Name of the Procedure:

Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (e.g., retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral.

Summary

Extended ophthalmoscopy is an advanced eye examination procedure used to diagnose and evaluate serious conditions affecting the retina. This includes detailed retinal drawings and scleral depression to assess peripheral retinal diseases, such as retinal tears, retinal detachments, and retinal tumors. The examination can be performed on one or both eyes and includes a comprehensive interpretation and report of findings.

Purpose

The primary purpose of extended ophthalmoscopy is to detect and evaluate conditions affecting the peripheral retina. The goal is to identify issues like retinal tears, detachments, or tumors early, so that appropriate treatment can be administered to prevent vision loss or other complications.

Indications

Extended ophthalmoscopy is indicated for:

• Symptoms such as flashes of light, sudden floaters, or shadow in vision.
• High-risk conditions like severe myopia or a history of retinal detachment.
• Pre- or post-operative examination following eye surgery.
• Monitoring known retinal conditions.

Preparation

• Patients may be instructed to avoid driving as pupil dilation can impair vision temporarily.
• Bruising around the eye may be a common preparation for indirect ophthalmoscopy.
• It is recommended to bring any current eye medication and a list of medical history.
• No fasting is typically required.
• It is helpful if patients arrange for someone to drive them home after the procedure, due to possible vision impairment from pupil dilation.

Procedure Description

1. The patient's eyes are dilated using special eye drops.
2. A detailed examination using an indirect ophthalmoscope and a scleral depressor is performed.
3. The eye specialist (ophthalmologist) gently presses on the eye with a scleral depressor to manipulate the view of the peripheral retina.
4. Detailed retinal drawings are made to document findings.
5. The entire ocular structure is assessed, and any peripheral retinal disease is thoroughly examined.
6. Findings are interpreted and a comprehensive report is prepared.

Duration

The procedure typically takes between 30 to 60 minutes.

Setting

Extended ophthalmoscopy is usually performed in an ophthalmology clinic or specialized eye care center.

Personnel

• Ophthalmologist (eye specialist)
• Possible assistance from ophthalmic technicians or nurses

Risks and Complications

Common risks include:

• Discomfort due to scleral depression.
• Temporary blurred vision or light sensitivity. Rare complications:
• Increased intraocular pressure
• Eye infection
• Retinal detachment (rarely caused by scleral depression)

Benefits

• Early detection of retinal conditions can prevent severe vision loss.
• Accurate and detailed diagnosis aids in formulating effective treatment plans.
• Comprehensive understanding of peripheral retinal status.

Recovery

• Patients might experience temporary blurred vision and light sensitivity post-examination.
• Use sunglasses to manage light sensitivity.
• Avoid driving and operating machinery until vision returns to normal.
• Follow-up appointments might be necessary for further assessment or treatment.

Alternatives

• Standard ophthalmoscopy offers less detailed examination.
• Optical Coherence Tomography (OCT) for retinal layer imaging.
• Ultrasound B-scan if retinal visibility is obscured. Pros and cons:
• While alternatives are less invasive, they might not provide the comprehensive detail needed for specific peripheral retinal issues.

Patient Experience

• Patients may feel pressure or mild discomfort during scleral depression.
• Vision may be temporarily blurred, and sensitivity to light can persist for a few hours.
• Pain management typically involves over-the-counter pain relief if needed.
• Comfort measures include dim lighting in recovery areas and clear post-procedure instructions.