– Ed

This is a photo of a healthy fundus of a 35 year-old. This is what the optometrist can see when doing ophthalmoscopy.

The value of an eye examination goes way beyond performing a refraction and producing a spectacle prescription. Optometrists are in the front line of primary eye care and often the first to detect ocular pathology and systemic diseases.

This is a peek into some examples of what the optometrist can see in the back of the eye. Using an ophthalmoscope, she can look through the pupil, coming very close up and focus on the fundus, which includes the retina, optic disc, macula, arteries and veins.

The fundus can tell a story about age related changes, systemic diseases and ocular pathology. Two of the more common diseases will be shown here.

Diabetic Retinopathy

Diabetic retinopathy presents with definitive changes in the retina, which are quite easy for the optometrist to pick up. This will often be the first time it is discovered that the patient has diabetes. It is obviously the diabetes that must be controlled to minimize the retinal changes. If left unchecked, the consequences can be severe.


The eye has a drainage system. When intra ocular fluid is produced quicker than it is leaving the eye, it results in a build-up of pressure and this can kill off nerve fibres, which in turn will result in visual field loss. This damage is irreversible and the patient will only become aware of this condition when it is too late. Glaucoma is sometimes referred to as “The thief in the night” because it sneaks in and steals one’s vision.

There are several other conditions that can be detected in this way, as well as using other techniques, such as fundus photography and Indirect Ophthalmoscopy. This certainly shows how important routine eye examinations are, especially in the over-forty age group when the incidence of ocular pathology escalates. It is all about the early diagnosis.


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