Ophthalmoscopy (examination of eye) – what is it?
Ophthalmoscopy is the visual method of evaluation of the fundus with the help of special devices. This method allows high accuracy to study the bottom of the eye by the focused beam of light. There are two types of such surveys: direct and indirect ophthalmoscopy, differing methods of implementation. Fundoscopy is performed for suspected diseases affecting the retinal vessels and the retina, such as diabetes or hypertension.
Ophthalmoscopy is designed to study the structures of the fundus using the Ophthalmoscope, a special instrument consisting of a light source and focusing lenses.
The use of direct ophthalmoscopy allows us to study the structure of the fundus due to the increase in image more than ten times. For this examination, use the special bassreflex ophthalmoscopes or special attachments for the slit lamp.
The Ophthalmoscope is a small device that can split a beam of light into separate beams, and to detect reflected rays from the formations in the fundus. In this image obtained has no glare and allows the doctor with high magnification to explore the necessary structures. As a rule, before the start of the study it is necessary to expand sracek using eye drops containing the agonists, for example, Tropicamide.
The procedure is performed in the following way. The attending physician places the Ophthalmoscope between your eye and the eye of the patient at a distance of about 4 cm from the latter. In the unit visible structures of the ocular fundus: the place of exit of the optic nerve, vascular education, the Central part of the retina, the macular area and other entities. The inspection is carried out in strict sequence, necessary to ensure the best results and eliminate medical errors.
It is important to highlight the advantages of this method:
- A large increase of the investigated objects allows easy identification of pathological changes, especially in the macular area and the optic disk.
- Thanks to the use of the ophthalmoscopes doctor can assess changes in the level structures of the fundus, which plays an important role in the identification of swelling of the optic disc or tumor growth.
- It is possible to determine the true refractive error of the eye.
Despite the good increase, direct ophthalmoscopy has a number of shortcomings. When using this kind of examination, your doctor is almost unable to examine the peripheral retina, which can have serious consequences for the diagnosis of several diseases (retinal tears, etc.). The second drawback is the impossibility of obtaining three-dimensional image that makes it difficult to identify tissue edema and its severity.
Indirect variation studies of the ocular fundus is performed using a special concave mirror and a magnifying glass. The light source is placed to the left and behind of a human head, creating a shadow in the field of the investigated eye. The attending physician is placed in front of the patient and puts the Ophthalmoscope to your eye. The second eye close is not because they are the doctor evaluates the patient’s condition and accuracy of direction of the light beam. After the beam of light is caught in the studied eyes, use magnifier to increase the image.
To obtain a three-dimensional image has a special binocular Ophthalmoscope is worn on the head of the doctor. It is important to note that in contrast to direct ophthalmoscopy, the doctor sees an image of the retina upside down.
The advantages of indirect method:
- To explore the peripheral parts of the retina.
- High level of detail in the resulting images.
- Better suited for the study of the fundus of the eye when opacities in the structures of the eye.
- The lack of direct contact with the eye of the patient.
- The possibility of application even in low lighting conditions.
The only two disadvantages of the method: low values increase the resulting images and roll over, which could interfere with the interpretation of what he saw.
Such kind of research is used to assess the condition of the retina and vitreous body, located in front of her. For this method use a conventional slit lamp and a lens with large refractive power. It is possible to conduct photographing of the identified changes, which is very important for assessing the progression of disease and effectiveness of treatment.
Important benefits of binocular biomicroscopy:
- The lack of contact between the device and the eye of the patient.
- High definition of the image obtained.
- Assessment of the relationship of the retina and vitreous.
- The main drawback – the image is upside down.
There are modifications of this method, which consists in using multiple lenses Goldman, Minster and so the lens must be placed directly on the cornea of the eye, which complicates the application of the method in connection with the use of local anesthesia and high requirements for sterility of instruments and premises.
The choice of a particular method of research of the ocular fundus remains a doctor-optometrist is able to assess all the available indications and contraindications for their conduct.
Conducting ophthalmoscopy in children
Conducting such research in children requires additional training of the child, as the equipment used and the procedure itself can scare him. Therefore, in some cases it is possible to conduct surveys during baby’s sleep, allowing stress and discomfort to assess the condition of the fundus.
In addition to conducting such surveys requires special types of lenses, adapted to the particularities of the structure of the eyeball in children.
Use any variety of ophthalmoscopy (direct, indirect or slit lamp) allows the doctor to assess the condition of the fundus structures and to detect the disease. No need special preparation of the patient and the wide availability of necessary equipment, cause the high popularity of this study and its widespread use in clinical practice.