Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA
The simplest ophthalmoscopes consist of an aperture to look through, a diopter indicator, and a disc for selecting lenses. The ophthalmoscope is primarily used to examine the fundus, or the inner wall of the posterior eye, which consists of the choroid, retina, fovea, macula, optic disc, and retinal vessels (Figure 1). The spherical eyeball collects and focuses light on the neurosensory cells of the retina. Light is refracted as it passes sequentially through the cornea, the lens, and the vitreous body.
The first landmark observed during the funduscopic exam is the optic disc, which is where the optic nerve and retinal vessels enter the back of the eye (Figure 2). The disc usually contains a central whitish physiologic cup where the vessels enter; it normally occupies less than half the diameter of the entire disc. Just lateral and slightly inferior is the fovea, a darkened circular area that demarcates the point of central vision. Around this is the macula. A blind spot approximately 15° temporal to the line of gaze results from a lack of photoreceptor cells at the optic disc.
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1Department of Pediatrics-Division Cardiology, University of Rochester
1Institute of Genomic Sciences, National Yang-Ming University, 2Institute of Molecular Biology, Academia Sinica