The College of Optometrists

In some patients, it is extremely difficult or even impossible to perform direct ophthalmoscopy because the patient simply cannot tolerate it. Their eyes water profusely and as a caring practitioner, you feel bad putting them through this 'torture'.

Apart from turning the brightness down to a minimum, is there anything else you can do?

Should you push these patients as much as possible to 'grin and bear it'.

Does anyone think using a fundus camera is more appropriate in these pxs as more of the fundus will be seen, and the picture is taken before the px can react to the light.

i owuld say that if you do have access to a fundus camera then use that, but what i usually do is just give them a tissue, put the ophthalmoscope on the lowest brightness and let them take a break to wipe their eyes throughout the procedure... i know this may take longer but i feel that its in their best interests!

I tend to use a smaller stop (like macula stop)and keep it bright. A gloomy looking fundus is hard to analyse -