Fundoscopy: to dilate or not to dilate?

doi:10.1136/bmj.332.7532.3

BMJ 2006;332:3 (7 January), doi:10.1136/bmj.332.7532.3

Editorial

Fundoscopy: to dilate or not to dilate?

The risk of precipitating glaucoma with mydriatic eye dropsis very small

The first 150 words of the full text of this article appear below.

Fundoscopy is commonly used by non-ophthalmologists to screenfor diabetic retinopathy.¹ The sensitivity of fundoscopy througha dilated pupil for detecting diabetic retinopathy is twiceas high as detection through an undilated pupil,² but surveysof general practitioners have found that only 1 in 250 regularlydilate pupils, even when assessing patients at high risk ofdiabetic eye disease.³ A common reason for not dilating pupilsis concern about the risk of precipitating acute angle closureglaucoma.³ How big is this risk?

Recent population based studies indicate that this risk is extremelylow. In the Rotterdam study of 6760 people, routine use of mydriaticeye drops in all participants aged 55 and over precipitatedacute angle closure glaucoma in only two individuals (0.03%).⁴The Baltimore eye survey of 4870 people found no cases of acuteglaucoma precipitated by mydriasis.⁵ In Australia the Blue Mountainseye study of 3654 people . . . [Full text of this article]

Gerald Liew, research fellow

Centre for Vision Research, Department of Ophthalmology (Westmead Hospital), Westmead Millennium Institute, University of Sydney, Australia and Vision Co-operative Research Centre
(gerald_liew@yahoo.com.au)

Paul Mitchell, professor of ophthalmology, Jie Jin Wang, senior research fellow

Centre for Vision Research, Department of Ophthalmology (Westmead Hospital), Westmead Millennium Institute, University of Sydney, Australia and Vision Co-operative Research Centre

Tien Yin Wong, associate professor of ophthalmology

Centre for Eye Research Australia, University of Melbourne, Victoria, Australia

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This article has been cited by other articles:

Bhan, K. J, Bastawrous, A., Davey, K. G (2006). Funduscopy: to dilate or not?: Precipitation of angle closure may not be a disservice. BMJ 332: 179-179 [Full text]
Cackett, P. D (2006). Funduscopy: to dilate or not?: Other drugs can cause partial pupil dilatation. BMJ 332: 179-179 [Full text]

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