Funduscopie

Funduscopie, also known as fundoscopy, is an eye examination that visualizes the interior surface of the eye, including the retina, optic disc, macula, and retinal vessels. It is performed with an ophthalmoscope or via a slit-lamp with a condensing lens, and can be done with or without pupil dilation. The aim is to detect retinal pathology and assess the health of the posterior segment and optic nerve.

There are several techniques. Direct ophthalmoscopy uses a handheld instrument to view the retina upright with magnification, but provides a relatively small field of view and requires close approach. Indirect ophthalmoscopy uses a condensing lens (typically 20D or 28D) and a light source held at some distance, offering a wider field of view and better visualization of the peripheral retina. Slit-lamp biomicroscopy with lenses such as 60D or 78D allows high magnification of the posterior segment and can be combined with scleral depression to examine the peripheral retina.

Indications include routine eye examination, screening for diabetic or hypertensive retinopathy, and evaluation of symptoms such as sudden vision loss, flashes, or floaters. It is also used to assess optic neuropathies, retinal detachments, and other posterior segment conditions.

Procedure notes. Pupil dilation with mydriatic drops is commonly performed for a comprehensive exam, although non-dilated examination may be possible in some cases. The examiner inspects the optic disc and cup-to-disc ratio, retinal vessels, macula, and the peripheral retina for signs such as hemorrhages, exudates, cotton-wool spots, microaneurysms, edema, tears, or detachment. Findings are documented and compared with prior examinations if available.

Safety and limitations include the need for patient cooperation, adequate lighting, and clinician training, particularly for indirect techniques.