7/17/2019 Funduscopic Grading Card With Instructions

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C/D Ratio

 

0.1 0.15

 0.2 0.25

 0.3 0.35

 0.4 0.45

 0.5 0.55

 0.6 0.65

 0.7 0.75

 0.8 0.85

 0.9 0.95

A/V Ratio

  0.1 0.6

  0.2 0.7

  0.3 0.8

  0.4 0.9

  0.5 1.0

ALR Ratio

  0.1

  0.2

  0.3

  0.4

  0.5

  0.6

  0.7

  0.8  0.9

JLC Grading Card

7/17/2019 Funduscopic Grading Card With Instructions

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Grading the C/D RatioDetermine Size of Optic NerveDefined as the inner margin of the white peripapillary scleral ring of Elschnig.

Determine Size of CupThe first discernible change in surface contour, as the surface of the optic nerve head courses posteriorly at the rim of the cup.

Point at which the smaller disc vessels bend/course abruptly over the rim of the cup.

The boundary at which parallax movements indicate a difference in depth, noting where thestreak breaks as it is passed over the disc.

Cupping is not equivalent to the area of central pallor.

Grading the RatioCD ratio recorded in decimal form to the nearest 0.05 disc diameter.

Using the standards, the horizontal CD ratio is the longest diameter ofthe optic cup to the longest diameter of the optic disc on the horizontalmeridian.

Using the standards, the vertical CD ratio is the longest diameter of the opticcup to the longest diameter of the optic disc on the vertical meridian.

Estimate the 3:00 – 9:00 meridian.

Estimate the 6:00 – 12:00 meridian.

Confounding Factor  When the optic nerve enters the sclera obliquely and the anatomic configuration is tilted withrespect to the optical axis, an estimate is made of the ratio at the plane perpendicular to theaxis of insertion of the optic nerve to the eye.

Grading the A/V RatioLocate an arteriole and venule at approximately 1 disc diameter from the papillary margin.Using the standards, the ratio is the closest match of the arteriole over the venule.

Grading the ALR RatioLocate an arteriole at approximately 1 disc diameter from the papillary margin.Using the standards, the ratio is the closest match of the arteriole light reflex to the width ofthe artery.