Direct ophthalmoscopy, or fundoscopy, is used to assess concerns related to the retina, macula, optic nerve, or vasculature of the eye. In most cases, eye concerns in the primary care setting present with sufficient signs and symptoms (by history and physical exam) to guide clinical decision-making without the reliance on the results of the fundoscopic exam to determine the need for referral to ophthalmology. Signs, symptoms, and/or history that are concerning for serious eye disease or increased intracranial or IOP should be urgently referred.
RESOURCES
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- American Association for Pediatric Ophthalmology and Strabismus. (2019). Five things physicians and patients should question. Retrieved from http://www.choosingwisely.org/societies/american-association-for-pediatric-ophthalmology-and-strabismus
- American Diabetes Association (2022). 12. Retinopathy, Neuropathy, and Foot Care: Standards of Medical Care in Diabetes—2022. Diabetes Care. https://doi.org/10.2337/dc22-S012
- American Optometric Association Evidence-Based Optometry Guideline Development Group. (2015). Evidence-based clinical practice guideline—Comprehensive adult eye and vision examination. Retrieved from http://aoa.uber flip.com/i/578152-aoa-clinical-practice-guidelines-adult-eye-exam
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- U.S. Preventive Services Task Force. (2022). Primary open-angle glaucoma: Screening. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/primary-open-angle-glaucoma-screening
- U.S. Preventive Services Task Force. (2022). Impaired visual acuity in older adults: Screening. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/impaired-visual-acuity-screening-older-adults
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