Evolution of Fundus Photography - Lessons for Neuro-Ophthalmology as Well as the Retina Service

In 1850, Helmholtz developed the ophthalmoscope which for the first time allowed practitioners to see the back of a living eye. Prior to this, the only studies of the retina were post mortem. Photography had started in the 1830s, but at adapting it to allow pictures of the fundus was limited. It was not until Nordonsen working with Zeiss in the 1920s was able to reduce reflections off the cornea and lens surface with a dot that a practical camera was invented. There were still limitations, including the amount of light, leading to attempts at improving lightening, especially with something like Xenon photocoagulator and later with incandescent bulbs. Significant limitations remained including in most cases the need to dilate the patient, limited illumination, and limited field to the posterior pole (initial studies on diabetes were done with multiple overlapping shots of the posterior pole).