How to use an ophthalmoscope
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Fundoscopy takes practice. A steady routine makes it work.
Step by step
Set up
Dim room, patient looks at a distant point, set the lens to 0. [1]
Same side
Your right eye and right hand for their right eye. [1]
Red reflex
From about 15 inches, look for the orange-red reflex. [1]
Move in
Follow the reflex in slowly, about 15 degrees from the side. [1]
Optic disc
Follow a vessel to the disc: margins, color, cup. [1]
Vessels and macula
Each quadrant, then ask the patient to look at the light for the macula. [1]
Abnormal
Swollen disc, bleeding, exudates, pale disc. [1]
Common errors
- Bright room.
- Wrong eye.
- Moving in too fast.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Postpartum hemorrhage
- Imminent childbirth
- Hypertensive emergency
- Infective endocarditis
- Type 2 diabetes
- Cataract
33 Making Synapses cases train this skill: open the case library
Sources
- Stanford Medicine 25 (bedside exam)
- NCCPA PANCE Content Blueprint
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.