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The Indirect Ophthalmoscope: George T. Timberlake, PH.D
The Indirect Ophthalmoscope: George T. Timberlake, PH.D
Gullstrand Indirect
Ophthalmoscope
ca. 1910
What You Need to Know
Name
Instructions to Faculty: Please observe the resident perform the following tasks, and grade each step, "P" (successful
completion of step) or "X" (needs additional training or practice). The resident must successfully perform each step in order
to pass t
GTT 04
Fundamental Principle of
Indirect Ophthalmoscope
Ophthalmoscopic lens
GTT 04
Viewing the aerial image with a magnifier
GTT 04
Allvar Gullstrand
1862 - 1930
Professor of Physical &
Physiological Optics,
University of Uppsala
Swedish Ophthalmologist
GTT 04
Gullstrand Principle
for Reflex-free Ophthalmoscopy
Light entrance and exit separated in pupil plane
20 D Nikon
Emmetropic Aspheric
Gullstrand Lens Retina
Eye Pupil
Cornea
70 44*
152
168
2.0 mm
entrance pupil
1.75 mm
7 mm
diameter
pupil
GTT 04
Gullstrand Retinal Illumination
Light introduced in pupil
conjugate plane
In focus in pupil plane
20 D
74.1
Pupil Conjugate
Plane
153.6
Mpupil 153.6
conjugate = = 2.1
74.1
Mconjugate 1
pupil = = 0.48
2.1
GTT 04
G u lls tr a n d M o d e l E y e
c r y s ta llin e le n s
r e tin a ir is c o rn e a
o p tic a x is
p u p il
aqueous
v it r e o u s
le n s c o r e
p u p il p u p il
c o n ju g a te p la n e
p la n e
SIDE VIEW
GTT 04
Light leaving the eye from a disk-shaped
area in the pupil is imaged in the pupil
conjugate plane
pupil pupil
conjugate
1 m m
2 .1 m m
Lamp
Aperture
45 mirror
2.0 mm
entrance pupil
1.0 mm
exit pupil
4.0 mm
7 mm
diameter
pupil
GTT 04
Gullstrand Retinal Imaging
Light from retina passes through
area in pupil plane
Pupil-plane area is in focus
in pupil conjugate plane
20 D
Pupil Conjugate
Plane
Mpupil 153.6
conjugate = = 2.1
74.1
1
Mconjugate pupil = = 0.48
2.1
GTT 04
RAYS FROM THE EXIT PUPIL PASS THROUGH
THE CONJUGATE PUPIL
PP
RIP
TOP VIEW
GTT 05
RAYS FROM RETINA MUST GO THROUGH
PUPIL CONJUGATE TO BE SEEN
GTT 04
optic
axis
stop in pupil plane
conjugate
circular aperture
in stop
GTT 04
VIEWING THE RETINAL IMAGE
OL PP
conjugate
PP
RIP
Observer’s pupil at
PP conjugate
optic
axis
observer’s pupil in
conjugate pupil plane
OBSERVER
VIEWING THE RETINAL IMAGE
S’s eye
Obs. R eye
Combine L and R eye views
MAGNIFICATION
FIELD OF VIEW
SUBJECT’S RETINA APPEARS REVERSED
LEFT TO RIGHT
L exit
pupil Observer
TOP VIEW L Eye
SUBJECT’S RETINA APPEARS REVERSED
TOP-TO-BOTTOM
inf
RIP
subject’s retina appears
reversed top-to-bottom
SIDE VIEW
OPHTHALMOSCOPE MAGNIFICATION
20 D
60 D lens
eye RI
Mag of RI
P eye 60 D
M = = = 3.0
P le ns 20 D
MONOCULAR FIELD OF VIEW
2.0 mm 20 D
42 50 mm
40 mm
GTT 04
B IN O C U L A R F IE L D O F V IE W
20 D
A r e a o f b in o c u la r v ie w
40
GTT 04
ESTIMATING FIELD OF VIEW
Clear Aperture: CLAP
Working Distance: WD CLAP
= 24 mm
2
WD
47 mm
51.04 mm
54.72 mm
CLAP
(½ WD
-1
Example: OI Maxlight 20 D = tan (
CLAP = 48 mm
WD = 47 mm = 23.7 FOV = 47.4
FOV = 50 = 25.2 FOV = 50.3
= 25.2 FOV = 50.3
SUMMARY
Be able to explain:
Image orientation
Field of view
Magnification
BIO RETINAL ILLUMINATION
light source
entry O.L.
pupil RIP’ Observer
Subject PP Mirror
M Observer
O.L.
Subject RIP’
PP
PP
GTT 04
BIO MAGNIFICATION
Peye
Maerial image =
Plens
BIO APPROXIMATE FIELD OF VIEW
CLAP
2
WD
RIP prism
PP
prism
axis parallel to
optic axis
GTT 04
Formation of Final Aerial Retinal Image
retinal
image
lens
retinal
image
GTT 04
retinal image
GTT 04
Galilean Telescope
biconvex
(positive)
lens fp
biconcave
(negative)
lens fp
put fp’s
together
fp’s
coincide
final
telescope
parallel
rays
GTT 04
MAGNIFICATION OF GALILEAN TELESCOPE
objective
eyepiece
fep
fobj
Example:
fobj fobj = 50.0 mm
M= fep
fep = - 5.0 mm
50.0
M= = 10.0
- 5.0 GTT 04
Viewing Through a Galilean Telescope
parallel
rays iImage
object
emmetropic
eye
Retinal image
plane--begin
new raytrace
Subject
Observer
Galilean
telescope
GTT 04
COMPLETE MONOCULAR
OPHTHALMOSCOPE
telescope
OBSERVER
GTT 04
GTT 04
Complete binocular
Indirect
ophthalmoscope
GTT 04
Retinal Image Orientation
Subject
Observer
sup.
inf.
7.77 mm
35.5
70 mm mm
Peye 56.4
M= = = 2.99
2.547 mm Plens 18.86
Himage 7.77
M= = = 3.05
Hobject 2.55
2.99 3.05 (2% diff)
OPHTHALMOSCOPE MAGNIFICATION
20 D
lens 25D
RI1 12.5X
60 D lens
telescope
eye RI2
p q
230 mm
Mtotal = M1 M2 Mtelescope
Observer Subject
telescope field
lens Ophthalmoscopic
lens
GTT/98