slit-lamp-examination
March 25, 2019
For further examination, you can add a few drops to dilate the patient’s pupil. Before you can observe the back of the eye, wait 15 to 20 minutes for the drops to dilate the pupils.


Types of Illumination Techniques

The slit lamp is mounted on a moveable stand. The joystick is used to move the slit lamp left, right, backwards and forwards, as well as raising or lowering it. It has a slit projector which can pivot 180 degrees. The instrument also consists of a beam that can be projected tangential, perpendicular or adjusted to an angle of preference. Ensure you move the light source frequently at different angles while performing the examination - it makes it easier to identify abnormalities.

There are several slit lamp lighting techniques which are used during an examination:

Direct Focal Illumination
The direct focal illumination is the most frequently used method for closer inspection of the eye. The optic section, parallelepiped and conical beam are types of direct focal illumination.

The optical section is used to evaluate the severity of the patient’s cornea or finding out the opacity and depth within the lens. Direct the biomicroscope into the patient’s eye. The angle between illuminating and viewing path should be as big as possible but not extended beyond 90 degrees. Keep the slit length small, the most commonly used magnification is between 7 – 10 X.

The parallelepiped is used to assess corneal scars, abrasions, nerves and blood vessels. Focus the biomicroscope into the patient’s eye parallelepiped slit should be around 1 mm wide and 2 mm long. The light beam should be directed to the pupil at a 45 – 60 degrees angle. The examination should be done in a dark room and make sure to allow time to adapt to the change.

The conical beam is used to observe floating debris in the anterior chamber. It is recommended to use high magnification and dim the lights to a minimum or total darkness for this technique. At approximately 45 degrees, the beam is focused between the cornea and the surface of the anterior lens.

Diffuse Illumination
Diffuse illumination is used to provide light to the eye for general survey and observation. This method is useful if the patient’s cornea is opaque, and if you can’t obtain any optical section images. A wide beam of light with the slit fully opened is directed to the cornea or area of interest at 30 – 50 degrees angle. A low to medium magnification (5 – 12 X) is used to display a view of the eye and visualise the structures. Also, with particular dyes, cobalt blue filter or green (red-free) filter can be used together with diffuse illumination to determine various eye conditions.

Retroillumination
Retroillumination is the best method to study the cornea. It uses parallelepiped light to reflect unfocussed light of structures such as the iris, crystalline lens or the retina and observes the back-lighting. Firstly, you should dilate the patient’s pupils and adjust the slit width to 1-2 mm wide and 4-5 mm high. Use a low magnification (7-10 X) before reflecting light from the edge of the iris to illuminate the cornea. The iris is defective if you see an orange glow within the eye.
 
Sclerotic Scatter Illumination
Maximise the light source and focus a wide beam on the limbal region of the cornea. A low magnification (6 – 10 X) and a low angle should be selected so you can see the entire cornea at first glance. The cornea will appear transparent and clear if the eye is normal. However, an illumination or shadow suggests scars, deposits and opacities.

Specular Reflection Illumination
The specular reflection illumination is used to observe the endothelial cells of the cornea. Firstly, focus the biomicroscope in front of the patient’s eye. You should use high magnification and parallelepiped illumination at 45 – 60 degrees for this method.


Indirect Illumination
The indirect illumination is useful to determine irregularities of the corneal epithelium or foreign particles embedded in the cornea. A biomicroscope is directed to the area of interest, and immediately the light beam is positioned next to the focus area at approximately 45 degrees. The beam passes through the cornea but not the iris. As a result, the reflected, indirect light illuminates the cornea and allows close inspection.

Having read this I thought it was very enlightening. I appreciate you spending some time and energy to put this article together.
I once again find myself spending a significant amount of time
both reading and leaving comments. But so what, it was still
worthwhile!

turn on a dime (Bennie)
http://boreliozakrakow.tumblr.com

I know this if off topic but I'm looking into starting my own weblog and was wondering what all is required to get set up?

