I have just finished residency. In my first year I could only focus on the retina, but after watching your video two years ago I learned how to examine different parts of the retina, how to do it through the narrow pupil. I re-watched it again to make sure I did not miss anything Thank you so much, that is the best tutorial about this topic!
Remember when examining the optic nerve head: 1st, ask the patient to look at your right ear when you examine his\her right eye (your right is opposite to his\her right), because if you didn't, the patient will move his\her eye and focus it on your examining lens (so you will see only the macular region) & it will become frustrating in the beginning and you will blame your self as incompetent, the same apply for the left eye.
I just found your channel. Great videos! I always think like this: when the patient looks up, I see the superior part of the retina. When the patient looks temporally, I see the temporal part of the retina. And so on.
This was Eye opening, to say the least haha. The textbook describes the opposite of how you describe the trick tom finding focus with an objective lens, yet your method feels so much more intuitive. i myself focus that way now and i learnt by trial and error over weeks haha.
Greetings with honoring you and posting this video. I am a recovering Patient of a torn retina. And also a fine artist. I searched for a video that would explain what the doctor would see, when he/she was repairing my torn retina. This video is incredibly clear and wonderful. I was crying whilst watching it. Just wanted to say thankyou. You are awesome artists!😊
I was seriously struggling to get to the ON and was genuinely convinced noway I will ever be able to got to a point where I would lie to my classmate because I was embarrassed of how long it took me, now I can get to with the 90d in under a minute , idc how bad you think you are you will not be as bad as how bad I was
I'm japanese resident and very impressed by your video. Next time, I want to watch an instruction video about fundus examination with contact lens (especially panretinal lens such as H-R wide field and SuperQuad160). I'm looking forward to your video.
Hello @glasses thank you for the comment. HR wide field and superquad render the image just like 90D and co. but instead of moving the lens you can only tilt it. try watching my video about laser for retinal tears to see how to put the lens onto the eye. i will make a video about 3-mirror lenses soon.
@@373hamabe I don't think there's a difference. the superquad is just a newer model from what I understand. I use the digital widefield non contact to find 90% of the tears. then a 3-mirror contact lens for the other 10%. i've never seen something with a super quad that I didn't see with my digital wide field.
OMG. I have many difficult to use volk lens to see the fundus in 3 months and i didn’t improve my skill. But now, i see your video. It’s perfect. I can understand the skill. I will partice in tomorrow. Thanks professor about the video. It’s great ❤️❤️❤️ I immediately subscribe your channel. Thank you so much ❤️❤️❤️❤️
Ironically I started my residency with examination of the retina using a 90D lens. First in dilated pupil and then in undilated ones. Now I can identify peripheral retinal changes using a 90 D lens on slit lamp.
Thank you for this video. You did an incredible job at explaining this. I'm only a CPO, but I love this field and learning more about it. I may have to try to see if I can do it myself. 🤔
wow, the video ive been looking for!!! just started ophthalmology 2weeks. Im still struggling to maneuvre how to get to where i wanna be. you have been very helpful
@@learnabouteyes refraction first. but another thing, does this method also same as using BIO? I can see easier with BIO, with bigger view, but also had difficulty with maneuvering
Thank you so much. I was always confused when doing this examination till I saw your video. Now I'm sure I will master it after few days of practice. Please share more ophtalmology videos. I like your channel.
Nice video doctor. Next time you could make another video explaining some generall topics. For example you could tell us about ophthalmology residency in your country its working hours compensation lifestyle etc. Congratulations keep up the good work.
May you please do a video about clinical examination 1st day post operative for cataract , ppv , rd , glaucoma surgery ? And the schedule of examination , please 🥺❤️
just to make sure you're terminology is correct: The technique described here is called indirect ophthalmoscopy. This in contrast to direct ophthalmoscopy: with the little handheld device (ophthalmoscope) that you hold very close to the patients eye. I'm assuming that you want a video about how to use a 20D lens with a helmet light. This technique is often called BIO (binocular indirect ophthalmoscopy). We never use it anymore except in children so I don't have much experience. But I'm going to try and have a colleague from another country do some instructions for you
Hi super helpful video. I often struggle to get a wide slit of light, basically only a thin strip of light, and my attending always manages to get a wide strip like in your video, do you know why this happens and how to solve this?
manage your reflections. start with a small slit, get a sharp picture, widen your slit until you start to get reflections/glare off the lens, then slowly tilt the lens until they disappear. practice in a dilated patient first. if your slitlamp has a stereo variator, it's much easier too
This video was so helpful! I’m an optometry student in the US and am shocked no one taught me this technique before. If you can, could you do tips for BIO?
Could you do a video for Indirect Ophthalmoscopy reversed image interpretation? I still struggle a bit while examining when asking patients to look up or down and then visualizing their retinas.
