NCJ Number
212657
Journal
Journal of Forensic Sciences Volume: 50 Issue: 6 Dated: November 2005 Pages: 1450-1452
Date Published
November 2005
Length
3 pages
Annotation
Postmortem monocular indirect ophthalmoscopy permits examination of the posterior fundus and peripheral retina of the decedent even if there is less than perfect anterior segment media, such as postmortem corneal clouding.
Abstract
Slit lamp ophthalmoscopy is not practical after death, but postmortem fundal examination can be accomplished with monocular indirect ophthalmoscopy, which uses a focal light source and a spheric, convex condensing lens. A halogen or xenon surgical headlamp creates a collimated beam of bright light and permits the examiner to stabilize the condensing lens with both hands. An eyelid speculum readily retracts the decedent's eyelids, and instillation of normal saline keeps the cornea moist during the examination. After dimming the room lights, the light source is held against the examiner's lateral canthus and cheek or positioned between the observer's eyes. The light source must be directed through the pupil to illuminate the fundus and establish the pupillary light reflex. Held between the thumb and index finger, the condensing lens is then positioned in front of the decedent's eye and then slowly pulled toward the examiner until the image of the fundus fills the lens. The condensing lens focuses the light from the headlamp into the decedent's pupil, illuminating a large part of the retina, capturing light reflected from the fundus, and creating the inverted, laterally reverse aerial image of the retina. Even with the lower magnification, the resolving power of indirect ophthalmoscopy is such that even small details can be observed. Postmortem corneal opacity may cause the fundus to appear hazy; however, the emergent image is usually of sufficient quality to permit detection of lesions such as fundal hemorrhages and retinal folds. 2 figures and 12 references