Fundus Examination (easier when eyes are dilated): examine optic disc for clarity, color, size, and condition of vessels; examine macula last to minimize miosis and discomfort; to locate macula, focus on disc, then move light 2 disc diameters temporally;
Fundus conditions: visualize blood in retinal artery
Vascular changes: focal narrowing (usually due to vasospasms), narrowed blood column --> narrowed light reflex, copper wire (increased light reflects), silver wire (100% light reflecting back; common in atherosclerosis and hypertension patients); arterio-venous nicking (see gap between vein and artery blood because wall isn't see through)
Fundus - hypertension: optic disc blurred, increased light reflexes from vessels, AV nicking, cotton-wool spots, exudates, hemorrhages)
Fundus - diabetic retinopathy: coalesced exudates, microaneurysms, deep hemorrhages