When I am using the volk, I can only get an image of the fundus with a small portion of the slit. I have the slit a little bit wider than the pupil. Please can you guide me on how I need to fill the entire portion of the image with the fundus. Thank you.
I am a 1º Year Ophthalmology Resident but I am trying to buy an Ocular Instruments lens, I'm struggling a lot with the best choice, I was pretty impressed with the explanations for Volk lenses, but I wish you could tell me more about OI lenses so I could guide my decision.
you center the slitlamp on the eye, then pull it STRAIGHT back. this way you know that the lamp is in the correct position. now you introduce the lens. put it in front of the patients eye so you can see the whole eye upside down. then just slightly move it left/right/up/down until you see the red reflex. from then on you know that your lens is in the correct position and you just need to do tiny movements to correct as needed.
@@learnabouteyes Pretty sure the animation is representing a R eye, as the ONH is on the right hand side. However of course on the volk view it is inverted & so appears on the left hand side
@@learnabouteyes It didn't make sense to me either to me I thought I get your professional take I am just concerned if the combination of lighting from ophthalmoscope and Slit Lamp can damage my eye sight during a test?
I bought a +78D lens on ebay from India , tried to get a view of the fundus but it’s so hard to even get a focus of the eye and patient keep complaining of the lights 😿
When your eyes are dilated, how long before the slit lamp/light begins to damage the retina? I had an examination by a retina specialist a couple of days ago and I am concerned that the examination could have damage my retina and/or macula. He said it would be counterintuitive if the instrument did that, but some online government sources say that the exam can damage your macula/retina and lead to permanent vision loss down the line. Is this really true? I am stressed out. I don't want to lose my vision or go blind.
I never realized how confusing this could be. It must be intuitive for me but I'm an optometrist and spent 3.5 years practicing this skill before getting to call myself a doctor
I have just finished residency. In my first year I could only focus on the retina, but after watching your video two years ago I learned how to examine different parts of the retina, how to do it through the narrow pupil. I re-watched it again to make sure I did not miss anything
Thank you so much, that is the best tutorial about this topic!
Remember when examining the optic nerve head: 1st, ask the patient to look at your right ear when you examine his\her right eye (your right is opposite to his\her right), because if you didn't, the patient will move his\her eye and focus it on your examining lens (so you will see only the macular region) & it will become frustrating in the beginning and you will blame your self as incompetent, the same apply for the left eye.
I just found your channel. Great videos! I always think like this: when the patient looks up, I see the superior part of the retina. When the patient looks temporally, I see the temporal part of the retina. And so on.
This made a lot of sense as I was doing it and imagining it, thanks!
This was Eye opening, to say the least haha. The textbook describes the opposite of how you describe the trick tom finding focus with an objective lens, yet your method feels so much more intuitive. i myself focus that way now and i learnt by trial and error over weeks haha.
Greetings with honoring you and posting this video.
I am a recovering Patient of a torn retina. And also a fine artist. I searched for a video that would explain what the doctor would see, when he/she was repairing my torn retina. This video is incredibly clear and wonderful. I was crying whilst watching it. Just wanted to say thankyou. You are awesome artists!😊
This is so helpful :) Thank you so much.
1 year resident from Russsia here.
I was seriously struggling to get to the ON and was genuinely convinced noway I will ever be able to got to a point where I would lie to my classmate because I was embarrassed of how long it took me, now I can get to with the 90d in under a minute , idc how bad you think you are you will not be as bad as how bad I was
I'm japanese resident and very impressed by your video.
Next time, I want to watch an instruction video about fundus examination with contact lens (especially panretinal lens such as H-R wide field and SuperQuad160).
I'm looking forward to your video.
Hello @glasses thank you for the comment. HR wide field and superquad render the image just like 90D and co. but instead of moving the lens you can only tilt it. try watching my video about laser for retinal tears to see how to put the lens onto the eye. i will make a video about 3-mirror lenses soon.
@@learnabouteyes Thank you very much for your response.
Which do you think is better HR wide field or superquad, if I use it only for diagnosis ?
@@373hamabe I don't think there's a difference. the superquad is just a newer model from what I understand. I use the digital widefield non contact to find 90% of the tears. then a 3-mirror contact lens for the other 10%. i've never seen something with a super quad that I didn't see with my digital wide field.
OMG. I have many difficult to use volk lens to see the fundus in 3 months and i didn’t improve my skill. But now, i see your video. It’s perfect. I can understand the skill. I will partice in tomorrow. Thanks professor about the video. It’s great ❤️❤️❤️ I immediately subscribe your channel. Thank you so much ❤️❤️❤️❤️
Ironically I started my residency with examination of the retina using a 90D lens. First in dilated pupil and then in undilated ones. Now I can identify peripheral retinal changes using a 90 D lens on slit lamp.
