Retinal photography: what to expect

• Retinal photography captures a detailed image of the back of the eye to visualize tissues including the retina, optic nerve, and blood vessels.
• Digital retinal imaging helps optometrists and eye doctors assess the health of the eye, diagnose eye conditions, and monitor changes in eye health over time.
• The process of taking retinal photographs is non-invasive, safe, quick, and painless.

Retinal photography (also known as digital retinal imaging or fundus photography) uses a high-resolution camera to create detailed images inside the back of the eye, which is collectively known as the fundus.

Retinal images capture a snapshot of the back of the eye at a particular point in time, which helps optometrists and eye doctors assess the health of several important structures, including:

• The retina - a thin layer of tissue at the back of the eye that plays a crucial role in vision.
• Optic disc – the visible area of the optic nerve, which connects the back of the eye directly to the brain. The optic nerve is responsible for carrying visual signals in a one-way direction from the eye to the brain, allowing the brain to process vision.
• Blood vessels – as with other parts of the body, blood vessels within and around the retina supply oxygen and other nutrients to maintain normal health and function.
• Macula – a small region at the center of the retina responsible for detecting small details within your central vision.

Retinal imaging helps identify early signs of eye diseases that may not show any obvious symptoms at first.

It is also used to monitor any existing eye conditions such as glaucoma, age-related macular degeneration, diabetic retinopathy to ensure they are managed effectively.

In addition, retinal imaging also helps build a detailed eye health record, making it easier for healthcare providers to understand changes over time and support long-term vision care.

Retinal photography is a safe, non-invasive, and painless procedure that is usually quick to perform.

Modern retinal cameras can often capture clear images without the need to dilate the pupils. The test is typically performed in a dimly lit room, which helps the pupils naturally widen and improves image quality. In some cases, if the patient has naturally small pupils or when the initial images are not clear enough, eye drops may be used to temporarily enlarge the pupils.

No special preparation is required. Your child will be asked to look at a target inside the camera, while a small flash of light captures the image — similar to having a regular photograph taken. There are no lasting side effects, and the test is usually completed within a few minutes, making it easy for most children to tolerate.

After the photographs are taken, you eye care professional will review the images and discuss the findings with you. In many cases, the results are available straight away, allowing them to explain whether everything appears healthy, or whether there are any abnormal findings or changes.

When reviewing retinal images, eye care professionals assess the health of the eye by examining the features of key tissues such as the optic nerve, retina, macula, blood vessels, and more. While these provide an indication of eye health, they can even offer insight into the state of general health issues such as diabetes. In rarer occasions, retinal photographs can highlight signs of neurological problems and unusual growths such as tumours.

If anything unusual is detected, this does not necessarily mean there is a serious problem. Your eye care professional may recommend monitoring, additional tests, or referral to a specialist to gather more information. In many cases, retinal photography provides reassurance that the eyes are healthy and establishes a useful baseline for future comparisons.

Different imaging filters and techniques may be used to examine specific parts of the retina more closely:

•          Wide field retinal imaging – provides a comprehensive view of the retina that captures both the central and peripheral, outer regions
•          Red-free Filter – Enhances visibility of blood vessels and nerve fibres. Fundus autofluorescence – highlights pigment (lipofuscin) build-up associated with age-related changes.
•          Fluorescein angiography – tracks blood flow to detect leakages or blockages.

The frequency of retinal photography depends on your child’s eye health and individual risk. For children with healthy eyes, it is typically recommended once a year during their regular eye examination. If your child has an existing eye condition or strong risk factors, your optometrist or eye doctor may recommend more frequent imaging to monitor changes and guide treatment decisions.

1.         Mishra, C. and Tripathy, K., 2022. Fundus camera.
2.         Mizuno K, Majima A, Ozawa K, Ito H. Red-Free Light Fundus Photography: Photographic Optogram. Investigative Ophthalmology & Visual Science. 1968 Jun 1;7(3):241-9.
3.         Sepah YJ, Akhtar A, Sadiq MA, Hafeez Y, Nasir H, Perez B, Mawji N, Dean DJ, Ferraz D, Nguyen QD. Fundus autofluorescence imaging: Fundamentals and clinical relevance. Saudi Journal of Ophthalmology. 2014 Apr 1;28(2):111-6