I'm assuming having a blog like yours would cost
a pretty penny? I'm not very internet smart so I'm not 100% certain. Any tips or
advice would be greatly appreciated. Appreciate it

command prompt, Celeste,

http://boreliozakrakow.tumblr.com

When I initially commented I seem to have clicked on the -Notify
me when new comments are added- checkbox and from now on every time a comment is
added I get 4 emails with the exact same comment. There has to be a way you are able to remove me from that service?
Appreciate it!

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http://boreliozakrakow.tumblr.com

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be really something that I think I would never understand.
It seems too complex and very broad for me. I am looking forward for your next post, I will try to get the hang of it!

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http://boreliozakrakow.tumblr.com

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Will probably be back to get more. Thanks

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http://boreliozakrakow.tumblr.com

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Meta Title
How to Conduct Slit Lamp Examinations | Brawn Medical
Meta Description
Read our article to learn various techniques you can use when conducting a slit lamp examination on a patient.

How to Conduct Slit Lamp Examinations

A slit lamp is an instrument which consists of a high-intensity light source. An eye doctor can shine a light from the instrument into the patient’s eye. This allows different structures of their eye to be observed in more detail as the slit lamp provides a magnified view. Also, a biomicroscope is used in combination with the slit lamp to allow the eye doctor (ophthalmologist) to see the structure of the back of the patient's eye. The slit lamp is used to determine the health of the patient’s eyes and diagnose whether they may have an eye disease.

If you’re starting optometry school or are an experienced eye doctor, it is important to learn or review slit lamp lighting techniques to refresh your memory. Continue reading to learn various techniques you can use when conducting a slit lamp examination on a patient.

The General Procedure

Once the patient is seated in the examination chair, Instruct them to rest their chin and forehead as direct by the ophthalmologist to steady their head, and then begin to examine the patient’s eye with a biomicroscope.

You may need to carry out a fluorescein eye stain test if you suspect their cornea is damaged or you have detected foreign objects in their eye. Touch the piece of paper stain with fluorescein on the side of the patient’s eye and ask them to blink. The dye will spread and coat the tear film that covers the surface of their cornea after blinking. You can shine cobalt blue light in the patient’s eye to highlight any abnormalities or abrasion on their
cornea. If the dye appears smooth across the patient’s eye, their cornea is not damaged. However if the dye appears green under cobalt blue light, this suggests that the patient has an eye abnormality.

For further examination, you can add a few drops to dilate the patient’s pupil. Before you can observe the back of the eye, wait 15 to 20 minutes for the drops to dilate the pupils.


Types of Illumination Techniques

The slit lamp is mounted on a moveable stand. The joystick is used to move the slit lamp left, right, backwards and forwards, as well as raising or lowering it. It has a slit projector which can pivot 180 degrees. The instrument also consists of a beam that can be projected tangential, perpendicular or adjusted to an angle of preference. Ensure you move the light source frequently at different angles while performing the examination - it makes it easier to identify abnormalities.

There are several slit lamp lighting techniques which are used during an examination:

Direct Focal Illumination
The direct focal illumination is the most frequently used method for closer inspection of the eye. The optic section, parallelepiped and conical beam are types of direct focal illumination.

The optical section is used to evaluate the severity of the patient’s cornea or finding out the opacity and depth within the lens. Direct the biomicroscope into the patient’s eye. The angle between illuminating and viewing path should be as big as possible but not extended beyond 90 degrees. Keep the slit length small, the most commonly used magnification is between 7 – 10 X.

The parallelepiped is used to assess corneal scars, abrasions, nerves and blood vessels. Focus the biomicroscope into the patient’s eye parallelepiped slit should be around 1 mm wide and 2 mm long. The light beam should be directed to the pupil at a 45 – 60 degrees angle. The examination should be done in a dark room and make sure to allow time to adapt to the change.

