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Let Me "write with light" . I want to play with colours ! I want to live in these moments ,forever !
      I want you to live forever , forever in the world of my photography , forever in my albums !  
    Life , it would pass in just a Flickr , then why not capture it on some film !
  When you view my snaps , you actually see various events and things by my eyes !

You are Welcome to view this world by my eyes !  You are Welcome to TSNAPS !

Saturday, June 18, 2016

Fundoscopy

Technique of Fundoscopy.


First I shall introduce myself to the patient/child and his parents.
Then tell them that i have reviewed the Chart and done physical examination and i further need to examine the eyes. Tell them that its a simple device that illuminates the inside of the eye and no pain or harm will be done to the child. Make reputation with the child and show him the light fall on his hand .
Then Instill Tropicamide eye drops for Dilatation of pupil and Atropine eye drops for Cyclopegic effect.
Sit at level with the child at 1 arm length.
Right eye of examiner for right eye of patient.
Left eye of examiner for left eye of patient.

Ask the patient to see distant object  and hold fundoscope about 1 arm length and move closer till you see the RED REFLEX. RED reflex denotes that the media of the eye from The cornea to Lens to Vitreous humor is clear . Keeping Red Reflex in focus move closer and closer to the eye till blood vessels are visible , now as one vessel is traced move Nasally where all vessels are converging , it is the Optic Disc. It is Pale to pink in colour with a greyish round margin. papilledema,  the vessels , their tortuosity if any , hemorrhages on the retina, chery red spot are observed. Papilledema has 5 grades,
grade 1 half of the disc is edematous
grade two circumferential edema of disc
grade 3 disc edema + vessels as they move away from the disc become tortuous and appear 'broken'
grade 4 vessels appear tortuous and broken just as they emerge from the disc
grade 5 no clear demarcation of the disc.



Fundoscopy may also help identify if the eye is Emmetropic, myopic, or hypermetropic.

Examine the other eye.

Write notes of the findings in the chart.
Inform parents about the findings and further steps to be taken accordingly.

Ask patient to not to drive till the effect of medicine goes away, and ask attendants to help patient walk about as he cannot see clearly.

Greet and Good bye.


CHERY RED SPOT
cherry-red spot is a finding in the macula of the eye in a variety of lipid storage disorders and in central retinal artery occlusion. It describes the appearance of a small circular choroid shape as seen through the fovea centralis Its appearance is due to a relative transparency of the macula; storage disorders cause the accumulation of storage material within the cell layers of the retina, however, the macula, which is relatively devoid of cellular layers, does not build up this material, and thus allows the eye to see through the macula to the red choroid below. 
Chery red spot may be seen in TAY SACHS disease, hurlers disease, Nieman picks diseases , CO poisoning ,  Quinine toxicity, metachromatic leukodystrophy.



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