Children may become frightened as the clinician approaches closely, during direct ophthalmoscopy and co-operation could be lost. Also, children often look at the ophthalmoscope light and track it as the clinician moves, allowing examination of the macula but not the optic disc. Furthermore, the field of view is small and the magnification is more than is necessary. This will prevent the examiner from seeing the ‘big picture’. To avoid these difficulties the direct ophthalmoscope can be used with a 20D condensing lens, the type used with head mounted binocular indirect ophthalmoscopes. This combination provides a moderately magnified and wider angle, view of the posterior pole and avoids the close proximity between the patient and clinician. The technique has been noted for providing a good view of the retina through a small pupil when dilation is contraindicated.