By Bernice Phua Rui Yi, Optometrist, International Eye Cataract Retina Centre, Singapore

Ms Ng Shu Yi, Optometrist and Clinic Manager at International Eye Cataract Retina Centre, gave a lecture on “Interpreting Fundus Photographs” at the Singapore Primary Eye Care Symposium (SPECS) 2018 held on 18-19 July at One Farrer Hotel.

Fundus photography, also known as retinal imaging, is the use of high resolution technology to capture an image of the interior of the eye. This allows detection and documentation of ocular pathology such as age-related macular degeneration (AMD), glaucoma and retinal detachment. It is important for primary eye care professionals to know how to operate the fundus camera and interpret the photographs captured since fundus photography is often part of a comprehensive eye health examination.

Ms Ng first addressed the importance of recognising a normal fundus. She highlighted that no one fundus has the same appearance as another although not all differences should raise suspicion of pathology. Variations in the appearance of an ocular fundus could be linked to an individual’s age, race or prescription. An example of such variations is the tigroid fundus typically seen in highly myopic individuals.

Ms Ng also discussed the areas to focus on when assessing fundus photographs. These include the evaluation of the optic disc, macula and retinal blood vessels which help eye care professionals identify abnormalities (eg, drusen, cotton wool spots, neovascularisation and retinal tears) that aid in detecting retinal changes and diagnosis of pathology.

Ms Ng emphasized the importance of distinguishing a normal fundus from an abnormal one, as the presence of abnormalities may be a warning sign of more serious sight-threatening pathology. Early detection of an ocular condition is ideal as it may mean early treatment and better treatment outcome. Ms Ng also cautioned against using fundus photography as a standalone test for diagnosing difficult pathology. Other tests such as optical coherence tomography (OCT) and Humphrey visual fields (HVF) can supplement the information derived from fundus photography alone and aid in more accurate diagnosis of patients.