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Fundoscopy in cats: a practical guide and common findings

Natalia Giannakopoulou DVM, PGCertSAO, MRCVS
Ben Blacklock BVSc, DipECVO, SFHEA, MRCVS

Background
Fundoscopy is a vital component of feline physical and ophthalmic examinations, particularly for senior cats and those with ocular or systemic disease signs. This technique allows clinicians to assess the retina and detect early manifestations of systemic illnesses, including hypertension, taurine deficiency, and infectious diseases such as feline infectious peritonitis (FIP). Fundoscopy can significantly influence diagnostic accuracy, treatment decisions, and outcomes, especially when used routinely.

Methods
This clinical review provides a practical guide based on published evidence and the authors’ extensive clinical experience. It outlines step-by-step procedures for performing direct and indirect ophthalmoscopy, including equipment recommendations such as condensing lenses, ophthalmoscopes, and smartphone fundus photography setups. Techniques for preparing the examination room, dilating pupils, and restraining the patient are detailed, with emphasis on using tropicamide as the preferred mydriatic agent. The article also includes a guide to interpreting fundoscopic findings and troubleshooting tips for image acquisition.

Results
The article describes typical fundoscopic appearances of the healthy feline retina and catalogues characteristic lesions associated with congenital, degenerative, hypertensive, infectious, and neoplastic diseases. Notable findings include:
-Retinal dysplasia (hyporeflective retinal folds)
-Retinal degeneration (tapetal hyper-reflectivity, vessel attenuation)
-FCRD (elliptical lesions at the area centralis)
-Hypertensive retinopathy (arteriole tortuosity, haemorrhages, retinal detachment)
-Chorioretinitis (active vs inactive lesion differentiation)
-Pathognomonic findings in systemic diseases (e.g., perivascular cuffing in FIP, granulomas in toxoplasmosis or mycobacterial infections)
-Secondary neoplastic lesions with wedge-shaped fundic changes
-Smartphone fundoscopy is highlighted as a cost-effective and accessible imaging method. A case study illustrates its utility in diagnosing and monitoring FIP-related retinal detachment, with fundic recovery observed following antiviral therapy.

Limitations
The review does not present original experimental data or a systematic meta-analysis. Its findings are primarily based on literature synthesis and expert opinion. The procedures and disease manifestations may vary based on equipment quality, clinician expertise, and individual patient presentation. Limitations also include the absence of prospective clinical trial data validating specific fundoscopic techniques or lesion correlations.

Conclusions
Routine fundoscopy should be integrated into feline veterinary care to facilitate early diagnosis of systemic and ocular diseases. Mastery of both direct and indirect ophthalmoscopy—complemented by smartphone photography—enables thorough retinal assessment. Characteristic fundic changes can serve as critical diagnostic clues and help monitor therapeutic outcomes, thereby enhancing patient management and prognosis.

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