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Ophthalmoscopy is a test that allows the doctor to examine the fundus, which is the inner portion at the back of the eye. The procedure is performed using an ophthalmoscope which is an instrument with a powerful magnifying glass and a light source. Ophthalmoscopy may be part of a general eye examination but may also be ordered if the doctor suspects an underlying condition that affects vision.

The ophthalmoscope allows the doctor to examine the fundus which consists of the nerve cells of the retina, blood vessels, choroid and the optic nerve.

Types

Opthalmoscopy may be of various kinds. They include:

• Direct ophthalmoscopy - The room in which you are sitting will be darkened and the doctor will begin the procedure by directing light from the ophthalmoscope into your pupil. An ophthalmoscope is roughly as big as a cudgel and contains several lenses that allow the doctor to view a magnified image of the back of your eyeball.
• Indirect ophthalmoscopy - This test is conducted while lying down or sitting in a semi-reclining position. The doctor will hold your eyelid open and shine a very bright light into your eye with the help of an instrument similar in appearance to a miner's head lamp. The doctor will then hold a viewing lens close to your eye which will enable him or her to examine the back of your eye. A small probe may be used to apply pressure to your eye and you will have to look around while the doctor performs the examination.
• Slit-lamp ophthalmoscopy - The instrument is placed on a table in front of you. You will have to sit in front of it and steady your head by resting your chin and forehead on the support. The doctor will sit on the opposite side of the instrument and use the microscope in the slit-lamp and another lens to examine the back of your eye. This technique allows for a much higher magnification than indirect opthalmoscopy.

The examination usually takes about fifteen minutes to perform.

Prior to the commencement of the procedure you may be asked to place medicated eye drops into the eye. Eye drops are usually used in the case of indirect and slit-lamp ophthalmoscopy, while they may or may not be used in the case of direct opthalmoscopy.

Tips

Here are some tips that will make your examination much more comfortable:

Inform your doctor if you have any allergies to medications and any other medications you may be taking. Also inform the doctor if you have glaucoma or any other pre-existing condition or if any member in your family has ever had glaucoma.

The drops may make it difficult for you to focus for several hours after application. Since your pupils have been dilated, keeping your eyes open in brightly lit conditions may prove to be difficult. Sunglasses or tinted glasses can help you keep your eyes open under these conditions. It is also advisable for you to arrange to have someone drive you after an opthalmoscopy.

Side Effects

During the test you may experience:

• A certain degree of discomfort due to the bright light but no pain.
• A brief flash of images after the light has been shone in your eyes.
• A certain degree of discomfort due to pressure, during indirect ophthalmoscopy, but no pain.
• A stinging sensation in your eyes, if and when, eye drops are used.
• An funny taste in your mouth

An ophthalmoscopy may be ordered by your doctor for a variety of reasons. They include:

• As part of a routine physical or a complete eye examination
• To diagnose and evaluate symptoms of eye diseases such as glaucoma or a detached retina
• It may also be performed if you suffer from underlying conditions that affect your vision such as high blood pressure, diabetes or diseases of the blood vessels

In a healthy eye, the retina, blood vessels and the optic disc will appear normal.

Abnormalities if detected could be caused by a number of conditions including:

• CMV retinitis
• Diabetes
• High blood pressure
• Glaucoma
• Macular degeneration
• Melanoma of the eye
• Problems with the optic nerve
• Partially detached or torn retina

While the test in itself poses no risk, the eye drops used to dilate the pupils may on rare occasion, cause certain side effects. These include:

• Dizziness
• Dryness in the mouth
• Flushing
• Nausea and vomiting

The CPT code for ophthalmoscopy will depend on the type of examination and the purpose for which it is carried out.

Reference

• http://www.umm.edu/ency/article/003881all.htm