Fundoscopy Simulator

Slit-lamp indirect biomicroscopy of a dilated fundus, on the same 3D slit lamp and the same patient as the anterior-segment simulator. A hand-held condensing lens is held in front of the eye; it forms a real, inverted aerial image of the retina about a focal length in front of itself, and the microscope is focused on that image rather than on the eye — which is why the view is upside down and back to front, and why beginners cannot find it.

What you practise

  • Finding and focusing the aerial image: lens working distance, then the joystick pulled back onto the image
  • Tilting the lens a few degrees to throw the lens and corneal reflexes out of the central field
  • Keeping the beam through the pupil instead of clipping it on the iris
  • Centring the lens so the field is not vignetted in one ocular
  • Nine fixation targets — a systematic sweep of disc, vessels, macula and periphery
  • Choosing the lens: a +90 D for a dilated-pupil overview, a +78 D as the general-purpose compromise, a +60 D for magnified disc and macula detail

A written fundus examination guide runs beneath the simulator: how the optics work, preparing and dilating the patient, beating the reflexes, examining each structure in turn, which lens suits which purpose, and how to document a fundus exam.

A free OcuLearning account is needed to open the simulator.

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