What procedural requirement is necessary for fundic examination?

• A. Not required to dilate
• B. Dilating is harmful
• C. It should be performed with topical anesthetic
• D. Must be dilated with 1% tropicamide

Answer: (D)

To see the fundus clearly you need the pupil dilated so the retina, optic nerve, and macula can be examined without obstruction. A mydriatic drop is used to achieve this dilation, and 1% tropicamide is a common choice because it provides rapid onset, enough dilation for a thorough view, and a short duration with minimal cycloplegia and systemic effects. This makes dilation with a mydriatic a standard, necessary step for routine funduscopic examination.

Topical anesthetic isn’t required for the exam itself, and while dilation isn’t harmful in most patients, there are cases (like angle-closure risk) where dilation must be considered carefully. Still, in typical practice, the essential procedural step is achieving adequate dilation with a mydriatic agent, and 1% tropicamide is the example given for that purpose.