The ophthalmoscope is a tool used in medicine to examine the inside of the eye.An ophthalmoscope can be used to diagnose diseases of the eye as well as conditions like hypertension and diabetes.The ophthalmoscope can be mastered if you understand it and practice it.
Step 1: Determine if the ophthalmoscope is working correctly.
If the light doesn't work, turn the power switch to the on position.If you can't, try again.To get clarity, look through the eyepiece.If there is a cover, remove it or slide it open.
Step 2: The appropriate setting should be selected.
There are a number of options that can be used in an eye examination.Most exams are done in a darkened room when the patient has not been treated with mydriatic eye drops.Ophthalmoscopes can be used in a variety of settings, including small light, large light and half light.
Step 3: The focusing wheel is used to focus the instrument.
The baseline is the ophthalmoscope's setting.The positive numbers are marked on the instrument in green and the negative numbers in red, and they focus on things closer to you.The PanOptic ophthalmoscope can be focused using the focusing wheel.
Step 4: Explain the procedure to your patient.
The examinee should sit in a chair or on the table.If they are wearing glasses or contacts, please remove them.The patient should be warned about the brightness of the light emitted by an ophthalmoscope.Explain the procedure and effects if you will be dilating the pupil with mydriatic drops.There is no need to go into much detail about the eye exam.I will use this instrument to look into your eye.It will be bright, but not uncomfortable.
Step 5: You need to wash your hands.
Before and after any physical exam, it is recommended that you wash your hands with soap and water.
Step 6: If it's necessary, apply mydriatic drops.
Dilating the pupils makes it easier to see the eye structures.The patient should tilt their head back.Drop the appropriate number of drops into the eye after pulling out their lower lid.For about 2 minutes, have your patient close their eyes and press on the corner of their eye.This should be done in both eyes.About 15-20 minutes before your exam, apply 1-2 drops of Tropicamide 0.5%.Other agents used are Cyclopentolate 1%, Atropine 1% solution, Homatropines 2%, andPhenylephrine 2.5% or 10% solution.All of these drops are not recommended for patients with a head injury.Review the list of your patient's medications to make sure they don't interact with the eye drops.Lighter-colored eyes may be less sensitive to drops.
Step 7: The room should be dark.
The lights should be dimmer.The sharpness of the ophthalmoscope magnification is affected by having extra lights on.If you can't make the room darker, adjust the light setting on your ophthalmoscope.
Step 8: In relation to your patient, position yourself.
Stand straight, bend forward, or sit in a chair if you want to be eye-level with your patient.If you want to approach your patient from a 45 angle, position yourself at their side.
Step 9: Understand your scope and approach the patient in the right way.
The first thing we want to do is evaluate the patient's right eye.When you move, your head, hand, and scope should move as one.Put your left hand on the patient's forehead and spread your fingers out to provide stability.Lift the right eyelid with your left thumb.Use your right hand and right eye to look at your patient.When using a PanOptic, approach the patient from 6 inches away at a 15-20 angle.Don't worry about getting too close to the patient during the exam.You need to be as close to the exam as possible.
Step 10: Your patient should be told where to look.
Tell your patient to look straight ahead and past you.If you can give your patient a specific spot to steady their gaze, you will be able to relax them and prevent eye movement that will disrupt your examination.
Step 11: The red reflex is what you should look for.
At about arm's length from the patient, hold the ophthalmoscope up to your eye.The light should shine into the patient's right eye at about 15 from the center of the eye.Check to see if there is a red reaction.The red light in the eye is caused by the reflection of light off the retina, like what you see in a cat's eye.There is a problem with the eye if there is no red reflex.Depending on your eyesight, you may need to adjust focus as you look through the scope.
Step 12: The red reflexes can be used as a guide to start the exam.
When moving your head, hand and scope as one unit, slowly follow the red reflex in closer to the patient's right eye.When your left thumb comes into contact with your forehead, stop moving forward.You should be able to see the retina if you follow the red reflexes.To bring features of the eye into focus, you may need to focus your scope.The lens dial can be turned with your forefinger.
Step 13: Take a look at the disc.
To angle the ophthalmoscope, use a pivot motion.Look at the disc for its shape, color, and cup-to-disc ratio.If you can't find the disc, follow a blood vessel.The blood vessels will lead you to the disc.If you see cupping or swelling of the optic disc, that's a sign.
Step 14: Check the blood vessels and fundus.
The four quadrants of the eye are superotemporal, Superonasal, inferoTemporal, and in.Carefully look for signs of disease.You should use clinical judgement and knowledge during your exam, but watch for the following.
Step 15: Evaluate the fovea last.
Tell your patient to look at the light.It is saved for the end of the exam because it can be uncomfortable.The visual acuity tests show if the macula is healthy or not.The fovea is a bright point in the middle of the macula, which appears to be a darker disc.
Step 16: Look at the other eye.
You should repeat the procedure on the other eye if you want to check it out.Some illnesses can cause changes in both eyes, but other problems can only be seen in one eye.
Step 17: Inform your patient.
Explain any abnormality that you noticed to your patient, what it means, and any further actions they should take.Light sensitivity and blurred vision can be experienced by your patient if mydriatic drops are used.They should have someone drive them home.If they didn't bring their own, give them disposable sunglasses.
Step 18: Take the time to document your findings.
Specific notes on any abnormality are included in the document.It is helpful to include pictures as visual clues to remember what you saw, and to compare that patient's later exams to see how things have changed.