YAMOUT OPTICAL CENTER

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he Fundus Exam

The fundus of the eye includes the retina, macula, fovea, optic disc and retinal vessels. The retina is actually part of the central nervous system. It is the surface where light rays are converted into neuronal signals which ultimately result in "vision." The following components are evaluated during a fundoscopic examination:

Optic Disc 

The small circular region in the retina where the fibers of the retinal cells converge to form the optic nerve. This area contains no light-sensitive rods or cones and is therefore called the "blind spot." The arteries and vessels also converge at the disc in a central area called the "optic cup." Intracranial disease can sometimes be detected in the optic disc. The following are evaluated when examining the optic disc:

· Color - normally yellowish-orange in color. The central cup is yellowish-white.

· Size - the central cup should be less than half the diameter of the optic disc.

· Margin - the edge of the disc should appear sharp (the nasal margin may be slightly less sharp).

Arteries and Veins

The central artery of the retina, a branch of the ophthalmic artery, sends branches from the optic disc to supply the retina. The venous branches draining the retina converge at the disc. The vessels should be smooth with no compression at the crossing of vessels. The normal light reflex on the vessels should be less that 1/4 the diameter of the vessel.

Macula

The macula is an oval area lateral to the disc used for central vision. The macular region is composed of cones (visual sensory cells sensitive in daylight and specific for color perception). The fovea is a small depression in the macula composed entirely of cones (cells responsible for color perception) and is where visual acuity is best.

Retina

The retina is composed of rods (visual sensory cells sensitive in dim light) and cones (visual sensory cells sensitive in daylight and specific for color perception). The retina should be pink to tan-purple in color and evenly pigmented. Evaluation for lesions (spots, hemorrhages, exudates, drusen) is performed during the retinal examination.