Distant direct ophthalmoscopy

  • Used to get a preliminary idea about the status of the ocular media and fundus
  • This should be done routinely before doing a direct ophthalmoscopy
  • Equipment needed – self illuminated ophthalmoscope or plane mirror with a hole in centre
  • Procedure
    • Should be performed in a semi dark room
    • The ophthalmoscope should be kept at a distance of 20-25 cm from the patient’s eye
    • Normally a red reflex is seen at the pupillary area
  • Uses
    • Opacities in the ocular media are seen as dark spots in the red glow at the pupillar area
      • The plane of the opacities can be assessed by asking the patient to move the eye from side to side while the examiner is observing the pupillary glow (based on parallax principle)
        • opacities in front of the pupil move in the direction of eye movement
        • opacities in the pupillary plane do not move
        • opacities behind the pupillary plane move opposite the direction of eye movement
    • To differentiate between a mole on the iris and a hole in the iris
      • in oblique illumination, both appear dark
      • in distant direct ophtalmoscopy
        • mole – appears dark
        • hole – red glow is seen
    • To detect a retinal detachment or fundal mass
      • Both of them are visible as a grayish reflex
      • It is not possible to differentiate them in distant direct ophthalmoscopy

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Normal ocular fundus - as seen through an ophthalmoscope Click on image for an enlarged view Visualisation of the interior...