Indirect micro-ophthalmoscopy: intraoperative binocular indirect ophthalmoscopy with the operating microscope

Abstract

A hand-held indirect lens and an operating microscope can provide a view of the fundus similar to that provided by the usual binocular indirect ophthalmoscope headpiece. The only modification required is that the working distance must be increased to allow the microscope to be focused on the aerial image created by the hand-held lens. This technique provides a cost-effective means of retinal examination in preparation for intraocular lens implantation. Also, the view of the fundus it provides when complications such as choroidal hemorrhage or lens nucleus dislocation occur, facilitates appropriate management. It also can be used during posterior segment procedures such as foreign body removal, posterior vitrectomy, and retinal detachment repair. The advantages of this method include the possibility of using the microscope's zoom capability to provide greater magnification, and beam splitters for video or still-camera documentation of the findings during examination under anesthesia.