185:: A group of eye diseases that can cause vision loss due to damage to the optic nerve, generally from increased intraocular pressure. Changes on ophthalmologic exam include deepening and enlargement of the optic cup (leading to a high cup/disc ratio), a more vertical oval optic cup shape, pallor of the disc, and an increase in the blood vessels within the optic nerve on the nasal side of the disc. Other disc findings may include notching of the disc, or flame/splinter hemorrhages, which are located in the outer nerve layer.
140:(0.5% or 1%). While phenylephrine stimulates receptors that contract the dilator muscle of the pupil, tropicamide blocks stimulation of the pupillary sphincter muscle to allow for relaxation. As the insertion of these drops may cause some stinging or burning, some practitioners choose to first insert a drop of topical anesthetic to numb the eye. Pupil dilation typically begins within 15 minutes and may last for 3–8 hours.
29:
191:: An often age-related condition that leads to gradual vision loss secondary to clouding of the lens. Examination may reveal opacification of the lens and often an absent or blunted red reflex. Dilated fundus exam allows for examination of more peripheral cataracts, as well as evaluating candidacy for cataract surgery.
215:
The
American Academy of Ophthalmology recommends comprehensive eye examinations, including dilated fundus examination, for asymptomatic patients without risk factors for eye disease at varying frequencies based on age: every 5–10 years in adults under 40 years, every 2–4 years in adults aged 40 to 54
239:
For individuals at risk of developing glaucoma, the
American Academy of Ophthalmology recommends screening every 2–5 years in adults under 40 years, every 1–3 years in adults aged 40 to 54 years, every 1–2 years in adults aged 55 to 64 years, and every 1 to 2 years in adults aged 65 years and older.
260:
A child will continue to be screened for vision issues, as well as normal eye alignment and movement, at regular intervals during their well child exams; if they fail a vision test or findings are inconclusive, the child can be referred for a more comprehensive eye examination including dilation. A
231:
should have their first comprehensive eye examination at the time of diagnosis, followed by yearly exams. Women with type 1 or type 2 diabetes who are planning a pregnancy should have a comprehensive eye examination prior to conception as well as early in the first trimester; women with
147:, also known as the optic nerve head, and retina to better evaluate for any ophthalmic pathology. Evaluation of the optic disc may include noting the color of the disc, the sharpness of the disc outline and if any swelling is present, and signs of an enlarged or bulging
162:
Following a dilated fundus examination, patients may experience blurred vision and light sensitivity until the effects of the mydriatic eye drops wear off; for this reason, the use of sunglasses is recommended to prevent damage to the eyes while dilated.
179:, dot and blot hemorrhages, and neovascularization. Dilated fundus exam is the preferred method of diagnosis, as undilated exam may be too limited to visualize lesions or neovascularization that are more peripheral.
197:: A common cause of central vision loss; early diagnosis via ophthalmologic examination may facilitate slower disease progression. The examiner will evaluate the macula for deposits of cellular debris called
248:
A child's first vision screening is typically done shortly after birth during the newborn exam, during which a pediatrician will perform simple vision testing such as assessing pupillary response and a
108:, and other important features. DFE has been found to be a more effective method for evaluating eye health when compared to non-dilated examination, and is the best method of evaluating
216:
years, every 1–3 years in adults aged 55 to 64 years, and every 1 to 2 years in adults aged 65 years and older. However, routine DFE is relatively low yield for asymptomatic patients.
240:
Screenings may be recommended even more frequently for individuals of
African or Hispanic/Latino descent, as these ethnic groups have a further increased risk of developing glaucoma.
253:. However, if an infant is premature (gestational age under 32 weeks) or has a low birth weight (less than 1500 g) a dilated fundus examination is indicated due to risk of
1423:
314:
History or suspicion of cerebrovascular or neurologic disease (head injury, coma, etc.) due to the need for continual reassessment of pupillary reactions
1428:
1629:
1023:
1312:
1559:
1552:
461:
1382:
1262:
1768:
1205:
602:
570:
201:, in particular their size, number, and distribution, as well as pigmentary changes, atrophy, and hemorrhage, among other signs.
151:, the central depression in the optic disc. Evaluation of the retina includes examining the arteries and veins for narrowing or
143:
After the pupil has been dilated, an ophthalmoscope can be used to examine the fundus. This allows for 15x magnification of the
1180:
534:
486:
175:: A complication of diabetes mellitus that progressively damages the retina. Examination findings may include microaneurysms,
1661:
1456:
265:
more accurately than a non-dilated exam, as children tend to accommodate well; this allows for a more accurate prescription.
