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How to Conduct an Ophthalmologic Examination

with the PanOptic

Ophthalmoscope

1. Take the PanOptic ophthalmoscope in your right hand with the

Practioner’s Side facing you and place your thumb on the Focusing

Wheel. Hold the instrument up to your right eye and look through

the eyepiece. By rotating the Focusing Wheel with your thumb,

focus the instrument on an object approximately 20 feet away.

2. Set the Aperture/Filter Dial to the small spot (green line).

3. Dim the room lights. Instruct the patient to look straight ahead

at a distant object.

4. Hold the PanOptic up to your eye and position the ophthalmo-

scope about 6 inches (15cm) in front and at a slight angle (15 to

20 degrees) on the temporal side of the patient. Direct the light

beam into the pupil. A red “reflex” should appear as you look

through the pupil.

5. Rest your left hand on the patient’s forehead and hold the upper

lid of the eye near the eyelashes with your thumb. While the patient

is fixating on the specified object, keep the red “reflex” in view and

slowly move toward the patient. Follow the red reflex into the pupil

until the PanOptic eyecup rests on the orbit of the patient’s eye. The

trip from 6 inches away to making contact must be one that is slow,

deliberate, and steady.

The optic disc should come into view when you are about 1 to 2 inches (3-5cm)

from the patient. Gentle compression of the eyecup will maximize the field of view.

If the optic disc is not focused clearly, rotate the Dynamic Focusing Wheel with

your thumb until the optic disc is as clearly visible as possible. The hyperopic,

or far-sighted, eye requires more “plus” (rotation towards green) focus for

clear focus of the fundus; the myopic, or near-sighted, eye requires “minus”

(rotation towards red) focus for clear focus.

If you lose the view of the optic disc while approaching the patient’s eye, pull

back slowly, relocate the red reflex, and try again.

6. Now examine the disc for clarity of outline, color, elevation and condition

of the vessels. Follow each vessel as far to the periphery as you can.

7. To view the macula, instruct your patient to look directly into the light of

the ophthalmoscope. This will automatically place the macula in full view. An

alternative technique is to have your patient fixate straight ahead. Attain the

red reflex from a 15º angle at 6 inches away from the patient’s eye. When the

PanOptic is 3 inches from contact, instruct the patient to look into the light

while the patient is still facing straight ahead. Continue moving towards the

patient until the eyecup reaches the orbit of the patient.

Look for abnormalities in the macula area. The red-free filter facilitates

viewing of the center of the macula.

8. To examine the extreme periphery, instruct the patient to fixate straight

ahead while performing the examination. Pivot around the eye by leveraging

the eyecup against the orbit of the patient’s eye to achieve the desired view. It

is important to compress the eyecup to maximize this technique. Without full

compression, the chances of losing your view increase significantly.

This routine will reveal almost any abnormality that occurs in the fundus.

9. To examine the left eye, repeat the procedure outlined above.

ADDITIONAL EXAMS WITH

THE PANOPTIC

OPHTHALMOSCOPE

To look for abrasions and foreign bodies

on the cornea with the corneal viewing

lens, no contact is made between the

ophthalmoscope and the patient.

Begin the exam about 6 inches from the

patient with the focus wheel in the neu-

tral position.

Look through the scope at the patient’s

cornea to direct the light at the target area.

Adjust the focus wheel into the green

(plus) diopters while moving slightly in

(closer) or out (further) until a comfort-

able working distance and magnification

of the cornea is achieved.

The following steps will help the practitioner obtain satisfactory results with the PanOptic Ophthalmoscope:

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