FUNDOSCOPIC

LENSES
HRUBY LENS
2 WAYS TO OVERCOME HIGH
CORNEAL POWER
 Nullify it.
 Utilise power of cornea as a telescope.
 This is to view posterior pole and posterior
vitreous.
HRUBY LENS
 Powerful plano-convex lens
 Power = -58.6D
 Virtual, erect and dimnished image of
illuminated retina.
 Restricted field of 5-8 degrees or just larger
than one disc diameter.
 As an attachment from either above or below
that can be rotated into the line of sight.
PROCEDURE
 Patient co-operation is extremely important .
 Focus the oculars to accommodate any practitioner refractive error,
set the pupillary distance, remove all filters and set the
magnification to the lowest setting, usually 6-10x.
 The illumination of the slit-lamp should be adjusted for an
intermediate slit height and a 2 mm width, and then placed in the
straight ahead position.
 The height of the patient is adjusted with the chin rest so that the
fixation device is in the centre of the patient's field in front of the
contra-lateral eye.
 After the slit-lamp is moved into position so that the slit is imaged in
the patient's pupil, the Hruby lens is introduced in front of the
patient's eye as close as possible without contacting the cornea or
lashes.
 The plano side of the lens should be toward the examiner. 
 The patient’s eye is then moved in all directions with the eye
fixed on the object, depending on areas to be examined.
ADV & DIS-ADV
 Stereoscopic viewing of  The main disadvantage of this
technique is the field of view(less
the optic cup and macula. than two disc diameters for an
 Useful for viewing the emmetropic patient).
vitreous.  More dilation is required than in
other binocular techniques.
 When used with redfree  The quality of the image is easily
illumination, the hruby degraded by media opacities.
lens can demonstrate the  As the magnification is so high,
optically empty space small movements of the
between the posterior practitioner, lens, or patient have
an immediately noticeable
vitreous face and the negative effect on image quality.
retina in the case of a  Because the lens does not come in
posterior vitreous contact with the cornea, like a
detachment contact Hruby lens, reflections
are somewhat of a problem.
90D LENS
90 D LENS
 High powered, biconvex, condensing lens.
 Projects an INVERTED, REVERSED, REAL image in
front of the lens.
 Higher the power-lower the magnification but
greater the field of view!!!
 Either clear or yellow filter.
SIMPLE MAGNIFICATION

Emmetropic Eye Is Considered To Be 60

Diopters

MAGNIFICATION = POWER OF THE EYE /

POWER OF THE CONDENSING LENS MAG. =
60D / 90D
 MAG. = .666 X MAGNIFICATION OF SLIT LAMP
 MAG. = .666 Times 10X
 MAG. = 6.66 X (ETC.)
PROCEDURE
• Direct view of the left • Image of the Left Optic
optic disc as seen with a Disc and Vessels as Seen
non-contact HRUBY LENS With a 90D LENS and Slit
and slit lamp. It shows Lamp. The Image Seen is
Inverted. The Magnification
decreased and reduced
is increased, and the Field
field of view. of View is Large.
USES
1.)Papilloedema
2.) Drusens of the nerve head
3.) Neovascularization of the nerve head (diabetes)
4.) Estimating the cup to disc ratio (glaucoma diagnosis)
5.) Optic atrophy (color and lack of vessels)
6.) Cystoidal macular degeneration
7.) Macular edema (central serous retinopathy)
8.) Retinal detachments
9.) Evaluating the nerve fiber layer of the retina (red-free,
cobalt)
10.) Posterior vitreous detachment
11.) Macular holes, cysts, hemorrhages, scars, pseudoholes, etc.
CAN ANY LENS FIND THIS
OUT!??
THANK YOU!!!
NIKHIL.J
PRE-FINAL M.B.B.S