The Art of Ophthalmology

Fundus flowers make front-page news.

By Annette Terebuh, MD

In 2015, my mother—a medical technologist, nurse, and talented artist—asked me to participate in a charitable art event being sponsored by the Logan County Art League. The paintings were to be displayed in a gallery in downtown Bellefontaine, Ohio, for a month and then auctioned off for charity. I said yes with great reluctance and trepidation, because my drawing/painting capabilities leave much to be desired. My first instinct was to paint ballet dancers, because I was a ballerina before changing my college major from dance to premed. I quickly discarded that idea, since ballerina stick figures are not very elegant.

I then recalled the charcoal sketch of “floaters” that one of my patients gave me after I examined him for an acute posterior vitreous detachment. His art reminded me that the one thing that I am extremely good at drawing is optic nerves. In fact, my nerve drawings are one of my trademarks. I realized, however, that a nerve drawing in and of itself would not be a very interesting painting, so I had the idea to combine my love of ophthalmology with my love of gardening. The idea to paint “fundus flowers” was born.

The optic nerve became the center of the flower, the fundus vessels became the flower’s veins, the main petal color was arched in the manner of the nerve fiber layer, and retinal/choroidal pathology became markings or spots on the flower petals. My painting, “In the Eye of the Beholder,” shows three flowers, which are have three fundi each and represent different types of pathology:

1. The red flower shows a red retinal nerve fiber layer (RNFL), a glaucomatous nerve with an inferior acquired pit of the optic nerve, elevated malignant melanoma with vessels arching over it (inferior), three flat scattered nevi (nasal), and a large flat choroidal nevus with overlying optic disc drusen overlying (superior).

2. The orange flower shows an orange RNFL, a normal optic nerve, age-related macular degeneration with subretinal neovascular membrane degeneration, and nonproliferative diabetic retinopathy with scattered hard exudates and microaneurysms.

3. The pink flower shows a pink RNFL, papilledema, ora serrata, and six horseshoe tears.

The mayor, a judge, the sheriff, my ballet teacher, an organic farmer, a reporter, and many other “good people” in Bellefontaine created wonderful paintings that were judged good enough by the Logan County Art League to merit changing the event title from Bad Art by Good People to Not so Good Art by Good People.

To my surprise, all of us who participated were featured on the front page of our local newspaper.

Although I do think my idea of fundus flowers was rather clever, my execution leaves significant room for improvement. Perhaps when I retire from ophthalmology, I will work seriously on my artistic skills and embark on a new career combining ophthalmology and flowers, creating paintings in the new field of ophlowerology (oph-flower-ology).

Annette Terebuh, MD
• private practice, Bellefontaine, Ohio
• clinical assistant professor, Glaucoma Division, Havener Eye Institute, Ohio State University, Columbus
• (937) 593-3881;

Tags: Glaucoma

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