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.

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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.

Thank you for everey other great post. Where else may anyone gget that kind of information iin such an ideal means of writing?
I have a presentation next week, and I am at the look for such information.

Here is my web page: purchase coollege research papers - Zelma,

Hey there this is kiund of of off topic butt I was wanting
too now if blogs uuse WYSIWYG editors or if you have to manually code with HTML.
I'm starting a blog soon but have no coding knowledge so
I anted to get guidance froim someone with experience.
Any help would be enormously appreciated!

Also visit mmy web page ... forex trading tutorial (Paul)

What's Taking place i am neww tto this, I stumbled uponn this I ave discovered It
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I am hoping to give a contribution & assist different users like its aided me.
Great job.

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got me even more info!

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Youur style is unique compared to other people I've read stuff
from. Many thanks for posting when you have the opportunity, Guess
I'll just book mark this page.

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suggest to my friends. I am confident they wikl be benefited from
this website.

My site - superb paper essay

Hey very cool site!! Guuy .. Excellent .. Superb .. I will bookmark
your blog annd take the feeds additionally? I am happy to find a lot of helpful ino right here within the post,
wwe want work out more techniques inn this regard, thanks for sharing.
. . . . .

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Right here is the right blog for anyone who hopes to understand this
topic. You know a whole lot its almost tough to argue with you
(not that I actually will need to...HaHa).

You definitely put a new spin on a topic that's been discussed for years.
Great stuff, just excellent!

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What's Takibg place i'm new to this, I stumbled upon this I've discovered It positively useful
and it has helped me out loads. I am hoping to
give a contribution & help other customers like its aided me.
Great job.

my web page: Wiseessays services (jahandigital.ir)

My spousee and i have been joyful when Albert could finish
off his reports by way of the ideas he made while using the web site.
It's not at all simplistic to just be making a gift of helpful hints that other people may have been selling.

And wee recognize we need the writer to bbe grateful to for that.
The type of explanations you made, the easy web site menu,
the friendships you help promote - it's got many impressive, and
itt is facilitating our sonn in addition to the family feel that this matter is enjoyable, and that is exceptionallly fundamental.
Thank youu for everything!

Look at my homepage mfm7 ea download

I waas wondering if you ever considered chaging
the layout of your blog? Its very well written; I love what youve got too say.
But maybe you could a little more in the waay of ontent so people
could connect with it better. Youve gott an awful lot of text for only having one or two images.
Maybe you could space it out better?

Here is my web-site; football tipster

Hello there, I found your web sjte by the use of Google att the same time as looking for a related matter,
your web sit came up, it appears good. I have bookmarked it in my google bookmarks.[X-N-E-W-L-I-N-S-P-I-N-X]Hello there, simply was aware of
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This is very interesting, You are a very skilled blogger.
I've jkined your rss feed and look forward to seeking
more of your magnificent post. Also, I have shared your website in my social networks!

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I really like meeting useful info, this post has got me even more info!

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Howdy this is kind of of off topic but I was wanting to know if blogs use WYSIWYG editors or if you have to manually code with HTML.
I'm starting a blog soon but have no coding skillos so
I wanted to get advice from someone with experience. Any help would be enormously appreciated!

My site: forex grid trading strategy system - Gita,

Wow! Thank you! I always needed to write on my blog somethimg like that.
Can Iinclude a fragment of your post to my site?

Review my blog; mfm7 reviews

Havee you ever thought about creating an e-book orr guest auythoring on other websites?
I have a blogg centered oon the same information you discuss and would love to have you share some stories/information. I know my readers would appreciate your work.
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Oh my goodness! Amazing article dude! Thank you so much, However I am encountering difficulties with your RSS.
I don't understand the reason why I cannot subscribe to it.

Is there anybody having similar RSS issues? Anybody who
knows the answer will you kindly respond? Thanks!!

Calochortus [Cathryn]
https://rikardinho69.blogspot.com/2019/11/microcreditos-al-instante.html

We're a group of volunteers and starting a new scheme in our community.
Your web site provided us with valuable info to
work on. You have done a formidable job and our wwhole ommunity will be grateful to you.

My web-site forex best robot trtaders current (Andra)

Add new comment

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