The conical beam is used to observe floating debris in the anterior chamber. It is recommended to use high magnification and dim the lights to a minimum or total darkness for this technique. At approximately 45 degrees, the beam is focused between the cornea and the surface of the anterior lens.

Diffuse Illumination
Diffuse illumination is used to provide light to the eye for general survey and observation. This method is useful if the patient’s cornea is opaque, and if you can’t obtain any optical section images. A wide beam of light with the slit fully opened is directed to the cornea or area of interest at 30 – 50 degrees angle. A low to medium magnification (5 – 12 X) is used to display a view of the eye and visualise the structures. Also, with particular dyes, cobalt blue filter or green (red-free) filter can be used together with diffuse illumination to determine various eye conditions.

Retroillumination
Retroillumination is the best method to study the cornea. It uses parallelepiped light to reflect unfocussed light of structures such as the iris, crystalline lens or the retina and observes the back-lighting. Firstly, you should dilate the patient’s pupils and adjust the slit width to 1-2 mm wide and 4-5 mm high. Use a low magnification (7-10 X) before reflecting light from the edge of the iris to illuminate the cornea. The iris is defective if you see an orange glow within the eye.
 
Sclerotic Scatter Illumination
Maximise the light source and focus a wide beam on the limbal region of the cornea. A low magnification (6 – 10 X) and a low angle should be selected so you can see the entire cornea at first glance. The cornea will appear transparent and clear if the eye is normal. However, an illumination or shadow suggests scars, deposits and opacities.

Specular Reflection Illumination
The specular reflection illumination is used to observe the endothelial cells of the cornea. Firstly, focus the biomicroscope in front of the patient’s eye. You should use high magnification and parallelepiped illumination at 45 – 60 degrees for this method.


Indirect Illumination
The indirect illumination is useful to determine irregularities of the corneal epithelium or foreign particles embedded in the cornea. A biomicroscope is directed to the area of interest, and immediately the light beam is positioned next to the focus area at approximately 45 degrees. The beam passes through the cornea but not the iris. As a result, the reflected, indirect light illuminates the cornea and allows close inspection.

Having read this I thought it was very enlightening. I appreciate you spending some time and energy to put this article together.
I once again find myself spending a significant amount of time
both reading and leaving comments. But so what, it was still
worthwhile!

turn on a dime (Bennie)
http://boreliozakrakow.tumblr.com

I know this if off topic but I'm looking into starting my own weblog and was wondering what all is required to get set up?

I'm assuming having a blog like yours would cost
a pretty penny? I'm not very internet smart so I'm not 100% certain. Any tips or
advice would be greatly appreciated. Appreciate it

command prompt, Celeste,

http://boreliozakrakow.tumblr.com

When I initially commented I seem to have clicked on the -Notify
me when new comments are added- checkbox and from now on every time a comment is
added I get 4 emails with the exact same comment. There has to be a way you are able to remove me from that service?
Appreciate it!

syphilographer (Lida)
http://boreliozakrakow.tumblr.com

I've learn a few just right stuff here. Certainly price bookmarking for revisiting.
I surprise how much effort you set to make this sort of wonderful informative web site.

my weblog; november

Hello would you mind letting me know which web host you're utilizing?
I've loaded your blog in 3 different web browsers
and I must say this blog loads a lot quicker then most.
Can you recommend a good web hosting provider at a fair price?
Many thanks, I appreciate it!

woodenheads (Audry)
http://boreliozakrakow.tumblr.com

It's very easy to find out any topic on net
as compared to books, as I found this piece of writing at this site.

