- Spontaneous venous pulsations (SVPs) are subtle, rhythmic variations in retinal vein caliber on the optic disc and have an association with ICP.
- It is difficult to see SVPs without advanced equipment; however, if a handheld ophthalmoscope is available, it is worth an attempt to visualize the retinal veins.
- Don’t worry if you cannot see SVPs; this may actually be normal. However, if you do see them, it is very reassuring that ICP is normal.10
- If SVPs are initially present and can no longer be seen on subsequent examinations, the provider should be concerned for increasing ICP.
Technique
- Gently lift the eyelid until the pupil is in view.
- Using a handheld ophthalmoscope, the provider should maneuver himself or herself to a position where the optic disc can be visualized.
- Identify the retinal veins as they emerge from the optic disc. Retinal veins are typically slightly larger and darker than retinal arteries. Figure 1 demonstrates the typical appearance of the retina.
- Observe the retinal veins for pulsations. Note the presence or absence of spontaneous venous pulsations
- Repeat the step 1–4 sequence in the contralateral eye.