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New Instrument
March 2003

Imaging a Child's Fundus Without Dilation Using a Handheld Confocal Scanning Laser Ophthalmoscope

Author Affiliations

From Children's Hospital and Regional Medical Center, Seattle, Wash(Drs Kelly and Weiss), and Laser Diagnostic Technologies (LDT) Inc, San Diego, Calif (Drs Zhou and Dreher and Mr Schmode). Drs Kelly and Weiss were paid consultants for LDT Inc, and Mr Schmode is a former employee of LDT Inc, none of whom have any financial interest in the device. Ms Zhou is a paid employee of LDT Inc, and Dr Dreher is a shareholder in this company, which is the manufacturer of the device.

Arch Ophthalmol. 2003;121(3):391-396. doi:10.1001/archopht.121.3.391

Images of the fundus were acquired in children without pupil dilation using a prototype handheld confocal scanning laser ophthalmoscope (SLO). A 780-nm laser beam imaged a 20° × 20° area of the fundus while a 645-nm beam scanned a fixation target. Scorable images of the optic nerve, macula, and vessels were obtained in 67 (72%) of 93 eyes from pediatric patients with nystagmus, amblyopia, media opacities, or optic nerve or macular abnormalities. Images were obtained in all eyes of pediatric and adult controls. Unsuccessful imaging was associated with media opacities, high refractive error, and poor cooperation. Disadvantages of the SLO were the inability to detect optic nerve pallor or consistently image the periphery. Advantages of the SLO were seen in children with nystagmus, photophobia, eccentric fixation, cone dystrophy, and mild papilledema.