Amazing video , I’ve been struggling for the past two months
glad to help
You made it super easy doctor!!
I am a 1º Year Ophthalmology Resident in Taiwan(not Thailand) It's very helpful. Thanks a lot Dr.
Thank you for such a beautiful presentation.
thanks for watching
Wow! This has been so helpful, I finally understand why I had so much trouble in the first place! Thank you very much for this:)
Thank you for this video. You did an incredible job at explaining this. I'm only a CPO, but I love this field and learning more about it. I may have to try to see if I can do it myself. 🤔
Please keep on posting more videos, they are all really good!! Very helpful. Excelent job!
thanks so much. i'm planing one for next week
As a suggestion, a video about retina examination with a three mirror lens would be wonderful. Thank you very much in advance
wow, the video ive been looking for!!! just started ophthalmology 2weeks. Im still struggling to maneuvre how to get to where i wanna be. you have been very helpful
Thanks, happy to hear that. Tell me, what else are you struggling with? What topic would you like to see next?
@@learnabouteyes thanks man. love to see a summary of optics, or something about it to get started.
@@abekhemit3707 optics is a huge topic. do you want more physics or more refraction?
@@learnabouteyes refraction first. but another thing, does this method also same as using BIO? I can see easier with BIO, with bigger view, but also had difficulty with maneuvering
@@abekhemit3707 yes...it's the same with BIO. just moving your head instead of slitlamp
Thank you for perfect teaching
Very Helpful instructions. Thanks for sharing.
Thank you so much. I was always confused when doing this examination till I saw your video. Now I'm sure I will master it after few days of practice. Please share more ophtalmology videos. I like your channel.
thank you so much...please share with all your colleagues. and write down some ideas on what topic to do next.
Very instructive video
Thank you very much, I could exam the retina the day after watching your video!
so awesome...great to hear
I tried many times but i can't see fundus i can only see red glow now i watched your video inshallah it will improve my skills
𝘔𝘦 𝘵𝘰𝘰 😢
If you have to seen red glow you have to try focus on that red glow
Nice video doctor. Next time you could make another video explaining some generall topics. For example you could tell us about ophthalmology residency in your country its working hours compensation lifestyle etc. Congratulations keep up the good work.
Very nice and didactic video! Congratulations! I bet all your residents are great now ;)
Thank you so much , it helps me a lot.👍👍👍
Fantastic video! Thank you doc!
the is the DEFINITiVE guide on Retina Exam
Very useful video!!!
this video was so good omg thank you so much
God i needed this
Very nice and lucid.Thanks
thanks
Very useful for me thanks a lot
Very nice and clear
Thankyou
thanks for the comment
This video is amazing, you've helped me so much! Thank you!
The model eye link is not working....can you share it again please? Or share another website. Btw thanks for your great vídeo!
I rarely move my slit lamp, instead I told the patients to look at the celling/to his right/at the table/ to his left to exam the whole eye.
Thanks a lot for this video
Thank you.
This is easier, i wish i could watch it when i was a resident
Very helpful vedio thank you sir
Waiting for your other videos.
The best way
Tnx alot
Practice practice practice and practice 😊
Thanks for this❤️
May you please do a video about clinical examination 1st day post operative for cataract , ppv , rd , glaucoma surgery ? And the schedule of examination , please 🥺❤️
Great!! Very helpful 🌋
Great job man!
You are great 💫
thank you
THANK YOU SO MUCH!!!!
new resident here and love this video, can you do one for tips about indirect?
just to make sure you're terminology is correct: The technique described here is called indirect ophthalmoscopy. This in contrast to direct ophthalmoscopy: with the little handheld device (ophthalmoscope) that you hold very close to the patients eye.
I'm assuming that you want a video about how to use a 20D lens with a helmet light.
This technique is often called BIO (binocular indirect ophthalmoscopy).
We never use it anymore except in children so I don't have much experience. But I'm going to try and have a colleague from another country do some instructions for you
The beat way
Tnx alot
Excellent
It’s really helpful video thank you very much
Hi super helpful video. I often struggle to get a wide slit of light, basically only a thin strip of light, and my attending always manages to get a wide strip like in your video, do you know why this happens and how to solve this?
manage your reflections. start with a small slit, get a sharp picture, widen your slit until you start to get reflections/glare off the lens, then slowly tilt the lens until they disappear. practice in a dilated patient first. if your slitlamp has a stereo variator, it's much easier too
Thank you !!
Thanks for this!! So helpful 💯🙏🏼
cool...i'm happy to help
Can be a perform in the light room ??
