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2 minute Fundoscopy

2 minute Fundoscopy. Pennine VTS 28 th August 2012 Dr F Bhatti. Aims. Develop a 5 step approach to every examination Explanation to patient re the exam The examination itself and findings Knowledge base to interpret findings Explanation to patient Management.

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2 minute Fundoscopy

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  1. 2 minute Fundoscopy Pennine VTS 28th August 2012 Dr F Bhatti

  2. Aims Develop a 5 step approach to every examination • Explanation to patient re the exam • The examination itself and findings • Knowledge base to interpret findings • Explanation to patient • Management

  3. How do you explain what you do in the examination(fundoscopy)? Target time <1 min

  4. Instrument Familiarise yourself with the Instrument. Make sure you have batteries and its working.

  5. Examination(Max 2 minutes) • Approach to patient • Your position • Patient gaze fixing • Examining the different parts of the fundus Disc, cup, vessels, back ground and macula • What if you can’t? (Why are you doing the exam?)

  6. Common conditions • Variants of normal • Glaucoma (Optic Cupping) • Papilloedema • Hypertensive retinopathy • Diabetic retinopathy • Retinal/Vitreous detachment • Post laser treatment scarring • Haemorrhage • Age related macular degeneration • Central retinal vein/ Artery occlusion Rare you shouldn’t miss in kids- Retinoblastoma,cataracts (white reflex)

  7. How would you explain these conditions to the patient? Time limit 1-2 minutes

  8. Normal Fundus

  9. Normal or abnormal?

  10. Normal- Tigroid fundus

  11. What is the difference between Cupping of the disc vs Papilloedema? Why ? …because its quite important we understand the difference and the mechanism

  12. GlaucomaCupping due to increased IOP pushing disc out of the globe Late chronic glaucoma Early

  13. Another example of cupping

  14. What are the findings?

  15. PapilloedemaDisc is pushed in towards the globe due to increased ICP

  16. Edges of Disc and Cup are blurred and appear quite diffuse

  17. What can you see?

  18. Central Retinal Artery Occlusion The retina is supplied by one major artery. When this artery becomes blocked by a blood clot or plaque, little or no blood reaches the retina. This causes complete and sudden vision loss, usually in one eye. The sustained loss of vision is often preceded by short periods of vision loss which resolves. This condition, although painless, is similar to what happens in the brain during a stroke. Within 90 minutes of the loss of blood flow to the retina, the retina suffers irreversible damage.

  19. Diabetic Retinopathy Cotton wool spots, dot/blot hemorrhages and exudates +/- neovascularistion

  20. Diabetic retinopathy-another example….

  21. Hypertensive retinopathy

  22. One last diagnosis not to miss……

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