Podcast
Questions and Answers
What is the primary purpose of the parallelepiped illumination technique?
What is the primary purpose of the parallelepiped illumination technique?
- To examine the tear film, cornea, and lens in 3-D (correct)
- To visualize the anterior chamber and identify any debris
- To assess the clarity of the anterior chamber
- To evaluate the depth and extent of abnormalities within a tissue
What is the main difference between the parallelepiped and conical beam illumination techniques?
What is the main difference between the parallelepiped and conical beam illumination techniques?
- The angle between the observation and illumination systems
- The shape and size of the light beam (correct)
- The magnification used
- The purpose of the examination
What is the optimal angle between the observation and illumination systems for the conical beam technique?
What is the optimal angle between the observation and illumination systems for the conical beam technique?
- 20-30 degrees
- 50-60 degrees
- 40-50 degrees (correct)
- 30-45 degrees
Which of the following is NOT a characteristic of the conical beam illumination technique?
Which of the following is NOT a characteristic of the conical beam illumination technique?
Why is it important to compare the darkness of the anterior chamber zones above and below the light path to the zone in the light path when using the conical beam technique?
Why is it important to compare the darkness of the anterior chamber zones above and below the light path to the zone in the light path when using the conical beam technique?
What is the primary purpose of specular reflection?
What is the primary purpose of specular reflection?
What is the role of cobalt blue filter in ophthalmic procedures?
What is the role of cobalt blue filter in ophthalmic procedures?
How does a red-free filter improve visualization during ophthalmic examinations?
How does a red-free filter improve visualization during ophthalmic examinations?
What is the purpose of the Van Herick technique?
What is the purpose of the Van Herick technique?
Which of the following is NOT a step involved in performing specular reflection?
Which of the following is NOT a step involved in performing specular reflection?
During the Van Herick technique, the observation system should be positioned:
During the Van Herick technique, the observation system should be positioned:
Which of the following is NOT a typical filter used in filtered illumination?
Which of the following is NOT a typical filter used in filtered illumination?
What is the primary purpose of a neutral density filter in ophthalmic examinations?
What is the primary purpose of a neutral density filter in ophthalmic examinations?
What is the general angle of illumination used in retro-illumination procedures?
What is the general angle of illumination used in retro-illumination procedures?
What is the main purpose of sclerotic scatter?
What is the main purpose of sclerotic scatter?
Which structure can be used to reflect light during retro-illumination?
Which structure can be used to reflect light during retro-illumination?
When performing retinal retro-illumination, what is the specific angle of the illumination system?
When performing retinal retro-illumination, what is the specific angle of the illumination system?
What appearance indicates corneal abnormalities during sclerotic scatter?
What appearance indicates corneal abnormalities during sclerotic scatter?
What is the primary purpose of using a diffuser filter in slit lamp examination?
What is the primary purpose of using a diffuser filter in slit lamp examination?
Which of the following techniques uses a thin beam of light to examine the layers and depth of tissues?
Which of the following techniques uses a thin beam of light to examine the layers and depth of tissues?
What is the typical angle between the observation and illumination systems during slit lamp examination?
What is the typical angle between the observation and illumination systems during slit lamp examination?
Which of the following is NOT a component of the illumination system in a biomicroscope?
Which of the following is NOT a component of the illumination system in a biomicroscope?
What is the primary purpose of a red-free filter in a slit lamp examination?
What is the primary purpose of a red-free filter in a slit lamp examination?
What is the role of a cobalt blue filter in slit lamp examination?
What is the role of a cobalt blue filter in slit lamp examination?
Which of the following techniques is used to assess the depth of the anterior chamber?
Which of the following techniques is used to assess the depth of the anterior chamber?
What is the primary purpose of using diffuse illumination during a slit lamp examination?
What is the primary purpose of using diffuse illumination during a slit lamp examination?
What does a Van Herick Grade of II indicate regarding the depth of the anterior chamber?
What does a Van Herick Grade of II indicate regarding the depth of the anterior chamber?
Which illumination method uses a slit beam with variable height and intensity?
Which illumination method uses a slit beam with variable height and intensity?
In the Van Herick grading system, what ratio corresponds to a grade III?
In the Van Herick grading system, what ratio corresponds to a grade III?
What is the maximum angle between the slit lamp arms for the specular reflection method?
What is the maximum angle between the slit lamp arms for the specular reflection method?
Which beam characteristics are maximal in the conical section illumination method?
Which beam characteristics are maximal in the conical section illumination method?
What describes the slit beam width used in the parallelepiped method?
What describes the slit beam width used in the parallelepiped method?
Which characteristic is true for the indirect illumination method?
Which characteristic is true for the indirect illumination method?
What does a Van Herick Grade of I imply about the ratio of DAC to CT?
What does a Van Herick Grade of I imply about the ratio of DAC to CT?
Which observation technique utilizes a slit beam with maximal filter usage?
Which observation technique utilizes a slit beam with maximal filter usage?
What is the minimum slit beam height used in the conical illumination technique?
What is the minimum slit beam height used in the conical illumination technique?
What is the primary purpose of the conical beam technique?
What is the primary purpose of the conical beam technique?
What is the key difference between direct and indirect observation methods?
What is the key difference between direct and indirect observation methods?
Which of the following is NOT a characteristic of the conical beam technique?
Which of the following is NOT a characteristic of the conical beam technique?
What is the significance of the anterior chamber being 'optically empty' when using the conical beam method?
What is the significance of the anterior chamber being 'optically empty' when using the conical beam method?
When using the conical beam technique, why must the room be completely dark and the examiner dark-adapted?
When using the conical beam technique, why must the room be completely dark and the examiner dark-adapted?
