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The retinal examination:

                                                                                                    


Indirect ophthalmoscopy - visualization of the retina with a head-lamp and handheld lens to obtain a panoramic, three-dimensional (3-D) view of the macula, optic nerve and retinal periphery.  The indirect ophthalmoscope is the instrument of choice in viewing the peripheral retina for retinal tears and detachment.  Despite its simplicity of design, it requires years of practice to gain facility as the viewed magnified image is inverted up-side-down and reversed left to right.

                                                                                                                    
And may also include:                                         

Biomicroscopy - visualization of the retina with a slit lamp and handheld or contact lens provides a 3-D view with increased magnification.

Fundus photography - provides a high power two-dimensional view and record of the posterior retina including the disc and macula.

Fluorescein angiography - fundus photography performed with the simultaneous injection of fluorescein dye into the systemic circulation highlights vascular disease and disorders in the retina, RPE and choroid.   The angiogram helps identify damaged blood vessels, the quality of blood flow through the retina, and neovascular elements - in a flat plane of two dimensions.

Ocular coherence tomography - a retinal study with computerized low intensity laser scanning of the retina provides microscopic detail of the retinal structure and orientation.  Three-dimensional OCT gives precise analysis of retinal thickness and contour through the macular region in a three second non-contact sweep.  OCT helps identify macular edema, macular holes, choroidal neovascularization and vitreo-retinal interface disturbances.

Indocyanine green (ICG) angiography - fundus photography with ICG highlights occult choroidal neovascularization with low-grade leakage.

Automated visual field testing - tests the sensitivity of central and peripheral visual perception – often to help assess the integrity of the optic nerve.

Electrophysiology - special testing of the magnitude of electrical polarization and discharge within the retina under varying levels of illumination, is especially helpful to assess abnormalities in rod and cone function.  This testing helps identify and categorize retinitis pigmentosa, cone-rod dystrophies, night blindness, retinal dystrophies and ischemia.