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To the Editor.
—I would like to bring to the attention of our colleagues in ophthalmology a technique for the visualization of the posterior pole of the retina through a very small pupil. There is no limit to the smallness of the pupil, but I have been able to get through some of even 0.75 and 0.5 mm as long as the lens and vitreous are clear.The technique is as follows: The patient is placed in front of a good slit lamp. (I have been using the Haag-Streit 900 because of its fine slit and excellent illumination.) A topical anesthetic (eg, tetracaine, proparacaine, etc) is instilled in the eye to be examined. A fundus contact lens is then placed over the cornea. (I have been using the Goldmann three-mirror lens because of its excellent optics.) The fellow eye fixates on the small fixation light provided by the slit-lamp microscope.
Cohen SW. FUNDUSCOPY THROUGH THE MIOTIC PUPIL. Arch Ophthalmol. 1971;85(2):256-257. doi:10.1001/archopht.1971.00990050258029