Feel free to surf to my site - parkolas

You actually make it seem so easy with your presentation but I find this matter to
be really something that I think I would never understand.
It seems too complex and very broad for me. I am looking forward for your next post, I will try to get the hang of it!

reprinting - Stevie -
http://boreliozakrakow.tumblr.com

Hello, I do believe your site might be having
web browser compatibility issues. Whenever I look at your website in Safari,
it looks fine however, if opening in IE, it's got some overlapping issues.
I merely wanted to give you a quick heads up! Other than that,
wonderful site!

effulging (Lane)
http://boreliozakrakow.tumblr.com

Magnificent goods from you, man. I've understand your stuff previous to
and you are just too fantastic. I actually like what you've acquired here,
really like what you're stating and the way in which
you say it. You make it entertaining and you still care for to keep
it wise. I can not wait to read far more from you.
This is actually a wonderful website.

Sylvilagus palustris (Mohammed)
http://boreliozakrakow.tumblr.com

I do not know if it's just me or if everyone else experiencing issues with your site.
It seems like some of the text in your posts are running off the screen. Can someone else please comment and
let me know if this is happening to them too? This might be
a issue with my web browser because I've had this happen before.

Cheers

drubber - Dillon -
http://boreliozakrakow.tumblr.com

Please let me know if you're looking for a article writer for
your blog. You have some really great posts and I think
I would be a good asset. If you ever want to take some of the load off,
I'd absolutely love to write some material for your blog in exchange for a link back to mine.
Please send me an email if interested. Thank you!

mind's eye (Alberto)
http://boreliozakrakow.tumblr.com

Hello there I am so glad I found your blog page, I really found you
by accident, while I was browsing on Google for something else,
Regardless I am here now and would just like to say many thanks for a fantastic post and
a all round exciting blog (I also love the theme/design),
I don't have time to read through it all at the minute but I have saved it and also included your RSS feeds, so when I have time I will be back to read a great
deal more, Please do keep up the superb work.

Valentine (Graciela)
http://boreliozakrakow.tumblr.com

Undeniably believe that which you said. Your favorite justification appeared to be on the web the easiest thing to be aware of.
I say to you, I certainly get irked while people consider worries that they plainly don't
know about. You managed to hit the nail upon the top and defined out the whole thing without having side effect ,
people could take a signal. Will probably
be back to get more. Thanks

enflurane; Elton,
http://boreliozakrakow.tumblr.com

I'm extremely impressed with your writing skills and also with the layout on your blog.
Is this a paid theme or did you customize it yourself? Anyway keep
up the nice quality writing, it's rare to see a nice blog like this one nowadays.

Ascaphus (Lionel)
http://boreliozakrakow.tumblr.com

Hello there! I could have sworn I've visited this web site before but after looking at a few
of the articles I realized it's new to me. Anyhow,
I'm definitely delighted I stumbled upon it and
I'll be bookmarking it and checking back often!

cosmists (Junko)
http://boreliozakrakow.tumblr.com

It is appropriate time to make some plans for the future and it's time to be
happy. I have read this post and if I could I want to suggest you few interesting things or
suggestions. Perhaps you can write next articles referring to this article.
I desire to read more things about it!

fathers (Cheryle)
http://boreliozakrakow.tumblr.com

Heya i am for the first time here. I found this board and
I find It really useful & it helped me out much. I hope to give something back
and aid others like you helped me.

Also visit my web site - tourident

I believe what you typed was very reasonable. But, think about this, suppose you typed a catchier post title?
I ain't suggesting your information isn't solid, but what if you added something that makes people
want more? I mean Add new comment is kinda boring. You
could glance at Yahoo's front page and see how they write post titles to get people to click.
You might add a related video or a pic or two to get readers excited about everything've written. In my opinion, it might make your posts a little livelier.

up-to-date (Pasquale)
http://boreliozakrakow.tumblr.com

Definitely believe that which you said. Your favorite justification appeared to be on the net the simplest thing to be aware of.
I say to you, I definitely get irked while people think about worries that they plainly do not know about.
You managed to hit the nail upon the top and defined out the whole thing without
having side-effects , people can take a signal.

Will probably be back to get more. Thanks

crucifixion (Danilo)
http://boreliozakrakow.tumblr.com

Add new comment

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