Fundoscopic Findings

Mon, 09/06/2021 - 5:00am
Author: 
Valeria Chew
Editor: 
Alison Jaworski, MD

Findings in visual / eye emergencies on fundoscopic exam 

By Valeria Chew 

 

Identify:  

Optic disc - look for swelling, cupping 

Retina - hemorrhage, pallor, detachment 

Surrounding vessels - nicking, hemorrhage 

 

Normal: 


 

 

Papilledema: 

  • Associated with increased ICP 

  • Optic disc looks swollen, pale 

 

 

Central Retinal Artery Occlusion 

  • Sudden, painless vision loss 

  • Retinal edema, “cherry red spot” 


 

 

Central Retinal Vein Occlusion 

  • Sudden, painless vision loss 

  • “Blood and thunder” dilation and tortuosity of vessels, blurring of optic disc 

 

 

 

Retinal Detachment 

  • Associated with vision loss / flashers  

  • Main finding: loss of a lot of landmarks, retina looks lifted/pale 

  • Urgent opthal consult needed! 


 

 

Vitreous Hemorrhage 

  • Associated with flashers/floaters/vision loss, trauma 

  • Main finding: blood obscuring the retina 

 

 

CMV Retinitis 

  • Scintillating scotomas, “wavy” vision, decreased peripheral vision, floaters 

  • Cotton wool spot and hemorrhage, “pizza” or “cheese and ketchup” 

 

 

Referneces:

Effron D, & Forcier B.C., & Wyszynski R.E. (2021). Normal fundus. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), The Atlas of Emergency Medicine, 5e. McGraw Hill. https://accessmedicine-mhmedical-com.ezproxy.rowan.edu/content.aspx?book... 

 

Pokhrel, P. K., & Loftus, S. A. (2007). Ocular emergencies. American family physician, 76(6), 829–836.