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Step-By-Step Fundus Photography and Fluorescein Angiography

Plan the procedure

  1. Review patient records including: ocular diagnosis, allergies, pregnancy status, systemic diseases
  1. Review photographic request, confirm area of interest
  1. Plan the photographic procedure

Prepare the patient

  1. Confirm adequate dilation
  1. Inform patient of procedures, pharmacologic agents to be administered, and potential side effects
  1. Answer patient questions concerning the procedure
  1. Position patient for photography

Prepare the camera

  1. Enter patient demographic information into capture software or photograph patient ID
  1. Set eyepiece for accommodative correction
  1. Select camera back
  1. Set viewing angle
  1. Set flash power
  1. Set viewing light

Perform Fundus Photography

  1. Establish fixation with external or internal fixation device
  1. Use joystick to align illumination beam within pupil
  1. Focus on designated field of view
  1. Use astigmatic correction device if available/needed
  1. Take color photographs of required area of interest
  1. Use lateral shift of joystick to obtain sequential stereo pairs
  1. Review images for quality, correct artifacts and adjust settings accordingly
  1. Switch camera back/adjust settings for monochromatic green (red-free) photos
  1. Engage green filter
  1. Set flash power
  1. Take monochromatic green photographs of required area of interest
  1. Use lateral shift of joystick to obtain sequential stereo pairs

Perform Fluorescein Angiography

  1. Make preparations for IV fluorescein injection
  1. Switch camera back/ adjust settings for fluorescein angiography
  1. Engage exciter and barrier filters
  1. Set flash power
  1. Position patient for procedure (with arm extended)
  1. Establish fixation with external or internal fixation device
  1. Use joystick to align illumination beam within pupil of eye of interest
  1. Focus on designated field of view
  1. Take a control photograph to confirm absence of pseudofluorescence
  1. Cue injector to begin
  1. Start timer concurrent with the administration of dye
  1. Begin pre-planned photographic sequence
  1. Early transit capture rate of one frame per second of posterior pole or area of interest until about 40 seconds.
  1. Use lateral shift of joystick to obtain sequential stereo pairs
  1. Capture posterior pole photos of fellow eye.
  1. Follow with peripheral survey fields of transit eye if necessary
  1. Monitor and assess the patient's response to the procedure
  1. Respond to any adverse reactions experienced by the patient
  1. Perform mid-phase photographs of posterior pole at 2-4 minutes post injection
  1. Perform late phase photographs at 7-10 minutes post injection increase flash setting or camera gain settings for adequate late exposure
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COPYRIGHT © 2011-2013 THE AUTHOR(S) AND THE OPHTHALMIC PHOTOGRAPHERS' SOCIETY INC.
ALL RIGHTS RESERVED.