Ophthalmoscopy

Written by Janelle Martel
Medically Reviewed by George Krucik, MD

What Is Ophthalmoscopy?

Ophthalmoscopy is usually part of a routine eye test to screen for eye diseases. It looks at the back of the eye. The back of the eye is called the fundus. It consists of the:

  • retina
  • optic disc
  • blood vessels

This test may also be ordered if you have conditions that affect the blood vessels, such as high blood pressure or diabetes.

Opthalmoscopy may also be called funduscopy or retinal examination.

Reasons for Ophthalmoscopy

Ophthalmoscopy is used to screen for eye diseases and conditions affecting the blood vessels. These include:

  • diabetes
  • glaucoma (excessive pressure in the eye)
  • hypertension (high blood pressure)
  • macular degeneration (loss of vision in the center of the visual field)
  • melanoma, a type of skin cancer, in the eye
  • cytomegalovirus (CMV) retinitis, an infection of the retina
  • damage to the optic nerve
  • retinal tear or detachment

How to Prepare for Ophthalmoscopy

Your doctor may use eye drops to dilate your pupils. This makes them larger and easier to look through. However, these eye drops can make your vision blurry and sensitive to light for a few hours. You should arrange for someone to drive you after the test.

If you work in a job that requires you to have clear vision, such as operating heavy machinery, you should arrange to take the rest of the day off. You should also bring sunglasses to your appointment. These will protect your eyes from bright light while your pupils are dilated.

If you are allergic to any medications, it is important that you tell your ophthalmologist. Eye drops should not be used if you could have an allergic reaction. There is also the possibility that some medications could interact with the eye drops. Therefore, it is important to tell your doctor about all medications you are on. Make certain to include both over-the-counter and prescription medications.

Finally, you should tell your ophthalmologist if you have glaucoma or a family history of glaucoma. Most eye doctors will not use eye drops on a patient with suspected glaucoma. The drops can increase the fluid pressure in the eye too much.

What Happens During the Test?

You may receive eye drops to dilate your pupils. If you do, they may sting briefly for a few seconds. Drops can also cause an unusual taste in your mouth.

There are three different types of ophthalmoscopy. Your ophthalmologist may choose to use one or more of them. The goal is to get the best view of the back of your eye.

Direct Examination

You will be seated in a chair. The lights in the room will be turned off. Your ophthalmologist will sit across from you and use an ophthalmoscope to examine your eye.

An ophthalmoscope is an instrument that has a light and several small lenses for your ophthalmologist to look through. Your ophthalmologist may ask you to look in certain directions as he or she looks at the back of your eyes. The bright light may be slightly uncomfortable and cause afterimages to appear. However, it should not cause pain.

Indirect Examination

This test allows your doctor to see the structures in the back of the eye in more detail.

For this test, you will be asked to lie down or sit in a reclined position. Your ophthalmologist will have a bright light positioned around his or her forehead that will be shined in your eyes. A lens will be held in front of your eye. Then your doctor will hold your eye open to look into it.

You may be asked to look in certain directions. Pressure may also be applied to your eye with a small, blunt, probe. This may be uncomfortable but should not be painful.

Slit-Lamp Examination

This procedure gives your doctor the same view of your eye as an indirect examination, but with higher magnification.

You will sit with an instrument in front of you. There will be a place for you to place your chin and rest your forehead. This helps keep your head steady during the exam. A bright light will be turned on in front of your eye. Your ophthalmologist will use a microscope to look at the back of the eye.

You may be asked to look in different directions. Your ophthalmologist may use his or her finger to open your eye to get a better view. A small, blunt probe may also be used to apply pressure to the eye.

This examination may be uncomfortable, but it should not be painful. You may see afterimages after the light turns off. They should go away after blinking several times.

What Are the Risks?

The only risk of ophthalmoscopy is that of having a reaction to the eye drops. Such reactions are rare. However, they may cause:

  • dry mouth
  • flushing
  • narrow-angle glaucoma
  • dizziness
  • nausea and vomiting
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