Systematic Fundus Examination

· Mohamed Zaki Abd El-Samea (M.B.B.CH)

· Resident In Ophthalmology Department

Aim of this presentation

· To present a method of systematic thinking for identification of fundus lesions .

Fundus Regions

90 D Biomiocroscope

Indirect Ophthalmoscope+

Scleral Indentation

· 9 Regions ± Scleral depression

Once a lesion is found

Is it elevated ? Is it colored ? Is it distortion of normal anatomy ?

Elevated ?

1- Border

2- Blood vessels

3- Light reflection.

4- Light Focus

Double vessel effect = shallow RD

Elevated Lesions

Color Level

retinoblastoma

Nevus

hemangioma

hamartoma

· Morphology

· Movement

· Multiplicity and extent

RD*Folds*Wavy*Single extends to ora

Old RD

choroidal*Dome, stretshed*no move*Multicentric extends beyond ora

Cause ?

Color code

Black lesions

Yellow lesions

Hard drusen

Soft drusen

Stargartd disease

Best disease

Choroidal rupture

Red Lesions

· Red

· Remote

· Raised distinct edges

· Revealed by indentation

White lesions

Cilioretinal artery occlusion

Berlin edema

Distorted anatomy

· Optic disc lesions

· Blood vessel abnormalities