1619:
1614:
1446:
273:
1624:
1503:
1473:
1377:
1016:
109:
718:
304:
A dilated fundus examination is typically contraindicated in situations where mydriatic eye drops are contraindicated.
1252:
1075:
358:
227:
should have their first comprehensive eye examination 5 years after diagnosis, followed by yearly exams. Those with
1651:
1225:
1048:
254:
1747:
1307:
1242:
1097:
1542:
1742:
593:
Bickley, Lynn; Szilagyi, Peter; Hoffman, Richard; Soriano, Rainier; Bates, Barbara (2023). "Chapter 12: Eyes".
417:"Comparison of the effectiveness of a nondilated versus dilated fundus examination in the pediatric population"
510:
1604:
1451:
1413:
1247:
1185:
1009:
1483:
1461:
1347:
1292:
148:
1701:
1666:
1589:
1137:
891:"National consensus statement regarding pediatric eye examination, refraction, and amblyopia management"
832:
152:
889:
Saxena, Rohit; Sharma, Pradeep; Gopal, Santhan; Pediatric
Ophthalmology Expert Group (February 2020).
851:
268:
Finally, children with certain medical conditions that place them at a higher risk for eye pathology (
1773:
1215:
280:) require comprehensive eye examinations with dilation. Similarly, children with a family history of
233:
220:
194:
172:
1726:
1599:
1532:
1408:
1317:
293:
1609:
1594:
1579:
1547:
1165:
156:
77:
1716:
1706:
1257:
1220:
1156:
1033:
987:
969:
930:
912:
871:
808:
759:
700:
659:
641:
598:
566:
436:
428:
397:
389:
277:
176:
1686:
1584:
1372:
1362:
1297:
1272:
1114:
977:
961:
920:
902:
863:
798:
790:
749:
690:
649:
631:
376:
Siegel, B. S.; Thompson, A. K.; Yolton, D. P.; Reinke, A. R.; Yolton, R. L. (January 1990).
262:
1641:
1569:
1508:
1498:
1392:
1302:
1235:
1195:
1129:
1109:
1104:
1065:
1001:
228:
224:
121:
113:
1691:
1478:
1418:
1387:
1352:
1210:
1092:
982:
949:
925:
890:
803:
778:
654:
619:
289:
93:
28:
155:, as well as detecting any lesions, exudates, retinal hemorrhages, microaneurysms, or
1762:
1282:
1190:
1175:
1058:
269:
133:
678:
1342:
1142:
1119:
105:
85:
1696:
1656:
1287:
1053:
794:
137:
117:
754:
737:
695:
1681:
1676:
1518:
1513:
1488:
867:
285:
261:
dilated fundus examination will allow for an ophthalmologist to calculate the
250:
144:
101:
973:
916:
875:
763:
704:
645:
432:
393:
1466:
1200:
281:
89:
70:
66:
991:
965:
934:
907:
812:
663:
378:"A comparison of diagnostic outcomes with and without pupillary dilatation"
948:
Liew, Gerald; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Yin (2006-01-07).
440:
416:
401:
377:
296:
or glaucoma may also require more frequent or comprehensive examinations.
1493:
636:
188:
182:
73:
736:
Thomas, Catherine J.; Mirza, Rukhsana G.; Gill, Manjot K. (2021-05-01).
1322:
39:
1084:
328:
Closed-angle glaucoma, as this may rarely precipitate an acute attack
198:
97:
236:
do not require screening for diabetic retinopathy during pregnancy.
679:"The role of dilated fundus examination following cataract surgery"
1230:
81:
96:
to view the eye's interior, which makes it easier to assess the
1005:
677:
Tan, Colin S.; Lim, Louis W.; Ting, Dominic S. (January 2019).
219:
In contrast, individuals with diabetes mellitus are at risk of
1037:
223:
and therefore require more frequent screening. Those with
779:"How frequently should asymptomatic patients be dilated?"
415:
Parisi, M. L.; Scheiman, M.; Coulter, R. S. (May 1996).
