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This article aims to offer an overview of the technique and its advantages (and disadvantages), before then describing my experience with a new headset BIO model, the Keeler Spectra Plus.
Binocular indirect ophthalmoscopy
There are several distinct advantages offered by BIO and these have driven its rise in popularity, primarily of slit-lamp BIO. The advantages include better clarity of retinal view through media opacities. As someone who primarily sees elderly patients, the increased quality of retinal image provided by BIO is significant. The reason for this improved vision is that the incident light path and reflected light path are separate, unlike with direct ophthalmoscopy. Interestingly, indirect illumination also has the benefit of exaggerating the appearance of pigmented lesions. It is very noticeable when first moving to indirect how much easier it is to notice naevi. If one looks at a choroidal naevus using the macular stop of direct instrument, the pigmentation is clearly seen outside the area of illumination but invisible under the beam. The intensity of the light source of BIO instruments also serves to improve the resolution of lesions (something patients do not always appreciate)
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