NEURO-OPHTHALMOLOGY: Edited by Valérie BiousseExamining the ocular fundus in neurologyRodenbeck, Stefanie J.a,b; Mackay, Devin D.a,b,cAuthor Information aIndiana University School of Medicine bDepartment of Neurology cDepartments of Ophthalmology and Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA Correspondence to Devin D. Mackay, MD, Assistant Professor of Clinical Neurology, Ophthalmology, and Neurosurgery, Indiana University School of Medicine, 355W. 16th Street, Suite 4400, Indianapolis, IN 46202, USA. Tel: +1 317 948 5450; fax: +1 317 962 2141; e-mail: email@example.com Current Opinion in Neurology: February 2019 - Volume 32 - Issue 1 - p 105-110 doi: 10.1097/WCO.0000000000000637 Buy Metrics Abstract Purpose of review The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient care. Recent findings Medical practitioners are often first taught to examine the ocular fundus using a direct ophthalmoscope, however, this skill requires frequent practice. Nonmydriatic tabletop and portable fundus photography and even smartphone-based photography offer alternative and practical means for approaching examination of the ocular fundus. These alternative tools have been shown to be practical in a variety of settings including ambulatory clinics and emergency departments. Decreased retinal microvascular density detected with fundus photography has been linked to accelerated rates of cognitive decline. Research has also found optic disc pallor and retinopathy detected via fundus photography to be more prevalent in patients with recent stroke or transient ischemic attack. Summary Alternative methods of funduscopic examination based on fundus photography have the potential to improve the ease of use, portability, and availability of funduscopy. Recognition of changes in retinal microvasculature has the potential to noninvasively identify patients at the highest risk for cognitive impairment and cerebrovascular disease. However, further research is needed to determine the specific utility of measurements of retinal microvascular changes in clinical care. Innovative funduscopy techniques offer neurologists new approaches to this essential facet of the neurological examination. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.