Article Text

other Versions

How to use…the direct ophthalmoscope
  1. Sam P Gurney1,
  2. Taiwo Makanjuola1,
  3. Muhammad Kutubi1,
  4. Manoj Parulekar1,2,
  5. Joseph Abbott1
  1. 1Department of Paediatric Ophthalmology, Birmingham Children’s Hospital, Birmingham, UK
  2. 2Department of Ophthalmology, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Sam P Gurney, Department of Paediatric Ophthalmology, Birmingham Children’s Hospital, Birmingham, B4 6NH, UK; sam.gurney{at}


Ophthalmoscopy and red reflex examination are core medical skills required to identify sight-threatening and life-threatening disease. We discuss the predictive utility and limitations of findings with an ophthalmoscope and tips as to how to optimise these. We outline important considerations in three clinical scenarios: an abnormal red reflex, an abnormal optic disc and retinal haemorrhages in the context of child protection concerns.

  • ophthalmology
  • neurology
  • neurosurgery
  • general paediatrics
  • neonatology

Statistics from


  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.