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Test Description
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Ophthalmoscopy

Ophthalmoscopy is a test that allows a doctor to see the back of the eye (the fundus) and other structures using a handheld, lighted magnifying instrument (ophthalmoscope).

The fundus contains a lining of nerve cells (the retina) that can detect /images of what a person is looking at. The back of the eye also contains blood vessels that supply blood to the eye and the optic nerve.

Looking at the fundus can help determine the health of the eye. It can also provide clues about the health of other parts of the body, because some diseases (such as high blood pressure or diabetes) can cause damage to the eye in a certain way.

There are two types of ophthalmoscopy.

  • Direct ophthalmoscopy. Direct ophthalmoscopy uses an instrument about the size of a small flashlight with several lenses that can magnify up to 15 times. Direct ophthalmoscopy allows the doctor to see a limited area of the retina. This is the most common type of ophthalmoscopy done by doctors during a physical exam.
  • Indirect ophthalmoscopy. Indirect ophthalmoscopy is better than direct ophthalmoscopy for seeing structures at the back of the eye. Indirect ophthalmoscopy uses an instrument the doctor wears like a miner's light; it has a headlamp and a small handheld lens that can magnify up to 4 times. Unlike direct ophthalmoscopy, indirect ophthalmoscopy provides a wider view of the inside of the eye. It may also allow a doctor to view the fundus even if the lens is clouded by cataracts. Indirect ophthalmoscopy requires greater skill than direct ophthalmoscopy and is generally done only by ophthalmologists.

The structures at the front of the eye can also be examined with an instrument called a slit lamp. A slit lamp is an examining device that contains a binocular microscope and a light source. It is placed in front of your eyes in line with the doctor's eyes. A narrow beam of bright light is directed into your eye from the slit lamp while the doctor looks through the microscope. The slit lamp allows the doctor to examine the transparent covering of the eye (cornea), the colored part of the eye (iris), the lens of the eye, the white part of the eye (sclera), the membranes that line your eyelids (conjunctiva), and the eyelids. The slit lamp can also be used with a special lens to magnify structures at the back of the eye (such as the retina and optic nerve).

Ophthalmoscopy
Results

Ophthalmoscopy

Normal:

All of the structures inside the eye appear normal.

Abnormal:

The most common abnormal findings include cataracts, changes in the cornea (such as a corneal abrasion), changes in the space between the cornea (the anterior chamber) and the lens, a detached retina, swelling of the optic nerve (papilledema), optic nerve damage caused by glaucoma, or changes in the retina that may indicate macular degeneration (such as hard, white deposits beneath the retina called drusen or broken blood vessels called hemorrhages).

High blood pressure, diabetes, and other conditions can cause characteristic changes in the back of the eye, including damaged blood vessels or bleeding.

 
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