Fundoscopie

Fundoscopie, also known as ophthalmoscopy, is a diagnostic procedure that allows visualization of the interior surface of the eye, including the retina, optic disc, macula, and posterior pole. It is used to assess ocular health and screen for systemic diseases that affect the retina.

Techniques include direct ophthalmoscopy and indirect ophthalmoscopy. Direct ophthalmoscopy uses a handheld instrument to illuminate the eye and provides a magnified, upright view of a small retinal area. Indirect ophthalmoscopy uses a condensing lens (commonly 20 diopters) with a light source to obtain a wider field of view and better visualization of the peripheral retina. Slit-lamp biomicroscopy with a lens (such as 90D) can also be employed for a more detailed, multi-angle assessment.

Preparation and procedure typically involve pupil dilation with mydriatic drops to improve visualization. The examiner inspects the optic disc and cup-to-disc ratio, retinal vessels for caliber and signs of arterial disease, and the retina for hemorrhages, exudates, cotton-wool spots, microaneurysms, edema, or detachments. Documentation may include notes on the macula and peripheral retina.

Indications include routine screening in adults, evaluation of vision loss or eye pain, assessment after trauma, and monitoring of diseases such as diabetic retinopathy, hypertensive retinopathy, glaucoma, and optic neuropathies. Common findings span papilledema, glaucomatous cupping, diabetic retinopathy changes, hypertensive signs, retinal hemorrhages, and detachments.

Limitations involve dependence on pupil size and media clarity; media opacities such as cataracts or vitreous haze can hinder examination. Adequate training and patient cooperation are important for accurate interpretation.