Fundus examination
In a non-dilated state, using a slit lamp with a contact lens for fundus examination, is it possible to assess the peripheral retina, or can it only evaluate the macula and optic nerve?
Pa Yan Di Wen Ti Zhe, 10~19 year old female. Ask Date: 2022/08/07
Dr. Gao Pilin reply Ophthalmology
Hello, if you are concerned about retinal issues: for peripheral examination, I will perform a dilated fundus examination.
However, if we are examining the macula and optic nerve, dilation may not be necessary.
Reply Date: 2022/08/07
More Info
In a non-dilated fundus examination using a slit lamp and a lens, the ability to assess the peripheral retina is significantly limited compared to a dilated examination. While the slit lamp can provide a detailed view of the central retina, including the macula and optic nerve head, it does not allow for a comprehensive evaluation of the peripheral retina.
When the pupil is not dilated, the aperture through which light enters the eye is much smaller, restricting the field of view. This limitation means that while some peripheral structures may be visible, the examination will primarily focus on the central areas of the retina. The peripheral retina is crucial for detecting various conditions, including retinal tears, detachments, and peripheral lesions, which are often missed during a non-dilated exam.
Dilating the pupil with pharmacological agents allows the ophthalmologist to achieve a wider field of view, enabling a thorough examination of the entire retina, including the periphery. This is particularly important for patients at risk for retinal issues, such as those with high myopia, a history of retinal detachment, or other ocular conditions.
In summary, while a non-dilated fundus examination can provide valuable information about the central retina, it is not sufficient for a complete assessment of the peripheral retina. For a comprehensive evaluation, especially in patients with risk factors for retinal pathology, dilation is recommended.
In the context of clinical practice, it is essential for ophthalmologists to communicate the limitations of non-dilated exams to patients, particularly when they present with symptoms that may indicate peripheral retinal issues. Patients should be informed that if there are concerns regarding their peripheral retina, a dilated examination may be necessary for accurate diagnosis and management.
In conclusion, while slit lamp examinations can be useful for assessing the central retina, they fall short in evaluating the peripheral retina without dilation. For a thorough assessment, especially in high-risk patients, dilation remains the gold standard.
Similar Q&A
Understanding Retinal Exams: Do Non-Dilated Checks Work?
Hello, Doctor Gao. I am a patient with floaters and I regularly undergo dilated eye examinations. I previously visited a clinic for an examination where they did not perform dilation; they only used an indirect ophthalmoscope and a flashlight. Can the retina be adequately visuali...
Dr. Gao Pilin reply Ophthalmology
Hello: Using a direct ophthalmoscope or a slit lamp with lenses, sometimes it is possible to perform an examination without dilation. As for the directions—up, down, left, right, upper left, and lower left—they do not cause any impact.[Read More] Understanding Retinal Exams: Do Non-Dilated Checks Work?
Understanding Vision Testing for Patients with No Light Perception
Hello, I am a bit curious if it is possible to detect high hyperopia in an eye that has no light perception through refraction testing. (I previously heard a doctor mention that the eye with no light perception has high hyperopia.) What is the difference between a slit lamp exami...
Dr. Gao Pilin reply Ophthalmology
Hello, Xin: 1. The absence of light perception in the eyes is not related to the ability to perform a refraction test. Refraction testing measures the eye's refractive power, and as long as the ocular structure is intact, the refractive error can be determined. 2. A slit...[Read More] Understanding Vision Testing for Patients with No Light Perception
Understanding Fundus Exams: Alternatives to Pupil Dilation and Their Benefits
I underwent laser surgery for my myopia in 1996 and have a history of floaters. Recently, I want to have a fundus examination, but I heard that dilating drops are usually required. However, there are now fundus cameras, ultra-widefield fundus imaging devices, and optical coherenc...
Dr. Gao Pilin reply Ophthalmology
Hello Candy: The dilated fundus examination is a very quick procedure that typically involves minimal discomfort, allows for clearer vision, and has a high accuracy rate for examining the peripheral retina. If the physician recommends it, you should undergo the dilated examinatio...[Read More] Understanding Fundus Exams: Alternatives to Pupil Dilation and Their Benefits
Understanding Macula Examination During Dilated Eye Exams
Hello doctor, during a dilated fundus examination, will the macula be examined?
Dr. Gao Pilin reply Ophthalmology
Hello, Aya: During a dilated fundus examination, both the macula and the peripheral retina can be assessed. At the Puzi Hospital Eye Clinic in Taiwan, the hours are Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM. Online responses are fo...[Read More] Understanding Macula Examination During Dilated Eye Exams
Related FAQ
Fundus Examination
(Ophthalmology)
Refraction Test(Ophthalmology)
Visual Acuity Test(Ophthalmology)
Retinal Tear(Ophthalmology)
Visual Field Test(Ophthalmology)
Pediatric Vision Screening(Ophthalmology)
Laser Pointer(Ophthalmology)
Pupil Dilation(Ophthalmology)
Parallax(Ophthalmology)
Post-Retinal Surgery(Ophthalmology)