Fundus photography

Overview

Fundus photography is a test that takes detailed pictures of the back of your eye, called the fundus. This includes the retina, optic nerve, and blood vessels. The pictures help your eye doctor check for eye diseases like diabetic retinopathy or glaucoma, and monitor changes over time.

Fundus photography is a very common test in eye clinics. It is often done as part of a routine eye exam or to monitor eye conditions.

Anyone can have a fundus photograph taken, especially people with diabetes, high blood pressure, or a family history of eye disease. It is also used for people who have vision changes or are at risk for glaucoma or macular degeneration.

Symptoms

Common symptoms

• Blurred or distorted vision
• Seeing spots or floaters
• Sudden vision loss in one eye
• Difficulty seeing at night
• Eye pain or redness

Symptoms in children

• Frequent squinting or rubbing eyes
• Holding books very close
• Complaints of trouble seeing the board at school
• Crossed or wandering eyes

Symptoms in older adults

• Gradual loss of central vision (for reading or recognising faces)
• Needing brighter light to see up close
• Seeing wavy lines instead of straight ones
• Difficulty adapting to dim lighting

Causes

Main causes

• Fundus photography is not a disease. It is a test used to diagnose or monitor conditions like diabetic retinopathy, glaucoma, age-related macular degeneration, and blocked blood vessels in the eye.
• You may need this test if you have risk factors for eye diseases or if your eye doctor sees something unusual during a routine exam.

Risk factors

• Diabetes
• High blood pressure
• High cholesterol
• Being over the age of 50
• Having a family history of glaucoma or macular degeneration
• Being very short-sighted (myopia)

When to see a doctor

See a doctor urgently if:

• Sudden vision loss or changes in your vision that do not go away
• Flashes of light or a sudden increase in floaters
• Eye pain or redness that is new or severe

Book a routine appointment if:

• If you have diabetes, get a dilated eye exam at least once a year.
• If you are over 40 and have risk factors, have a baseline eye exam, including fundus photography, every 1–2 years.
• Follow your doctor's advice on how often to repeat the test.

Diagnosis

Fundus photography is part of the diagnostic process. Your eye doctor may also do a comprehensive eye exam, including dilating your pupils, checking your vision, measuring eye pressure, and looking at your retina.

Tests that may be done

• Visual acuity test (reading letters on a chart)
• Tonometry (measuring eye pressure)
• Slit-lamp examination (using a microscope to look at your eye)
• Optical coherence tomography (OCT) – a special scan that gives cross-section images of the retina
• Fundus photography – to take permanent pictures for comparison over time

What to expect at your appointment

Your eye doctor will put drops in your eyes to widen your pupils. This may sting briefly. After about 15–20 minutes, your pupils will be large. You will sit in front of a camera and rest your chin on a support. The technician will take a few pictures. You will see a bright flash. The whole test takes only a few minutes. Your vision may be blurry for several hours afterwards, so avoid driving until the drops wear off. Bring sunglasses because your eyes will be sensitive to light.

Treatment

Fundus photography itself is not a treatment. It helps your doctor decide if you need treatment for an eye condition. If the pictures show a problem, your doctor will discuss treatment options based on the specific diagnosis.

Self-care at home

• Wear sunglasses and a hat if your eyes are sensitive after dilation.
• Arrange for someone to drive you home if your pupils were dilated.
• Keep regular appointments to monitor any changes.

Medical treatments

If fundus photography finds a condition like diabetic retinopathy, glaucoma, or macular degeneration, treatments may include eye drops, laser therapy, injections into the eye, or surgery. Your doctor will explain which approach is best for you. Do not stop or start any eye medications without talking to your doctor.

When is surgery considered?

For some conditions, such as a detached retina or advanced glaucoma, surgery may be needed. This is usually done by an eye surgeon. Your doctor will refer you if necessary.

Living with this condition

If you need regular fundus photography, plan for a few hours of dilated pupils and blurred vision. Have sunglasses ready and avoid driving. Keep a log of your vision changes to share with your doctor.

Lifestyle tips

• Control blood sugar, blood pressure, and cholesterol if you have diabetes or high blood pressure.
• Protect your eyes from UV light by wearing sunglasses outdoors.
• Don't smoke – smoking increases the risk of many eye diseases.
• Eat a diet rich in leafy greens, fish, and fruits.

Diet and exercise

A healthy diet with lots of vegetables, fruits, and omega-3 fatty acids can support eye health. Regular exercise helps control conditions like diabetes and high blood pressure that affect your eyes.

Mental health and emotional wellbeing

Finding out you have an eye condition can be worrying. Feeling anxious or sad is normal. Talk to your doctor or a counsellor. Many people cope well with treatment and support. Reach out to friends, family, or support groups.

Prevention

You cannot always prevent the eye conditions that fundus photography detects, but you can reduce your risk. Keep your blood sugar, blood pressure, and cholesterol under control. Have regular eye exams as recommended. Wear protective eyewear to avoid injury.

Screening programmes

If you have diabetes, high blood pressure, or a family history of eye disease, talk to your doctor about screening with fundus photography. Many eye diseases have no early symptoms, so screening can catch them early when treatment works best.

Complications

If left untreated

• If an eye condition is found but not treated, it can lead to permanent vision loss.
• Delaying treatment for diabetic retinopathy can cause bleeding in the eye and scarring.
• Untreated glaucoma can cause irreversible damage to the optic nerve and loss of side vision.

Long-term outlook

When eye conditions are found early through tests like fundus photography, many can be treated successfully. Regular monitoring and treatment can prevent vision loss. Even if you already have some vision changes, treatment can often slow or stop further damage. Stay hopeful and follow your doctor's advice.

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