The Arclight illumination uses a light emitting diode placed directly below the viewing hole, facing the patient, creating a near-axial light source unlike the traditional direct ophthalmoscope, which uses a mirror to redirect light into an axial path. The Arclight illumination uses a light emitting diode placed directly below the viewing hole, facing the patient, creating a near-axial light source unlike the traditional direct ophthalmoscope, which uses a mirror to redirect light into an axial path. Rebecca Blundell et al. BMJ Innov 2018;4:98-102 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.