Getting ahead in fundoscopy with Heine Sigma 250

I am old enough to remember headset indirect ophthalmoscopy technique being an integral part of the undergraduate clinical skills training in optometry.

It is true the technique is not widely used in general primary care practice these days and this may be for a number of reasons. Attempting fundoscopy without dilation is not a good idea. Also, the patients under examination (often very young) are never grateful for the blast of light you hit them with while asking them to look to their extremes, often while poking them with an indenter.

But lack of practice and patients’ transient discomfort should not obscure the advantages of this technique. With suitable viewing lenses (mine are seen along with the indenter in Figure 1, the higher dioptric lens offering excellent peripheral field possibilities) and good dilation, a large swathe of far peripheral retina is visible in one view.