II. Pupil Dilation

  1. Medications
    1. Tropicamide 0.5% - 1% (Mydriacyl)
      1. Blue eyes more sensitive, lasts longer
      2. Start with 0.5% concentration
    2. Phenylephrine hydrochloride 2.5% (Ak-Dilate)
      1. Shorter acting
  2. Contra-indications to use
    1. Shallow anterior chamber OR angle-closure Glaucoma
    2. Following pupillary signs after Head Injury
    3. Iris supported intraocular lens implantation
      1. (square/hexagonal pupil 'sputnik')

III. Exam: Protocol

  1. Red Reflex
  2. Optic Disc
    1. Clarity of disc (evaluation for Papilledema)
    2. Cup Disc Ratio
      1. Ratio of horizontal diameter of the cup to disc
      2. Abnormal Cup:Disc >0.5 suggests Glaucoma
  3. Retinal Circulation
    1. Venous pulsations
  4. Macula
  5. Retinal Background

IV. Findings

  1. Increased Intracranial Pressure
    1. Papilledema
    2. Absent venous pulsations
  2. Retinal or subhyoid Hemorrhage
  3. Blood in center of disc
    1. Suggests Subarachnoid Hemorrhage
  4. Choked disc with engorged veins
    1. Suggests Methanol Intoxication

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Ontology: Ophthalmoscopy (C0029090)

Definition (MSH) Examination of the interior of the eye with an ophthalmoscope.
Definition (CSP) examination of the interior of the eye through an ophthalmoscope, an instrument consisting of lenses, light source and pierced concave mirror that directs reflected light through the pupil.
Concepts Diagnostic Procedure (T060)
MSH D009887
ICD9 16.21
SnomedCT 53524009, 164739003, 370998006, 164733002, 141906001, 274798009
CPT 1012822
LNC LP149841-1
English Ophthalmoscopies, Fundoscopy, Fundoscopy NOS, fundoscopic examination, fundoscopic exam, fundoscopic examination (physical finding), ophthalmoscopy (procedure), fundoscopy, ophthalmoscopy, funduscopy, Clinical evaluation of optic fundoscopy (procedure), Fundoscopic evaluation, Fundoscopy NOS (procedure), Ophthalmoscopy Procedures, Funduscopy, Ophthalmoscopic examination, Ophthalmoscopy (procedure), Ophthalmoscopy, NOS, Ophthalmoscopic examination, NOS, Fundoscopy, NOS, Funduscopy, NOS, Clinical evaluation of optic fundoscopy, Ophthalmoscopy
Italian Esame del fundus, Oftalmoscopia
Japanese 眼底検査, ガンテイケンサ
Swedish Oftalmoskopi
Czech oftalmoskopie, Fundoskopie
Finnish Silmäntähystys
French Examen du fond d'oeil, Ophtalmoscopie
Spanish fundoscopia, fondo de ojo, evaluación clínica de fundoscopia óptica, evaluación clínica de fundoscopia óptica (procedimiento), fundoscopia, SAI, fondo de ojo, SAI (procedimiento), fondo de ojo, SAI, oftalmoscopia, examen oftalmoscópico, oftalmoscopia (procedimiento), Fundoscopia, Oftalmoscopía
Polish Wziernikowanie dna oka, Oftalmoskopia
Hungarian Fundoszkópia
Norwegian Oftalmoskopi
Portuguese Fundoscopia, Oftalmoscopia
Dutch fundoscopie, Oftalmoscopie
German Fundoskopie, Ophthalmoskopie