If I wanted to see the macula in the right eye would I move the slit lamp right from the optic disc and also follow with the Volk lens ?
Thank you so much
Excelent video, thank you!
Please make a video on Gonioscopy and BIO 🙏🏾
Super great video
thanks a lot
This video was so helpful! I’m an optometry student in the US and am shocked no one taught me this technique before. If you can, could you do tips for BIO?
that's definitely on my list. unfortunately I'm in a hardcore fellowship right now - no time for videos
will do next year
Amazing
this,is,wonderful thank you
Tk u so much, love u 😊
Great channel! Mind doing a video on how you examine the periphery on the slit lamp alone? We always do it through a "helmet lens" in my country
same principle goes for the periphery. just that you let the patient look in a specific direction
3:56 - 4:20 : move the lens until you see the redreflex , BUT DON‘T MOVE YOUR SLIT LAMP !
4:23- 4:47
5:37-
Olá, meu filho tem retinopatia da prematuridade.
Could you do a video for Indirect Ophthalmoscopy reversed image interpretation? I still struggle a bit while examining when asking patients to look up or down and then visualizing their retinas.
maybe it's easier in person...let's talk. contact me on instagram: @learnabouteyes
@@learnabouteyes i have the same issue
Helpful 👍
When I am using the volk, I can only get an image of the fundus with a small portion of the slit. I have the slit a little bit wider than the pupil. Please can you guide me on how I need to fill the entire portion of the image with the fundus. Thank you.
you can't with this exam method. you will always see the fundus as a slit
I am a 1º Year Ophthalmology Resident but I am trying to buy an Ocular Instruments lens, I'm struggling a lot with the best choice, I was pretty impressed with the explanations for Volk lenses, but I wish you could tell me more about OI lenses so I could guide my decision.
just tell me what you'd like to know exactly...maybe I can help in writing
Is it possible to get this video with French subtitles? It seem so helpfulness
Hi Great Vid!! Could i ask whats your systematic approach for complete fundus exam like first ONH then macula then periphery etc?
correct. i always check the optic nerve first, judge color, rim, cdr. then go over to the macula, then up-down-left-right
Thats great, thanks for your help!
Another Q, what do you use to accurately judge the Cd ratio, colour change or BV kink etc?
@@ks5361 first define your rims based on the vessels and comor, then you compare that to the outer border of the nerve head
Thanks alot! Looking forward to these types of vids!
At 04:14 , he says "try to move your lens until you see the red reflex". But move lens in which direction ?
you center the slitlamp on the eye, then pull it STRAIGHT back. this way you know that the lamp is in the correct position. now you introduce the lens. put it in front of the patients eye so you can see the whole eye upside down. then just slightly move it left/right/up/down until you see the red reflex. from then on you know that your lens is in the correct position and you just need to do tiny movements to correct as needed.
Still, what i see is the very bright reflection of the light lamp filament. I couldn't get retina in focus
try tilting the lens or moving the light very slightly to the side. or use the stereo variator if you have one (see my video about it)
Hi. May i know at minute 2.10 are you referring to right eye or left eye ?
Thank you in advance.
doesn't matter. both eyes react the same. however, the animation is representing a left eye
@@learnabouteyes Pretty sure the animation is representing a R eye, as the ONH is on the right hand side. However of course on the volk view it is inverted & so appears on the left hand side
@@Yacob88481 you're right
What's the name of that "lens" used altogether with silt lamp?
watch my video on lenses ;-)
Can we detect ortho k lens modification of cornea by slit lamp
no, I don't think so
@@learnabouteyes thanks doctor
Do you know if it's safe to use ophthalmoscope while using the Slit Lamp?
can't really imagine how and why you would do that
@@learnabouteyes It didn't make sense to me either to me I thought I get your professional take I am just concerned if the combination of lighting from ophthalmoscope and Slit Lamp can damage my eye sight during a test?
I bought a +78D lens on ebay from India , tried to get a view of the fundus but it’s so hard to even get a focus of the eye and patient keep complaining of the lights 😿
90D is much better. 78 is difficult for beginners. only gives you a good image in dilated pupils
❤❤❤
🎉🎉🎉
I have floaters. I see flashes while blinking
go see a doctor next
When your eyes are dilated, how long before the slit lamp/light begins to damage the retina? I had an examination by a retina specialist a couple of days ago and I am concerned that the examination could have damage my retina and/or macula. He said it would be counterintuitive if the instrument did that, but some online government sources say that the exam can damage your macula/retina and lead to permanent vision loss down the line. Is this really true? I am stressed out. I don't want to lose my vision or go blind.
don't worry. the exam won't damage your retina
I never realized how confusing this could be. It must be intuitive for me but I'm an optometrist and spent 3.5 years practicing this skill before getting to call myself a doctor