Ocular fundus image can provide information on pathological changes caused by local ocular diseases and early signs of certain systemic diseases. Automated analysis and interpretation of fundus images has become a necessary and important diagnostic procedure in ophthalmology. Among the features in ocular fundus image are the optic disc, fovea (central vision area), lesions, and retinal vessels. These features are useful in revealing the states of diseases in the form of measurable abnormalities such as length of diameter, change in color, and degree of tortuosity in the vessels. In addition, retinal vessels can also serve as landmarks for image-guided laser treatment of choroidal neovascularization. Thus, reliable methods for blood vessel detection that preserve various vessel measurements are needed. In this paper, we will examine the pathological issues in the analysis of retinal vessels in digital fundus images and give a survey of current image processing methods for extracting vessels in retinal images with a view to categorize them and highlight their differences and similarities. We have also implemented two major approaches using matched filter and mathematical morphology respectively and compared their performances. Some prospective research directions are identified. / Singapore-MIT Alliance (SMA)