Fundoscopy

Fundoscopy, also known as ophthalmoscopy, is the examination of the interior surface of the eye (the fundus), including the retina, optic disc, macula, and retinal vessels. It is used to detect abnormalities of the posterior segment and to assess systemic diseases that affect the vasculature or optic nerve. Indications include sudden vision loss, floaters or flashes, suspected papilledema or optic neuropathy, diabetic or hypertensive retinopathy, retinal detachment, or macular disease, as well as routine screening in high-risk patients.

Technique and equipment: The examination can be performed directly with a handheld or head-mounted direct ophthalmoscope, or indirectly with a condensing lens (typically 20- to 40-diopter) during indirect ophthalmoscopy, often after pupil dilation. Direct ophthalmoscopy provides a magnified view of the optic disc and vessels but a narrower field; indirect ophthalmoscopy offers a wider view of the retina, including the peripheral retina. Pupil dilation improves access, but exam may be limited by media opacity or small pupils.

Findings: Normal fundus shows a pink to orange retina, a well-defined optic disc with a physiologic cup, clear margins, and orderly retinal vessels with a light reflex. Abnormal findings include optic disc swelling (papilledema or optic neuropathy), increased cup-to-disc ratio (glaucoma), retinal hemorrhages or exudates (diabetic or hypertensive retinopathy), microaneurysms, cotton-wool spots, macular edema, retinal breaks, lattice degeneration, or retinal detachment.

Limitations and importance: Fundoscopy requires adequate pupil dilation and a suitable media condition; it can be limited by cataracts or other opacities. Regular fundoscopy remains an essential component of medical and ophthalmic assessment.