Oftalmoskopia

Oftalmoskopia is the examination of the interior of the eye, including the retina, optic disc, retinal vessels, and vitreous, performed with an ophthalmoscope. It is a core technique in ophthalmology and primary eye care, used to detect local eye disorders and to assess systemic diseases that affect the eye.

There are two main approaches: direct ophthalmoscopy and indirect ophthalmoscopy. Direct ophthalmoscopy uses a handheld instrument that provides a magnified, upright view of a relatively small retinal field. Indirect ophthalmoscopy uses a light source together with a condensing lens (or a slit-lamp with a binocular indirect ophthalmoscope) to produce a wider field of view and better assessment of the peripheral retina, though the image is inverted. Pupil dilation with mydriatic drops is commonly employed to improve visualization, and adequate fixation and room illumination help.

Indications include screening and evaluation for diabetic and hypertensive retinal disease, glaucoma assessment, evaluation of optic neuropathies, retinal tears or detachments, macular disease, and assessment after ocular trauma or before intraocular surgery. Findings may include changes in the optic nerve head, retinal hemorrhages, hard exudates, microaneurysms, vessel abnormalities, and retinal tears.

Limitations of oftalmoskopia include media opacities such as cataracts, small or non-dilating pupils, and unsteady patients, which can hinder visualization. The technique requires training and practice to identify normal anatomy and pathology.

Historically, the ophthalmoscope was developed in the 19th century by Hermann von Helmholtz, with indirect ophthalmoscopy evolving later to expand the view of the fundus. Today, oftalmoskopia remains a standard, essential skill in eye care.