The ophthalmologic examination will determine the extent of intraocular tumor and presence or absence of orbital extension. It is crucial that intraocular examination with a binocular indirect ophthalmoscope be performed on both eyes with the pupils maximally dilated. The ophthalmologist should use diagrams of the retina to show the number, size, and location of all tumors. These diagrams are now being supplemented by the use of RetCam images, which are helpful in determining not only the extent of disease, but response to treatment. When the binocular indirect ophthalmoscope is used, the location of the tumor(s) should be related to specific landmarks such as the optic nerve head, fovea, and ora serrata. Size of the lesion is estimated by comparison with the optic nerve head diameter.
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