In the indirect observation method, when the slit beam is off-set, what is the advantage of this technique?
In the indirect observation method, when the slit beam is off-set, what is the advantage of this technique?
Why is the indirect observation method useful for examining the iris?
Why is the indirect observation method useful for examining the iris?
Why is the conical beam technique not typically used to assess for corneal edema?
Why is the conical beam technique not typically used to assess for corneal edema?
Flashcards
Slit Lamp (Biomicroscope)
Slit Lamp (Biomicroscope)
A specialized medical device for examining the eye, from the front to the back, using a focused beam of light.
Anterior Segment
Anterior Segment
The front part of the eye, including the cornea, iris, and lens.
Posterior Segment
Posterior Segment
The back part of the eye, including the retina, optic nerve, and vitreous humor.
Optic Section
Optic Section
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Diffuse Illumination
Diffuse Illumination
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Auxiliary Lens (78D or Hruby)
Auxiliary Lens (78D or Hruby)
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Goldmann Tonometry
Goldmann Tonometry
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Gonioscopy
Gonioscopy
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Parallelepiped Illumination
Parallelepiped Illumination
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Conical Beam Illumination
Conical Beam Illumination
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Anterior Chamber
Anterior Chamber
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Flare
Flare
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Cells & Flare
Cells & Flare
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Conical Beam
Conical Beam
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Conical Beam Examination
Conical Beam Examination
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Direct Observation
Direct Observation
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Indirect (or Proximal) Observation
Indirect (or Proximal) Observation
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Dark adaptation
Dark adaptation
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Anterior Chamber Debris
Anterior Chamber Debris
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Retro-illumination
Retro-illumination
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Sclerotic scatter
Sclerotic scatter
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Retinal retro-illumination
Retinal retro-illumination
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Retro-illumination angle
Retro-illumination angle
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Slit lamp examination
Slit lamp examination
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Specular Reflection
Specular Reflection
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Filtered Illumination
Filtered Illumination
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Van Herick Technique
Van Herick Technique
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Cobalt Blue Filter
Cobalt Blue Filter
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Yellow Wratten Filter
Yellow Wratten Filter
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Red-Free Filter
Red-Free Filter
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Neutral Density Filter
Neutral Density Filter
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Tear Film
Tear Film
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Van Herick Grading System
Van Herick Grading System
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Van Herick Grading System
Van Herick Grading System
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DAC/CT ratio
DAC/CT ratio
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Optic Section Illumination
Optic Section Illumination
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Study Notes
Slit Lamp Examination (SLE)
- Used for binocular examination of the eye, from anterior to posterior segments
- Used for anterior segment exam (tear film to anterior vitreous)
- Used for posterior segment exam with auxiliary lenses (78D or Hruby)
- Used for Goldmann tonometry (intraocular pressure)
- Used for anterior chamber depth assessment (irido-cornea angle)
- Used for contact lens fittings and assessments
- Used for gonioscopy
- Used for minor surgical procedures
- Used for laser delivery systems
Instrumentation
- Multiple biomicroscope types with various features
- Composed of two basic parts on a common pivoting base
- Observation system (microscope): binocular eyepieces, magnification control
- Illumination system: adjustable light beam (variable height, width, and angle), filters (red-free, cobalt blue, diffuser)
Methods of Illumination
- Diffuse Illumination:
- Wide, unfocused beam of light directed obliquely towards eye
- Used for general overview of eye and adnexa
- 30-45 degree angle between observation and illumination systems
- Can use low to medium magnification
- Optical Section:
- Thin slit beam (minimum 0.25mm) for optically slicing tissues
- Visualizes tissue layers & depth
- 30-45 degree angle between observation and illumination systems
- Use thin-slit beam, medium/high magnification to assess different layers/zones and depths of tissue
- Parallelepiped:
- 1-2mm slit beam illuminating a rectangular area of tissues
- Provides 3-dimensional view of tissue layers
- 30-45 degree angle between observation and illumination systems
- Use medium/high magnification
- Conical Beam:
- Small spot/square of light produced by narrowing the vertical height of a parallelepiped
- 40-50 degree angle between observation and illumination systems
- 2-3mm spot/slit beam (height and width)
- Used to evaluate clarity of anterior chamber and assess debris (cells, flare, or blood) within
Methods of Observation
-
Direct:
- Observation and illumination systems are focused coincidentally
- Used most commonly for general examination
-
Indirect/Proximal:
- Observation and illumination systems are not focused coincidentally
- Provides softer illumination for fine details and structures with bright direct light sources
- Useful when viewing iris, fine vasculature, pigment spots, corneal edema, etc
-
Retro-illumination:
- Object is illuminated by light reflected from a deeper structure
- Used when bright direct light ‘bleaches out’ the area needing visualization
- Used to view iris, fine vasculature, etc
-
Sclerotic Scatter
- A bright parallelepiped focused on light transmission in the cornea
- Used to view subtle corneal changes, e.g., edema, scars, striae, foreign bodies
-
Specular Reflection
- Creates a bright specular reflection from the cornea
- Used to observe irregularities/deposits in the smooth surface, particularly useful in corneal endothelium & tear film evaluation
-
Filtered Illumination:
- Use various filters to enhance assessment of structures/abnormalities.
- Ex: cobalt blue use with fluorescein dye to visualize corneal staining
- Ex: yellow wratten filters use with fluorescein for corneal staining
- Use various filters to enhance assessment of structures/abnormalities.
Van Herick Technique
- Used to assess anterior chamber depth
- Use low to medium magnification and 60-degree angle between slit-lamp arms and observation system perpendicular to the eye
- Optic section of medium to maximum height exactly at the limbus
- Move the observation system back/forth to establish ratio between dark shadow(DAC) and corneal thickness(CT)
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