Fundus Examination in Turkey: Procedure, Benefits, and Advanced Techniques

A fundus eye exam is an eye test performed to examine the entire structure of the back part of the eye.

The back of the eyeball consists of the retina, optic nerve, and blood vessels. A fundus exam is conducted to evaluate the health of these structures and tissues, allowing for early detection of potential damage and vision loss.

It is a simple and painless test that provides comprehensive information about the key structures at the back of the eye, including the optic nerve, macula, vascular arcades, peripheral retina, and choroid.

The results obtained help in diagnosing and monitoring various eye conditions and assist in determining the most appropriate treatment if needed.

What is a Fundus Eye Exam?

A fundus eye exam, also known as fundoscopy, ophthalmoscopy or fundus photography, is a diagnostic test used to examine the retina, optic nerve, and blood vessels at the back of the eye, helping detect potential damage or diseases that may lead to vision loss.

While some eye tests, such as Stratus Optical Coherence Tomography (OCT), assess the entire eye structure, the fundus exam specifically focuses on the back of the eye to evaluate retinal and optic nerve health.

What Does a Fundus Exam Show?

Visual examination of the fundus of the eye with an ophthalmoscope provides a detailed view of the retina, optic nerve, macula, and blood vessels at the back of the eye. It helps detect and monitor various eye conditions and systemic diseases that may affect vision.

Optic Fundus Examination vs. Retinal Fundus Examination

All terms refer to examining the back of the eye, but they emphasize different structures:

The ocular fundus examination is a comprehensive examination of the entire fundus, including the optic nerve, retina, macula, blood vessels, and choroid.

It is used for comprehensive eye health assessment and for diagnosing various ocular and systemic conditions.

Optic fundus examination is performed for examination of the optic nerve head (optic disc), assessing conditions like glaucoma, optic neuritis, optic atrophy, and papilledema (optic nerve swelling due to increased intracranial pressure).

Retinal Fundus Examination focuses on assessing the retina, including the macula, peripheral retina, and blood vessels, to detect conditions like diabetic retinopathy, retinal detachment, age-related macular degeneration (AMD), and vascular occlusions. It includes various tests such as optimap, ophthalmoscope, and fluorescent eye image

Dilated Fundus Examination vs. Non-Dilated Fundus Examination

Dilated Fundus Examination (DFE)

Uses pupil-dilating eye drops to enlarge the pupil for a clearer and wider view of the retina, optic nerve, and blood vessels.

Preferred for detecting diabetic retinopathy, retinal detachment, macular degeneration, and optic nerve disorders.

Essential for a comprehensive retinal evaluation, especially in high-risk patients (e.g., diabetes, glaucoma, unexplained vision loss).

Takes longer (drops take about 20–30 minutes to work), and patients may experience temporary blurred vision and light sensitivity.

Non-Dilated Fundus Examination (Undilated Fundus Exam)

Performed without pupil dilation, using a direct ophthalmoscope or special imaging techniques.

Provides a limited view of the retina, mainly the central area (optic nerve and macula).

Useful for quick screening but not as effective for detecting peripheral retinal diseases.

No temporary vision impairment, so patients can resume activities immediately.

Why Should You Do a Fundus Eye Test?

A fundus exam is used to detect eye health problems or systemic diseases that affect the blood vessels and optic nerve. It helps diagnose conditions such as:

• Retinal diseases: including diabetic retinopathy, retinal detachment, and macular degeneration.
• Optic nerve disorders: such as optic neuritis or optic atrophy.
• Glaucoma (increased eye pressure): A fundus ophthalmoscope is performed beside the other glaucoma test methods to detect optic nerve damage caused by high intraocular pressure.
• Vascular diseases in the eye: including retinal artery or vein occlusion.
• Hypertension and heart disease: high blood pressure can cause changes in the eye’s blood vessels.
• Detection of eye tumors or internal eye infections.

Who Needs a Fundus Exam?

1. Newborns: fundus examination in newborn infants is performed for premature babies or those at risk of retinopathy of prematurity (ROP) or retinoblastoma.