595:
Bates' Guide To
Physical Examination and History Taking
620:"Laser Treatment Modalities for Diabetic Retinopathy"
462:"Comprehensive Adult Medical Eye Evaluation PPP 2020"
723:
National
Institute of Health: National Eye Institute
363:
National
Institute of Health: National Eye Institute
132:
The most common agents used to dilate the pupil are
1735:
1715:
1640:
1568:
1531:
1439:
1401:
1361:
1333:
1271:
1164:
1155:
1128:
1083:
1074:
48:
38:
33:
Dilated pupil of an eye, measuring 9 mm in diameter
21:
618:Pande, Gauri S; Tidake, Pravin (October 2022).
563:Sapira's Art & Science of Bedside Diagnosis
535:"Label: Mydriacyl- tropicamide solution/drops"
421:Journal of the American Optometric Association
382:Journal of the American Optometric Association
167:Common conditions diagnosed during examination
1017:
597:(13 ed.). Philadelphia: Wolters Kluwer.
487:"Eye Health: Optometrist vs. Ophthalmologist"
8:
565:(5 ed.). Philadelphia: Wolters Kluwer.
539:DailyMed - NIH National Library of Medicine
92:. Once the pupil is dilated, examiners use
1424:Descemet membrane endothelial keratoplasty
1161:
1080:
1024:
1010:
1002:
683:Journal of Cataract and Refractive Surgery
136:(2.5% in pediatrics or 10% in adults) and
52:Obtain a better view of the fundus of eye.
27:
981:
950:"Fundoscopy: to dilate or not to dilate?"
924:
906:
802:
753:
694:
653:
635:
16:Method of viewing the interior of the eye
1630:Optical coherence tomography angiography
850:Promelle, V.; Milazzo, S. (2017-05-01).
84:in order to obtain a better view of the
1429:Pre-Descemet's endothelial keratoplasty
511:"Highlights of Prescribing Information"
347:
1313:Manual small incision cataract surgery
18:
1560:Botulinum toxin therapy of strabismus
1553:Minimally invasive strabismus surgery
826:
824:
822:
7:
1248:Phakic intraocular lens implantation
719:"Cataracts | National Eye Institute"
588:
586:
584:
582:
561:Orient, Jane (2018). "10: The Eye".
556:
554:
552:
550:
548:
529:
527:
505:
503:
456:
454:
452:
450:
353:
351:
1383:Minimally invasive glaucoma surgery
317:Iris clip intraocular lens implants
738:"Age-Related Macular Degeneration"
322:Relative contraindications include
308:Absolute contraindications include
14:
1206:Intrastromal corneal ring segment
837:American Academy of Ophthalmology
466:American Academy of Ophthalmology
856:Journal Français d'Ophtalmologie
742:Medical Clinics of North America
195:Age-related macular degeneration
112:. It is frequently performed by
44:Dilated-pupil fundus examination
1181:Automated lamellar keratoplasty
895:Indian Journal of Ophthalmology
1662:Bagolini Striated Glasses Test
1457:Corneal collagen cross-linking
1:
1620:Indocyanine green angiography
1615:Heidelberg Retinal Tomography
1447:Anterior chamber paracentesis
494:American Diabetes Association
274:juvenile idiopathic arthritis
1625:Optical coherence tomography
1504:Phototherapeutic keratectomy
1378:Excimer laser trabeculostomy
833:"Eye Screening for Children"
1253:Photorefractive keratectomy
954:BMJ (Clinical Research Ed.)
852:"Rétinopathie du prématuré"
795:10.1016/j.optom.2013.03.001
1790:
1672:Dilated fundus examination
1652:A-scan ultrasound biometry
1226:Laser thermal keratoplasty
1049:Anesthesia for eye surgery
831:Gudgel, Dan (March 2021).
755:10.1016/j.mcna.2021.01.003
696:10.1016/j.jcrs.2018.09.031
255:retinopathy of prematurity
110:structures behind the iris
59:Dilated fundus examination
22:Dilated fundus examination
1409:Whole eye transplantation
1308:Intraocular lens scaffold
1243:Limbal relaxing incisions
1098:East Asian blepharoplasty
1044:
868:10.1016/j.jfo.2016.12.013
26:
1769:Diagnostic ophthalmology
359:"Get a Dilated Eye Exam"
1605:Fluorescein angiography
1452:Boston keratoprosthesis
1414:Corneal transplantation
1186:Conductive keratoplasty
1484:Intravitreal injection
1348:Laser photocoagulation
1293:Glued intraocular lens
966:10.1136/bmj.332.7532.3
908:10.4103/ijo.IJO_471_19
1702:Slit-lamp examination
1667:Color perception test
1590:Electronystagmography
1138:Dacryocystorhinostomy
777:Varner, Paul (2014).
