Test Overview
Ophthalmoscopy (also called fundoscopy) is a test that lets a doctor see inside the back of the eye, which is called the fundus. The doctor can also see other structures in the eye. He or she uses a
magnifying tool called an ophthalmoscope and a light source to see inside the eye. The test is done as part
of an eye exam. It may also be done as part of a routine physical exam.
The fundus has a lining of nerve cells called the
retina. The retina detects images seen by the clear, outer
covering of the eye, called the cornea. The
fundus also contains blood vessels and the
optic nerve.
There are two types of ophthalmoscopy.
- Direct ophthalmoscopy. Your doctor uses a tool that is about the size of a small flashlight. It has many lenses that can
magnify up to about 15 times.
- Indirect ophthalmoscopy. Your doctor uses a small handheld lens and either a slit lamp microscope or a light attached to a headband. This test gives the doctor a wider view of
the inside of the eye. It allows a better view of the fundus, even if the lens
is clouded by
cataracts.
Why It Is Done
Ophthalmoscopy is done to:
- Find problems or diseases of the eye, such as
retina problems.
- Help find other conditions or diseases that
damage the eye.
- Look for the cause of symptoms, such as
headaches.
- Find other problems or diseases, such as head injuries
or brain tumors.
How To Prepare
You do not need to do anything special to prepare for this test.
Your doctor may use eyedrops to widen (dilate)
your pupils. This makes it easier to see the back of the eye. The eyedrops take
about 15 to 20 minutes to fully dilate the pupil. Your doctor may also use
eyedrops to numb the surface of your eyes. Tell your doctor if:
- You or anyone else in your family has
glaucoma.
- You are allergic to eyedrops used to dilate or numb the eye.
You may have trouble focusing your eyes for several hours
after the test. You may want to have someone drive you home after
the test. You also will need to wear sunglasses when you go outside or into a
brightly lit room.
Talk to your doctor if you have any concerns about the need for the test, its risks, how it will be done, or what the results mean. To help you understand the importance of this test, fill out
the
medical test information form(What is a PDF document?).
How It Is Done
Direct ophthalmoscopy
This type of exam can be
done with or without eyedrops.
- Your eyes may be dilated. You will be
seated in a darkened room and will be asked to stare straight ahead at some distant
spot in the room.
- Looking through the ophthalmoscope, your doctor
will move very close to your face and shine a bright light into one of your
eyes. Each eye is checked separately.
- Try to hold your eyes steady
without blinking.
This exam takes a few minutes.
Indirect ophthalmoscopy
This type of eye exam
gives a more complete view of the retina than direct ophthalmoscopy. The exam is
usually done by an
ophthalmologist.
- Your eyes will be dilated. You may be
asked to sit in a darkened room and to sit upright with your head on a chin rest.
- Your doctor will hold your eye open and shine a very bright light
into it. He or she will look at the eye through a special lens.
- Your doctor may
ask you to look in different directions. He or she may apply pressure to your eyeball
through the skin of your eyelids by using a small, blunt tool. The pressure helps bring
the edges of your fundus into view.
This exam takes a few minutes.
How It Feels
Direct ophthalmoscopy
During direct
ophthalmoscopy, you may hear a clicking sound as the tool is adjusted to
focus on different structures in the eye. The light is sometimes very strong,
so you may see spots for a short time after the exam. Some people report
seeing light spots or branching images. These are really just the outlines of the
blood vessels of the retina.
Indirect ophthalmoscopy
With indirect
ophthalmoscopy, the light is much stronger. It may be slightly painful. Pressure applied to your eyeball with the blunt tool may also hurt a little. After-images are common with this test. If the test is
painful, let the doctor know.
When dilating eyedrops are used
Dilating drops may
make your eyes sting and cause a medicine taste in your mouth. You will have
trouble focusing your eyes for up to 12 hours. Your distance vision usually is not affected as much as your near
vision. Your eyes may be very sensitive to light. Do not drive for
several hours after your eyes have been dilated, unless your doctor says it's okay. Wearing sunglasses may make
you feel better until the drops wear off. To learn more, see the topic Dilated Eye Exam.
Risks
In some people, the dilating or numbing
eyedrops can cause:
Call your doctor right away if you have severe and sudden
eye pain, vision problems such as halos that appear around lights, or loss of vision
after the exam.
Results
Ophthalmoscopy is a test that lets a
doctor see inside the back of the eye, which is called the fundus. He or she can also see other structures in the eye. The doctor uses a
magnifying tool called an ophthalmoscope and a light source to see inside the eye.
Ophthalmoscopy| Normal: | - All of the structures inside the eye
look normal.
|
|---|
| Abnormal: | - The
retina is detached.
- Swelling of the
optic nerve (papilledema) is found.
- Optic
nerve damage caused by
glaucoma is found.
- Changes in the retina
(such as hard, white deposits beneath the retina called drusen, or broken blood
vessels called hemorrhages) point to
macular degeneration.
- Damaged blood
vessels or bleeding in the back of the eye is seen. This could be caused by
diseases such as high blood pressure or
diabetes.
- Cataracts are
found.
|
|---|
What Affects the Test
You may not be able to
have the test, or the results may not be helpful, if:
- You can't stay still during the
exam.
- You have certain eye problems such as cataracts,
cloudiness of the liquid inside the eyeball, or pupils that don't dilate enough.
What To Think About
- Other eye tests may be done along with ophthalmoscopy. These may include vision testing and tonometry testing for
glaucoma.
- Indirect ophthalmoscopy is harder to do and requires greater skill and more specialized
tools than direct ophthalmoscopy. It is usually done by
ophthalmologists and
optometrists.
- Indirect ophthalmoscopy can be more helpful than direct ophthalmoscopy because:
- It lets the doctor see the
inside of the eye better if you have a cataract.
- It provides a
three-dimensional (3-D) view of the back of the eye. This gives the doctor a more detailed
view of certain eye conditions, such as growths, optic nerve swelling, or
a detached retina.
- It allows a wider view of the back of the
eye.
- If your doctor thinks you may have a problem with the blood
vessels in your eye, he or she may suggest a test called eye angiography. This test uses
fluorescein dye and a camera to take pictures of blood vessels in the eye. To learn more, see the topic
Eye Angiogram.
References
Other Works Consulted
- Chang DF (2011). Ophthalmologic examinations. In P Riordan-Eva, ET Cunningham, eds., Vaughan and Asbury's General Ophthalmology, 18th ed., pp. 27-57. New York: McGraw-Hill.
Credits
ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerAdam Husney, MD - Family Medicine
Current as ofMay 17, 2017