2. Diabetic patients: To monitor retinal health, detect early signs of damage, and prevent vision loss diabetic retinopathy fundus examination is performed routinely, either annually or more frequently for patients with type 1 and type 2 diabetes, especially for pregnant women, children, and individuals with uncontrolled diabetes.

3. People with high blood pressure or heart disease: To check the impact on retinal blood vessels.

4. Those experiencing vision problems: Such as blurred vision, black spots, or flashes of light.

5. Glaucoma patients or suspects: To check for optic nerve damage and choose a proper glaucoma treatment that may include a surgical option as a rescue therapy for optic nerve.

6. People with a family history of eye diseases: Including macular degeneration or hereditary retinal diseases.

7. Elderly individuals with progressive vision deterioration: To screen for age-related macular degeneration.

8. People with previous eye injuries: To assess potential damage to the retina and optic nerve.

9. Patients with autoimmune or inflammatory diseases: Such as uveitis or lupus.

10. People taking medications that may affect the eye: Such as hydroxychloroquine (Plaquenil), which can cause retinal changes.

Types of Fundus Examinations Techniques

Fundus examination techniques differ in image magnification, field of view, and the level of detail they provide.

A. Direct Ophthalmoscopy

• The doctor uses a direct ophthalmoscope, a small handheld device with a light and lens, to closely examine the fundus.
• This method provides a magnified view but covers only a limited area of the retina.

B. Indirect Ophthalmoscopy

• In indirect ophthalmoscopy a strong light source and a handheld lens are used to examine the fundus from a wider angle.
• This technique provides a broader view of the retina, making it useful for diagnosing retinal detachment and peripheral retinal diseases.

C. Slit Lamp Fundus Examination

• The examination is performed using a slit lamp with a special lens, offering a high-resolution magnified image of the internal eye structures.
• It is commonly used to detect retinal diseases and optic nerve disorders.

D. Fundus Imaging

• Includes Optical Coherence Tomography (OCT) and Fluorescein Angiography, which provide detailed images to diagnose conditions such as diabetic retinopathy and macular degeneration.

Fundus Examination Instrument

• Digital Retinal Camera (Fundus Camera): Captures high-quality diagnostic images of the eye's interior, aiding in the detection and monitoring of retinal conditions.
  
• Phoropter: Helps determine the precise prescription for glasses or contact lenses. Patients look through the device at an eye chart while the doctor adjusts lenses and settings to identify the optimal correction.
  
• Auto-Refractor: A computerized tool that measures refractive error by analyzing how light changes as it enters the eye. The process is quick, painless, and provides an initial prescription estimate based on multiple readings.
  
• Slit Lamp: A specialized microscope with a light source used to examine the eye’s structures, including the cornea, iris, and lens. With special lenses, it can also assess the retina and optic nerve.
  
• Manual Keratometer: Measures the curvature of the cornea, aiding in diagnosing conditions like astigmatism and keratoconus. It is commonly used for fitting contact lenses.
  
• Tonometer: Measures intraocular pressure (IOP), which is crucial for detecting and monitoring glaucoma.
  
• Retinoscope: A handheld device that assesses the refractive power of the eye by analyzing how light reflects off the retina. It is also used to evaluate eye coordination and focusing ability.

Fundus Examination Procedure

A fundus examination is performed using different techniques to visualize the retina, optic nerve, and blood vessels at the back of the eye.

The procedure involves several steps:

Preparation for the Examination

You will sit in a comfortable position and dilating eye drops such as tropicamide or phenylephrine will be applied before the examination.

The eye drops for fundus examination are used to widen the pupil, allowing for a clearer view of the fundus.

The drops take about 15-30 minutes to take full effect, during which the patient may experience blurred vision and light sensitivity.

During the procedure:

After pupil dilation, the doctor uses one of the ocular fundus examination techniques, selected based on the required field of view, image magnification, and level of detail, to examine the back of the eye with a light source and a lens.

