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WSVA7-0411
OPHTHALMOLOGY
FUNDOSCOPY: PRACTICAL TIPS TO IMPROVE YOUR SKILLS
E. Giuliano1
1University of Missouri- Veterinary Medical Teaching Hospital, Columbia- MO, USA
Appropriate examination of the fundus is often the
most challenging aspect of the complete ophthalmic exam for many veterinarians. First, for some individuals, proper ophthalmoscopic techniques can be dif cult to master. Second, the normal anatomical relationships of fundus structures are often not well-understood, making interpretation dif cult. Finally, the large variation in normal fundus appearance, especially in the canine species, adds to the complexity of this important diagnostic tool. This lectures aims to answer the following frequently asked questions and provide practical tips to help ensure good posterior segment ophthalmoscopic skills.
1. “What is Ophthalmoscopy?”
2. “What technique should I be using to get a good look at the posterior segment of my canine or feline patient?”
• Provide an overview of techniques with indications, advantages, and disadvantages of each method
3. “What am I looking at?” • Building a fundus
4. “OK, now I can get an image in focus, but what does it mean?”
• Is it normal or abnormal? If abnormal, is it an addition or a subtraction?
The fundus is composite picture formed by the 3 basic tunics of the vertebrate eye (neurosensory, vascular,
and  brous) superimposed on one another. As viewed ophthalmoscopically, those components (from the
inner to the outer aspects of the globe) are the retina, choroid, and sclera. Normal fundic  ndings can be
highly variable and are in uenced by the animal’s species, breed, age, and coat color. Ability to routinely and reliably evaluate the posterior segment of the eye
is essential in any patient with a visual disturbance or
for which the differential diagnose includes systemic infectious disease, vascular disorder, hypertension, or central nervous system disease. This author is a strong advocate of indirect ophthalmoscopy (versus direct)
and she strongly encourages her audience attendees to master this technique for routine examination of the small animal patient. In this author’s opinion, proper technique for direct ophthalmoscopy is more dif cult than indirect
technique. The high magni cation afforded by direct ophthalmoscopy often precludes accurate interpretation of the disease process in question. Once the clinician has mastered the techniques necessary to perform a good ophthalmoscopic exam, it is essential that the practitioner then become familiar with the wide variation in normal fundus  ndings routinely seen between species, within species, and from breed to breed.
EXAMINATION (follow these steps prior to performing direct or indirect ophthalmoscopy):
• Ophthalmoscopy is part of the complete ophthalmic examination and should be performed after the minimum ophthalmic data base has been acquired.
• In the initial stages of the complete ophthalmic exam, retroilluminate the patient. With the patient at eye level and using a Finoff transilluminator (or a direct ophthalmoscope set at 0 diopters) at arm’s distance, establish both tapetal re exes. Look for anisocoria (unequally sized pupils) and any opacities present in the ocular media (e.g., cataract).
• Pupillary dilation is essential for ophthalmoscopy. First, make certain the animal does not have glaucoma. Then, dilate the pupils with 1-2 drops of tropicamide (Mydriacyl®). Complete pupillary dilation will occur in 10-15 minutes and will last 8-12 hours in the dog.
• Perform your examination in a very dark room. COMPARISON OF OPHTHALMOSCOPIC TECHNIQUES: OPHTHALMOSCOPIC
TECHNIQUE
INDICATIONS ADVANTAGES DISADVANTAGES
An Urban Experience
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