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Direct ophthalmoscopy

practical approach to direct ophthalmoscopy for GPs
by

Mathys Labuschagne

on 1 March 2014

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Transcript of Direct ophthalmoscopy

Direct ophthalmoscopy
ophthalmoscope
examiner side of instrument
How to perform ophthalmoscopy
Patient side of ophthalmoscope
Questions?
Dr Mathys Labuschagne
Ophthalmologist
Clinical Simulation Unit,
School of Medicine, UFS
Viewing aperture
Filter settings
Horizontal dial for light settings
Filter settings
Open filter
Polarising filter
Red-free filter
small spot
full spot
Cobalt blue filter
Slit
Fixation target
patient fixate at a distance
right eye examine right and left examine left
red reflex first
move closer,
hand on head, lifting upper eye lid,
hand of examiner touch the cheek of the patient
Fundus examination
magnification 15x
look for bifurcation
in blood vessels
Optic disc
Margins
Colour
Blood vessels
Cup/Disc ratio
Features of glaucomatous disc
Bayonetting of blood vessels
Cup to disc ratio of more than 0,4
Pale disc with nasally displaced blood vessels
Thin rim that does not comply with the ISNT rule
Peripapillary choroidal atrophy
Slit:
To determine if a lesion is elevated or excavated.
Direct ophthalmoscope
Funduscopy
What is the cup/disc ratio?
Brow rest or pad
Viewing aperture
Focussing dial for Rekoss disk
Window indicator of lens power
Retinal vascular changes associated with systemic arterial hypertension. Hypertensive chorioretinopathy may also accompany the acute phases of hypertensive retinopathy.
Hypertensive Retinopathy (HR)
Pathophysiology of HR
2
1
Red Reflex
Ophthalmoscope on +10.
Opacities in lens seen as dark areas in the pupil red reflex.
Bio-microscope gives precise anatomical position.
Diagnosis of cataract
Full transcript