During the test you may be asked to move your eyes in different directions for a clearer view.

After the Examination

You may experience temporary blurred vision and light sensitivity due to pupil dilation.

Driving is not recommended until the effects of the drops wear off.

Fundus Examination Report and Findings

Throughout the procedure, the doctor documents findings in a fundus examination report, recording observations on the retina, optic nerve, and blood vessels, including any abnormalities such as hemorrhages, swelling, or signs of disease.

The results are discussed with the patient, and further tests or treatment may be recommended if necessary. The procedure is painless and takes only a few minutes.

Fundus Examination in Diabetes and Diabetic Retinopathy

Fundus examination is crucial for diabetic patients to detect diabetic retinopathy early, a condition caused by prolonged high blood sugar that can lead to vision loss if untreated. Screening is done through a retinal fundus exam, ophthalmoscopy using a slit lamp with a contact or 78D lens, or retinal photography using conventional film or digital imaging. Regular monitoring helps prevent complications and preserve vision.

Fundus Examination CPT Code

CPT code 92250 is used for fundus photography, a diagnostic imaging test that captures detailed photographs of the retina, optic nerve head, and retinal blood vessels.

This code is commonly used to document baseline retinal conditions and monitor disease progression in conditions like diabetic retinopathy, glaucoma, and macular degeneration.

In addition, other related CPT codes may apply depending on the specific technique used, such as 92201 and 92202 for extended ophthalmoscopy or 92081-92083 for visual field testing associated with fundus exams.

Related health topics:

LASIK Eye Surgery in Turkey: Cost, Procedure, Risks, and Results (2025)

Cost of Fundus Examination in Turkey

The cost of a fundus examination in Turkey typically ranges between $20 and $100, depending on the clinic’s reputation, the ophthalmologist's experiences, and the type of examination technique used in the test.

Best Clinics for Fundus Examination in Turkey

1. Advanced techniques: Turkey clinics use the cutting edge techniques that make eye procedures more precise, safe and with a high success rate.

2.Cost Effectiveness: Combining advanced technology, high service standards, and experienced ophthalmologists with affordable costs, competitive price quotes, and comprehensive packages makes Turkey one of the top destinations for eye procedures.

3. Medical tourism encouragement: Making the treatment journey easy, safe, affordable, and more accessible for international patients is key to promoting medical tourism, ensuring they receive high-quality care with seamless travel, accommodation, and support services.

4. Compliance with International Standards: Turkish clinics adhere to global healthcare regulations and quality standards set by JCI, WHO, and FDA, ensuring patient safety, effective treatments, and high medical care standards.

FAQs

What is included in a fundus exam?
A fundus exam includes the evaluation of the retina, optic nerve, and blood vessels at the back of the eye. It may involve pupil dilation, the use of a specialized lens or camera, and techniques such as direct or indirect ophthalmoscopy, slit-lamp examination, or fundus photography.

Is a fundus test painful?
No, a fundus exam is not painful. However, the dilation drops may cause mild discomfort, temporary blurry vision, and sensitivity to light.

What is a normal fundus of the eye?
A normal fundus appears with a well-defined optic disc, healthy retinal blood vessels, and an evenly pigmented retina without signs of disease, bleeding, or abnormalities.

What is the procedure of fundus?
The procedure involves dilating the pupils with eye drops, followed by an examination of the back of the eye using a light source and a lens or imaging device.

What is the fundus examination?
A fundus examination is a diagnostic eye test that allows doctors to assess the retina, optic nerve, and blood vessels to detect conditions such as diabetic retinopathy, glaucoma, and macular degeneration.

What is the purpose of the fundus check?

The purpose of a fundus exam is to diagnose and monitor eye diseases and systemic conditions that affect the retina, such as diabetes, hypertension, and optic nerve disorders.

Which eye drop is used for the fundus exam?
Common eye drops used for fundus exams include tropicamide, phenylephrine, and cyclopentolate, which temporarily dilate the pupils for a clearer view of the retina