Bought a 20D lens to practice. Is it pretty much useless without indirect?

[gregoryhouse]

Hey guys, so I bought a 20D lens to practice with since I don't have that much experience doing eye exams. I came across some videos like these, , and thought that I could get some practice using my phone and the lens to look at the retina but so far I have had absolutely zero luck. I am not sure if I just have no idea what I'm doing or what. Is it impossible to use an indirect lens without dilating the eyes? That is the only thing I can imagine is happening right now, I figured it would be more difficult to exam the eye without dilation but I can't even get a red reflex let alone a glimpse of the retina.

Do you guys have tips or tricks I can use to practice with my lens. Or any ideas what I'm doing wrong that I can't get the same results as those videos? Should I quit trying to get into ophthalmology since I can't even find a retina with my lens lol. Help me guys please.

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[orbitsurgMD]

Not necessarily. You can use a muscle lamp to make a coaxial beam, placing its light pipe at a point between our eyes in line with your view path, and then converge, a little trick from some visiting Russian doctors. It isn't as easy as an indirect, though. And a 20D is a great magnifier for penlight exams of the anterior segment.

 

[Quaero]

Have you tried using your phone as a light source? You can also use the video function to practice and review your findings afterward. It is difficult to visualize the fundus but not impossible with an undilated eye. Look up how to do indirect ophthalmoscopy (you are probably placing the lens way too close).

 

[100D]

I think for someone without any experience in ophthalmoscopy, you really need to be working with dilated eyes. It's hard enough for experienced ophthalmologists to do indirect ophthalmoscopy through an undilated pupil, and I would say close to impossible to have a meaningful exam using the muscle light and iPhone techniques if the eye is undilated. If you are a medical student, bring your 20 to the retina clinic and see if you can work the indirect on dilated patients, with the residents/fellows/attendings guiding you.

 

[Shamsports]

I find it pretty much impossible to do indirect ophthalmoscopy with a penlight or smartphone on an undilated pupil.

Assuming the patient's pupil is dilated, you can do monocular indirect ophthalmoscopy with a penlight. Simply, close one of your own eyes and put the penlight paraxial to your open eye.

 

[DrZeke]

I find it pretty much impossible to do indirect ophthalmoscopy with a penlight or smartphone on an undilated pupil.

Assuming the patient's pupil is dilated, you can do monocular indirect ophthalmoscopy with a penlight. Simply, close one of your own eyes and put the penlight paraxial to your open eye.

Yes this works well. It's what they learn to do in some vet school. At least this is what my girlfriend, a veterinarian, told me.


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