The fundus examination provides information not only about the condition of our eyes, but also tells a lot about the functioning of the entire organism. Early detection of changes in the eye fundus allows you to monitor the development of diseases such as diabetes, atherosclerosis or hypertension.

The fundus examinationallows you to diagnose many diseases, as well as monitor changes in the fundus, resulting from the progression of systemic diseases, such as hypertension or diabetes. Early detection of changes may prevent the development of difficult-to-treat forms of the disease.

They are commissioned by both ophthalmologists and doctors of other speci alties (diabetologists, cardiologists, internists) to assess the patient's he alth condition or to check if the therapy is well conducted. The examination is completely painless.

When should the fundus examination be done?

In the case of systemic diseases, the basic indications for the examination of the fundus are all vascular diseases, i.e. arterial hypertension, diabetes, atherosclerosis, and neurological diseases, e.g. stroke, suspicion of an intraocular tumor. In the case of ocular diseases, the indications for the examination are defects in the visual field (central or peripheral), sudden decrease in visual acuity and color vision disturbances.

Also, every seeing strange images, e.g. curving lines, seeing objects of different sizes with one eye smaller and larger with the other, a feeling of lack of vision on one side, seeing intense flashes of light or black points is an indication for the examination of the fundus of the eyes.

Specialists also recommend that this test be performed every 3 years before the age of 40, every two years between the ages of 40 and 50, and once a year in age 50. If there is a family history of glaucoma, it should be examined after the age of 35, in the case of myopia above 3.5 diopters, it is worth examining the fundus of the eye, especially the circumference of the retina, in order to examine the predisposition to retinal detachment.

Fundus examination: preparation for the examination

Performing the test does not require any special preparation. To make the fundus well visible - the pupil is dilated with atropine drops (they must not be used in people suffering from glaucoma). Therefore, it is worth going there with an accompanying person, because after a few hours your vision is worse, especially up close. You are also not allowed to drivecar. It is good to have sunglasses with you, because after instillation of the drops dilating the pupil, there is a temporary sensitivity to light. Before examining the fundus, the ophthalmologist conducts an interview. He asks, among others about age, profession (the possibility of detachment of the retina under the influence of exercise), medications taken, diet, past diseases as well as chronic and current ailments. Anyone who has trouble remembering the names of the medications taken should prepare a list of them. Important information for the doctor is also what we suffer from and whether we are allergic to any preparations. Patients with glaucoma must bring the so-called a glaucoma book or any previous tests, especially visual field, optic nerve examination. In the case of narrow-angle glaucoma - the examination will be performed without dropping, as these could cause a dangerous increase in intraocular pressure. You should notify your doctor if someone in your close family has glaucoma.

Three ways to examine the fundus

After talking to the patient and taking the interview, the doctor drops the eye drops to dilate the pupils. Now you have to wait a quarter of an hour or more for the pupils to dilate well. Thanks to this, the ophthalmologist will be able to see a larger area of ​​the fundus of the eye. The examination takes place in a darkened room. The specialist has 3 methods at his disposal.

  • She most often examines the fundus with an eye speculum - an ophthalmoscope. Using the camera, the doctor shines a beam of light into the patient's eye. It passes through the lens and vitreous body and illuminates the fundus of the eye. The fundus image allows you to assess the condition of the retina, blood vessels and the optic disc. The test also makes it possible to diagnose macular diseases (AMD) and uveal diseases. The doctor can also see changes that indicate atherosclerosis, diabetes and hypertension.
  • The fundus of the eye can also be examined by indirect ophthalmoscopy using a high-power focusing lens. Directing the light onto the pupil, the doctor observes from some distance an inverted and magnified image of the fundus (the magnification depends on the power of the lens), which is created in the plane of the lens held in front of the patient's eye.
  • The newest device for the assessment of the fundus condition is the Non-Mydriatic fundus camera. This method does not require pupil dilation in most patients. On the basis of a high-resolution color image of the fundus, the ophthalmologist can diagnose many diseases. The condition for the test is pupil width not less than 2.5 mm. Also note that the fundus image shows a section of the central part of the retina, with no circumference of the retina or the vitreous. Therefore, they are mainly used for researchscreening.
Important

From the vascular changes at the fundus, one can also infer the condition of the kidney, brain and heart vessels.

Angiography - examination of the blood vessels of the fundus

Sometimes the ophthalmologist orders supplementary tests, such as the contrast test of the blood vessels of the fundus, i.e. fluorescein angiography. After a solution of fluorescein sodium is administered into the ulnar vein, a series of images of the fundus is taken with a camera. Providing a contrast enables a more accurate assessment of the circulation in the retina. It reveals pathological changes, e.g. neoplastic, inflammation, edema, congestion, blood clots, and hemangiomas. The test takes about an hour.

Contrast makes some people nauseous, so it is better to come to the test on an empty stomach. There is also the possibility of allergy to the administered contrast, so tell your doctor if you are allergic.

The fundus examination helps to diagnose:

  • retinal diseases (detachment, retinal hemorrhages, macular diseases)
  • uve disease (inflammation, cancer)
  • diseases of the optic nerve (e.g. inflammation)
  • hypertension
  • diabetes
  • atherosclerosis
  • diseases of the hematopoietic system (leukemia, anemia, bleeding disorders)
  • increase in intracranial pressure, e.g. with a brain tumor

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