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The fundus camera is an instrument used for fundus photography. Fundus photography captures the images of the retina, optic nerve head, macula, retinal blood vessels, choroid, and the vitreous. Fundus photography impacts the detection and screening of various causes of treatable and preventable blindness, notably diabetic retinopathy, age-related macular degeneration, glaucoma, and retinopathy of prematurity. Over the decades, the quality of fundus images and the ease of photography has improved significantly. This activity describes the techniques of fundus photography and the use of fundus cameras for the management of various ophthalmic conditions and highlights the role of the interprofessional team in evaluating and managing the diseases of the vitreo-retina and optic nerve head with fundus photography. Objectives: Describe the principles of commonly used fundus cameras. Outline the anatomy and physiology of the ocular fundus related to imaging and indications of various fundus cameras. Review the clinical significance of fundus photography. Summarize the technique and personnel involved in fundus photography and the role of interprofessional collaboration in improving patient care. Access free multiple choice questions on this topic.

Fundus photography is taking the image of the retina of the eye with a fundus camera. Fundus photography is important for diagnosing and treating various posterior segments and other ocular diseases. The illumination and reflectance of the retina occur through the common optical path, i.e., the pupil. Jackman and Webster were the first to publish retinal photographs in 1886.[1] Carl Zeiss was the first commercially available fundus camera in 1926.[1] Hansell and Beeson attached the electronic flash tube enabling light to be directed through the pupil.[2] Over time, sharper images, non-mydriatic cameras, pupil tracking, smart-phone fundus imaging, ultrawide field fundus imaging, and artificial intelligence (AI) integrated into online or offline photography have resulted from technical advances in retinal imaging.

As a non-invasive technique, fundus cameras do not have complications. However, there is a risk of cross-infection from patients with active eye infections like conjunctivitis to the other patients who undergo fundus imaging in the same camera. Also, the strong flashlight might not be tolerable to some patients with photophobia. Artifacts in Fundus Photography Multiple artifacts (figure) may occur during the use of the fundus camera. The orange or bright crescent at the margin of the photo is due to the illuminated iris, specifically in a poorly dilated pupil. The joystick should be moved in the opposite direction so that the cone of light passes through the pupil and does not hit the iris. Eyelashes create hazy veils over some areas of the picture. The eyelids should be held open in such cases so that lashes do not obstruct the light or come in the path of the light. If the camera is very near or far from the eye, there is a haze and loss of detail. The distance between the eye and camera should be optimal to get the deepest tone of color of the fundus. A smudge in the system will produce a spot at the same place in the photos taken at different times. This is usually due to the touch of the objective lens by the patient's face, nose, or eyelashes, which resolves after removing the dirt or smudge from the system.

The fundus camera plays an important role in diagnosing and managing ophthalmic diseases. Apart from the ophthalmologists, optometrists, ophthalmic photographers, and paramedical workers are involved in taking images in the fundus cameras. While doing fundus fluorescein angiography or indocyanine green angiography, the nurses should be aware of the possible side effects of the dye-related invasive procedure.[29][30] Coordination between all the team members and caregivers and updating their knowledge about the fundus photography and procedures related to the fundus cameras is crucial.

Nurses are involved in the procedure of fundus photography. Their support during any side effects of the procedures like fundus fluorescein angiography is vital. They should possess strong knowledge regarding the emergency medicines needed during any complications related to the investigations. Retinal diseases are associated with various systemic illnesses like diabetes, systemic hypertension, and systemic drug toxicity. Clinical history provided by colleagues from specialties other than ophthalmology will help interpret the fundus images.

The fundus camera is used for non-invasive procedures like fundus photography and invasive procedures like FFA. Monitoring the quality of images taken, the indications for which the images are taken, a note of any adverse events, and their management is crucial for operating a fundus photography unit. Nurses, allied health personnel, ophthalmologists, and doctors from other specialties can use the fundus camera. An audit and monitoring of the events happening in the fundus photography unit are crucial for the smooth functioning of the unit.