![]() This should include identification of the red reflex, followed by evaluation of the arterioles and veins, characteristics of the retina, then identification of the optic disc. While a detailed explanation of fundoscopic examination is beyond the scope of this module, examiners should become familiar with a systematic approach to fundoscopic evaluation. You should screen patients without dilating their pupils, but for further evaluation of visual loss or to see peripheral structures, the pupils should be dilated unless contraindicated. However, with practice and determination, it becomes easier. –traditional-direct/35v_standard_ophthalmoscope.htmlĬopyright statement: Copyright Tania Padilla Conde, ©2018.Fundoscopic eye examination is difficult. “3.5V Standard Ophthalmoscope.” Accessed July 17, 2018.“Examination of the optic nerve at the slit-lamp biomicroscope with a handheld lens – EyeWiki.” Accessed July 17, 2018.Repeat the same technique on the other eye.Move out temporally to find the macula and fovea.Scan slightly up, down, right and left to look at the vessels.The nearsighted eye requires more minus/red number lenses.The farsighted eye requires more plus/green number lenses.Rotate the diopter lens until the optic nerve comes into focus.Move in closer, staying nasally until you see the optic nerve.Hold the ophthalmoscope about 6 inches from the eye and 15 degrees to the right of the patient.Place your left hand on the patient’s head and place your thumb on their eyebrow.To exam the patient’s RIGHT eye, hold the ophthalmoscope in your RIGHT hand and use your RIGHT eye to look through the instrument.Instruct the patient to focus on an object straight ahead on the wall.Turn on the ophthalmoscope and set the light to the correct aperture.Position the patient so that the ophthalmoscope is held directly at the level of the patient’s eye.Introduce yourself to the patient and explain what you are going to do.Used to approximate the relative distance between retinal lesions.Used to look at contour abnormalities of the cornea, lens or retina.Used to look for corneal abrasions or ulcers with fluorescein dye.Used to look closely at the vasculature.The small aperture is for a constricted pupil in a well-lit room.The medium aperture is the standard for a non-dilated pupil in a dark room.The Large aperture is used for a dilated pupil after administering mydriatic drops.This exam produces an upright image of approximately 15 times magnification. The direct ophthalmoscope allows you to look into the back of the eye to look at the health of the retina, optic nerve, vasculature and vitreous humor. Understand the utility of the direct ophthalmoscope Learn the exam technique of the direct ophthalmoscope.Learn the parts and settings of the direct ophthalmoscope.Identify key anatomical structures visible with the direct ophthalmoscope.Understand the utility of the direct ophthalmoscope.Introduction to the Eye Exam > Direct Ophthalmoscope > Using a Direct Ophthalmoscope – VIDEO LOCATION: Medical Student Education Outline > I. Title: How to Use the Direct OphthalmoscopeĪuthors: Tania Padilla Conde, 4 th Year Medical Student, University of South Dakota Sanford School of Medicine Christopher Bair, MD and Michele Burrow, MD Home / Basic Ophthalmology Review / Direct Ophthalmoscope
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