page_title: Fundus photography
section_title: Recording and interpretation
hierarchical_section_title: Fundus photography / Recording and interpretation
caption_attribution_description: Fundus photo showing focal laser surgery for diabetic retinopathy. Description: Fundus photo showing focal laser surgery for diabetic retinopathy. Credit: National Eye Institute, National Institutes of Health Ref#: EDA10
context_page_description: Fundus photography involves photographing the rear of an eye; also known as the fundus. Specialized fundus cameras consisting of an intricate microscope attached to a flash enabled camera are used in fundus photography. The main structures that can be visualized on a fundus photo are the central and peripheral retina, optic disc and macula. Fundus photography can be performed with colored filters, or with specialized dyes including fluorescein and indocyanine green.
  The models and technology of fundus photography have advanced and evolved rapidly over the last century. Since the equipment is sophisticated and challenging to manufacture to clinical standards, only a few manufacturers/brands are available in the market: Welch Allyn, Digisight, Volk, Topcon, Zeiss, Canon, Nidek, Kowa, CSO, CenterVue, and Ezer are some example of fundus camera manufacturers.
context_section_description: Fundus photographs are ocular documentation that record the appearance of a patient's retina. The photographs allow the clinician to study a patient's retina, detect retinal changes and review a patient's retinal findings with a coworker. Fundus photographs are routinely called upon in a wide variety of ophthalmic conditions.
  Fundus photography is used to inspect anomalies associated to diseases that affect the eye, and to monitor their progression. It is able to identify glaucoma and multiple sclerosis, as well as monitor disease processes such as macular degeneration, retinal neoplasms, choroid disturbances and diabetic retinopathy. Fundus photographs assist in the planning of additional management options for these irregularities. The medical necessity of fundus photography must be recorded comprehensively so that the clinician is able to compare photographs of a patient from different timelines.
  Documents of a patient's medical record must consist of a recent, relevant history, progress notes and fundus photographs depicting and supporting the relevant diagnosis. The photographs need to be labelled appropriately such as which eye, the date, and patient details.  The patient's records ought to contain documented outcomes of the fundus photography as well as a depiction of variations from previous photographs. They should contain an interpretation of those results and the relevant changes it could have on treatment plan.  Fundus photographs without an interpretation are seen as obsolete. The records should be legible, and contain suitable patient information and clinician details.
  The interpretation of fundus photographs that are glaucomatous must contain a description of the vertical and horizontal cup to disc ratio, vessel pattern, diffuse or focal pallor, asymmetry and development of the above factors. The retinal nerve fibre layer should also be studied and commented on.
  It is also a useful tool in objectively measuring torsion as well as in documenting and recording progression of diseases over time. Fundus photography does not replace binocular indirect ophthalmoscopy; it is a tool to supplement and complement existing findings and to maintain a record of disease progression. Fundus photography is mainly used to monitor the progression of a retinal or optic nerve head disorder. It is also good for providing photo documentation for the continuum of care and to monitor the patient's ocular condition.
caption: Fundus photography is also used to document the characteristics of diabetic retinopathy such as macular edema and microaneurysms. This is because retinal details may be easier to visualize in fundus photographs as opposed to with direct examination.
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