Off-axis nonmydriatic photography to evaluate the posterior pole through small pupils.
OBJECTIVE
The purpose of this study was to improve the clarity of retinal images photographed through small pupils.


METHODS
Retinal photographs were taken with a Topcon TRC-NW100 digital nonmydriatic camera centered and decentered about the pupillary axis. Four hundred and twelve consecutive individuals (age, 8-95 years) were screened for eye disease with nonmydriatic retinal photography in the District 33N Lions Eyemobile during a 1-year period.


RESULTS
Twenty-nine percent of the eyes photographed had pupillary diameters <4 mm and yielded or would have yielded poor-quality images of the posterior pole with standard, on-axis alignment. In 78% of these eyes with small pupils, photography with off-axis alignment produced images of sufficient clarity for clinical assessment of retinal appearance.


CONCLUSIONS
Off-axis alignment increases the percentage of gradable images of the posterior pole in individuals with small pupils.
From the *Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and †The Massachusetts Lions District 33N Eyemobile, Inc., Woburn, Massachusetts.
Michael A
MA
Sandberg
Alexander R
AR
Gaudio