Everything you need to know about an ophthalmoscopy

child getting an eye exam with an ophthalmoscope

An ophthalmoscopy (also known as a fundoscopy) is one of three routine tests performed by an eye doctor. Pediatricians and general practitioners also tend to include an ophthalmoscopy in routine physical exams. 

If you’ve ever had a doctor check your eyes, you’re probably very familiar with an ophthalmoscopy, even if now you’re wondering, “what is an ophthalmoscopy?”

This test involves the use of special lenses and bright, direct light to provide a better view of the back of your eye — specifically, the retina, optic disc and blood vessels.

What can an ophthalmoscopy detect?

This examination can reveal or rule out many different disorders that manifest in the back of your eye, some more serious than others.

If an ophthalmoscopy appears normal, your optician will see a normally functioning retina and blood vessels that show no signs of concern.

If a doctor sees something unusual, it may be the result of issues like:

  • Retinal inflammation due to a viral infection

  • Retinal detachment

  • Glaucoma

  • Hypertension (high blood pressure)

  • Diabetes

  • Macular degeneration

  • Melanoma of the eye, a rare form of cancer

  • Optic nerve disease

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What’s the difference between a direct, indirect and slit-lamp ophthalmoscopy?

  • A direct ophthalmoscopy is the most common procedure and involves the use of a handheld tool called an ophthalmoscope to look inside your eye. This tool uses special lenses and a bright light to focus past your pupil and onto the back of your eye. This is the least detailed of the three tests.

  • An indirect ophthalmoscopy involves a brighter light and a smaller lens, also handheld. The doctor will wear this light as a headlamp, instead of using a handheld light. In the case of a detached retina diagnosis, this test can be a critical first step.

  • During a slit-lamp ophthalmoscopy, you will place your chin on a chinrest while an optician looks into your eye with a more narrowly shaped light. He or she will move the light from side to side, providing a more detailed look than a direct or indirect test.

What is a fundoscopic exam?

Fundus is the medical term for the elements that make up the back of your eye. A fundoscopic exam, or fundoscopy, is the same thing as an ophthalmoscopy; it’s simply a different name for the same procedure.

Will my eyes need to be dilated for an ophthalmoscopy?

Sometimes, but not always. Only an optometrist or ophthalmologist can decide if dilation is recommended. Dilation is more common with an indirect or slit-lamp ophthalmoscopy.

If dilation is required, it will temporarily blur your vision, and you should never drive until the effect has worn off. Since this effect can last several hours, it’s important to arrange for transportation from your doctor’s office.

Does an ophthalmoscopy hurt?

While there may be slight discomfort from the brightness of the ophthalmoscope’s light, these tests will not cause any pain. An indirect ophthalmoscopy may involve a slight pressure on the surface of your eye, but it should not be painful.

If dilation is required, the temporary vision impairment may lead to slightly uncomfortable light sensitivity during that time. In the event your doctor elects to dilate your eyes, you should be given disposable sunglasses to reduce any discomfort before you leave the office.

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