6
6. Rest the left hand on the patient’s forehead and hold the
upper lid of the eye near the eyelashes with the thumb.
While the patient holds his fixation on the specified object,
keep the “reflex” in view and slowly move toward the
patient. The optic disc should come into view when you are
about 1
1
/
2
to 2 inches (3-5cm) from the patient.
If it is not focused clearly, rotate lenses into the aperture
with your index finger until the optic disc is as clearly visible
as possible. The hyperopic,
or far-sighted, eye requires more “plus” (black numbers)
sphere for clear focus of the fundus; the myopic, or near-
sighted, eye requires “minus” (red numbers) sphere for
clear focus.
7. Now examine the
disc for clarity of
outline, color,
elevation and
condition of the
vessels. Follow
each vessel as far
to the periphery as
you can. To locate
the macula, focus
on the disc, then
move the light
approximately 2
disc diameters
temporally. You
may also have the
patient look at the
light of the ophthal-
moscope, which will
automatically place
the macula in full
view. Examine for
abnormalities in the
macula area. The
red-free filter facilitates viewing of the center of the macula,
or the fovea.
• Ophth Broch ForeignWorking.2 4/26/99 1:02 PM Page 6