153:arteriovenous nicking
1543:Harada–Ito procedure
1216:Laser blended vision
783:Journal of Optometry
637:10.7759/cureus.30024
294:congenital cataracts
234:gestational diabetes
221:diabetic retinopathy
206:Screening guidelines
173:Diabetic Retinopathy
67:diagnostic procedure
1727:Plaque radiotherapy
1600:Electroretinography
1318:Phacoemulsification
1610:Fundus photography
1595:Electrooculography
1580:Corneal topography
1548:Strabismus surgery
157:neovascularization
1756:
1755:
1707:Visual field test
1527:
1526:
1258:Radial keratotomy
1221:Laser eye surgery
1151:
1150:
744:. Ophthalmology.
300:Contraindications
278:neurofibromatosis
177:cotton wool spots
56:
55:
1781:
1687:Ocular tonometry
1585:Electrodiagnosis
1373:Cyclodestruction
1298:Hydrodelineation
1162:
1115:Hughes procedure
1081:
1026:
1019:
1012:
1003:
996:
995:
985:
945:
939:
938:
928:
910:
886:
880:
879:
847:
841:
840:
828:
817:
816:
806:
774:
768:
767:
757:
733:
727:
726:
715:
709:
708:
698:
674:
668:
667:
657:
639:
615:
609:
608:
590:
577:
576:
558:
543:
542:
541:. February 2023.
531:
522:
521:
515:
507:
498:
497:
491:
483:
477:
476:
474:
473:
458:
445:
444:
412:
406:
405:
373:
367:
366:
355:
331:Anterior uveitis
263:refractive error
114:ophthalmologists
102:optic nerve head
31:
19:
1789:
1788:
1784:
1783:
1782:
1780:
1779:
1778:
1759:
1758:
1757:
1752:
1731:
1718:
1711:
1643:
1636:
1571:
1564:
1534:
1523:
1499:Photodisruption
1435:
1402:Transplantation
1397:
1393:Trabeculoplasty
1364:
1357:
1335:
1329:
1303:Hydrodissection
1274:
1267:
1236:Contoura Vision
1196:Epikeratophakia
1167:
1147:
1130:Lacrimal system
1124:
1110:Eyelid revision
1105:Epicanthoplasty
1070:
1066:Eye examination
1040:
1030:
1000:
999:
947:
946:
942:
888:
887:
883:
849:
848:
844:
830:
829:
820:
776:
775:
771:
735:
734:
730:
717:
716:
712:
676:
675:
671:
617:
616:
612:
605:
592:
591:
580:
573:
560:
559:
546:
533:
532:
525:
520:. January 2015.
513:
509:
508:
501:
489:
485:
484:
480:
471:
469:
460:
459:
448:
414:
413:
409:
375:
374:
370:
357:
356:
349:
344:
302:
246:
229:type 2 diabetes
225:type 1 diabetes
213:
208:
169:
130:
122:eye examination
80:or enlarge the
34:
17:
12:
11:
5:
1787:
1785:
1777:
1776:
1771:
1761:
1760:
1754:
1753:
1751:
1750:
1748:Cryoextraction
1745:
1739:
1737:
1733:
1732:
1730:
1729:
1723:
1721:
1713:
1712:
1710:
1709:
1704:
1699:
1694:
1692:Ophthalmoscopy
1689:
1684:
1679:
1674:
1669:
1664:
1659:
1654:
1648:
1646:
1638:
1637:
1635:
1634:
1633:
1632:
1622:
1617:
1612:
1607:
1602:
1597:
1592:
1587:
1582:
1576:
1574:
1566:
1565:
1563:
1562:
1557:
1556:
1555:
1545:
1539:
1537:
1529:
1528:
1525:
1524:
1522:
1521:
1516:
1511:
1506:
1501:
1496:
1491:
1486:
1481:
1479:Gundersen flap
1476:
1471:
1470:
1469:
1459:
1454:
1449:
1443:
1441:
1437:
1436:
1434:
1433:
1432:
1431:
1426:
1421:
1419:Corneal button
1411:
1405:
1403:
1399:
1398:
1396:
1395:
1390:
1388:Trabeculectomy
1385:
1380:
1375:
1369:
1367:
1359:
1358:
1356:
1355:
1353:Scleral buckle
1350:
1345:
1339:
1337:
1331:
1330:
1328:
1327:
1326:
1325:
1315:
1310:
1305:
1300:
1295:
1290:
1285:
1279:
1277:
1269:
1268:
1266:
1265:
1260:
1255:
1250:
1245:
1240:
1239:
1238:
1228:
1223:
1218:
1213:
1211:Keratomileusis
1208:
1203:
1198:
1193:
1188:
1183:
1178:
1172:
1170:
1159:
1153:
1152:
1149:
1148:
1146:
1145:
1140:
1134:
1132:
1126:
1125:
1123:
1122:
1117:
1112:
1107:
1102:
1101:
1100:
1093:Blepharoplasty
1089:
1087:
1078:
1072:
1071:
1069:
1068:
1063:
1062:
1061:
1051:
1045:
1042:
1041:
1036:involving the
1031:
1029:
1028:
1021:
1014:
1006:
998:
997:
940:
901:(2): 325–332.
