are signs of age related macular degeneration?

Answer 15

Drusen