The Ocular Fundus – a Unique View of the Brain and Its Microvasculature

INTRODUCTION Examination of the ocular fundus is a fundamental component of the general physical examination and critical to the diagnosis of lifeand sight-threatening medical conditions among patients with certain presenting complaints, such as headache. In addition, populationbased studies have shown the prognostic value of retinal microvascular findings in cardiovascular and neurologic disease. Yet, the examination of the ocular fundus is infrequently and inadequately performed in most non-ophthalmic settings. Non-mydriatic ocular fundus photography is a promising alternative to direct ophthalmoscopy, particularly when combined with telemedicine. The Fundus Photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTOED) study is discussed as an example of the use of nonmydriatic ocular fundus photography in an acute, nonophthalmic setting. The implications of non-mydriatic fundus photography on medical education, patient care, and clinical research are also addressed.