881:
862:(5): 430–437.
842:
818:
769:
748:(3): 473–491.
728:
725:. August 2023.
710:
669:
630:(10): e30024.
610:
603:
578:
571:
544:
523:
499:
478:
446:
427:(5): 266–272.
407:
368:
346:
345:
343:
340:
339:
338:
335:
332:
329:
319:
318:
315:
301:
298:
290:retinoblastoma
245:
242:
212:
209:
207:
204:
203:
202:
192:
186:
180:
168:
165:
129:
126:
120:as part of an
94:ophthalmoscopy
54:
53:
50:
46:
45:
42:
36:
35:
32:
24:
23:
15:
13:
10:
9:
6:
4:
3:
2:
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1407:
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1404:
1400:
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1368:
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1324:
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1314:
1311:
1309:
1306:
1304:
1301:
1299:
1296:
1294:
1291:
1289:
1286:
1284:
1283:Capsulorhexis
1281:
1280:
1278:
1276:
1270:
1264:
1261:
1259:
1256:
1254:
1251:
1249:
1246:
1244:
1241:
1237:
1234:
1233:
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1229:
1227:
1224:
1222:
1219:
1217:
1214:
1212:
1209:
1207:
1204:
1202:
1199:
1197:
1194:
1192:
1191:Corneal inlay
1189:
1187:
1184:
1182:
1179:
1177:
1176:Alpins method
1174:
1173:
1171:
1169:
1163:
1160:
1158:
1154:
1144:
1141:
1139:
1136:
1135:
1133:
1131:
1127:
1121:
1118:
1116:
1113:
1111:
1108:
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1774:Human pupil
1697:Retinoscopy
1657:Amsler grid
1644:examination
1533:Extraocular
1462:Enucleation
1288:Capsulotomy
1054:Eye surgery
960:(7532): 3.
365:. May 2021.
138:tropicamide
128:Examination
1763:Categories
1682:Gonioscopy
1677:Funduscopy
1519:Vitrectomy
1514:Sclerotomy
1489:Iridectomy
1166:Refractive
1034:procedures
1032:Tests and
689:(1): 113.
472:2023-11-02
342:References
286:strabismus
251:red reflex
244:Pediatrics
145:optic disc
69:that uses
1717:Radiation
1509:Pterygium
1467:Conformer
1201:Epi-LASIK
974:1756-1833
917:0301-4738
876:0181-5512
764:0025-7125
705:0886-3350
646:2168-8184
433:0003-0244
394:0003-0244
334:Pregnancy
282:amblyopia
189:Cataracts
149:optic cup
74:eye drops
71:mydriatic
1743:Couching
1494:Peritomy
1363:Glaucoma
1273:Cataract
992:16399709
935:31957721
813:24646902
664:36348830
183:Glaucoma
40:Synonyms
1736:History
1719:therapy
1572:imaging
1570:Medical
1535:muscles
1365:surgery
1336:surgery
1334:Retinal
1323:Prechop
1275:surgery
1168:surgery
1085:Eyelids
983:1325111
926:7003594
804:3938739
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211:Adults
199:drusen
98:retina
86:fundus
78:dilate
1440:Other
1263:SMILE
1231:LASIK
1157:Globe
514:(PDF)
490:(PDF)
82:pupil
1038:eyes
988:PMID
970:ISSN
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437:PMID
429:ISSN
398:PMID
390:ISSN
116:and
1642:Eye
978:PMC
962:doi
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903:doi
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799:PMC
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691:doi
650:PMC
632:doi
518:FDA
90:eye
76:to
63:DFE
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
