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Fundoscopy

Fundoscopy (dilated fundus examination) — direct examination of the retina, optic nerve, and ocular blood vessels.

A basic dilated eye examination in which the retina, macula, optic nerve head, and ocular blood vessels are evaluated using specialized instruments after the pupil has been dilated with eye drops.

Indication

  • Screening and follow-up of retinal changes (retinopathy) related to diabetes and hypertension
  • Complaints of vision loss, flashes of light, floaters, or shadows in the visual field
  • Screening in individuals with a family history of glaucoma, macular degeneration, or retinal disease
  • Optic nerve examination as part of a neurological evaluation for migraine, headache, or dizziness
  • Assessment of the risk of retinal tear or detachment in individuals with high myopia
  • Examination of the retina and posterior segment after eye trauma
  • Screening for retinopathy of prematurity (ROP) in premature newborns

Preparation

  • Pupil-dilating (mydriatic) drops are instilled; 20-40 minutes is needed for full effect
  • If you wear contact lenses, you will be asked to remove them before the examination
  • Bringing sunglasses with you is recommended; your eyes will be sensitive to light after the examination
  • Driving is not advisable as near vision will be blurred after the drops; having a companion with you is helpful
  • If you have a history of allergy to mydriatic drops or narrow-angle glaucoma, please inform your physician

How it's performed

  1. The examination begins after the pupil is sufficiently dilated with the drops
  2. The fundus is examined using a direct ophthalmoscope, an indirect ophthalmoscope, or a slit lamp with special lenses
  3. Using a bright light source, the physician evaluates the central retina (macula), peripheral retina, optic nerve, and blood vessels
  4. You will be asked to look in different directions in turn; this allows the peripheral parts of the retina to be visualized
  5. The procedure is generally painless; temporary discomfort with light and tearing may occur
  6. When needed, additional examinations such as fundus photography, OCT, or fluorescein angiography are planned

Post-procedure

  • Blurred near vision and light sensitivity due to the drops last about 4-6 hours; this duration may vary from person to person
  • It is recommended that you do not drive for several hours after the procedure and wear sunglasses outdoors
  • Depending on the findings, routine annual follow-up, more frequent monitoring, or additional tests (OCT, angiography) may be planned
  • Control of systemic conditions such as diabetes and hypertension is important for the health of the fundus
  • If you experience sudden vision loss, pain, or flashes of light, you must seek care without delay even after the examination

Risks

  • Blurred vision, light sensitivity, and temporary difficulty with near reading lasting 4-6 hours after the drops
  • Rare allergic reaction (redness, itching, stinging in the eye)
  • In previously undiagnosed narrow-angle glaucoma, risk of an attack-related rise in intraocular pressure (minimized by appropriate evaluation)
  • Transient headache, dry mouth, and mild palpitations (rare, related to systemic effects of the drops)

FAQ

How long will my vision be blurred after the drops are instilled?

Blurred vision and light sensitivity after pupil-dilating drops generally last 4-6 hours; in some people this duration may be a little longer. During this time it is recommended that you do not drive and wear sunglasses outdoors.

Is the fundus examination painful?

No, fundoscopy is a painless examination. Due to the bright light source during the procedure, you may experience temporary discomfort, tearing, and light sensitivity in the eyes; however, no pain is felt.

I am pregnant; will the dilation drops harm me?

In general, pupil-dilating drops are mostly considered safe during pregnancy and breastfeeding because only a limited amount is absorbed; however, especially during the first trimester and breastfeeding, you must inform your physician of your situation. The physician will decide based on the benefit-risk balance.

I have diabetes; how often should I have a fundus examination?

The general recommendation for people with diabetes is to have at least one fundus examination per year; the interval may be planned more frequently depending on existing retinopathy, blood sugar control, pregnancy, and the duration of the disease. The frequency is determined for you by your physician.