Slit Lamp Examination Overview

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

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?

  • 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?

  • 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?

<p>Utilizes a 2-3 mm slit beam in both height and width (D)</p> Signup and view all the answers

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?

<p>To assess the clarity of the anterior chamber (C)</p> Signup and view all the answers

What is the primary purpose of specular reflection?

<p>To examine the tear film and corneal endothelium for irregularities (A)</p> Signup and view all the answers

What is the role of cobalt blue filter in ophthalmic procedures?

<p>To enhance the visualization of fluorescein staining on the cornea (A)</p> Signup and view all the answers

How does a red-free filter improve visualization during ophthalmic examinations?

<p>By making blood vessels and certain stains appear black (C)</p> Signup and view all the answers

What is the purpose of the Van Herick technique?

<p>To measure the depth of the anterior chamber (B)</p> Signup and view all the answers

Which of the following is NOT a step involved in performing specular reflection?

<p>Using a yellow wratten filter (A)</p> Signup and view all the answers

During the Van Herick technique, the observation system should be positioned:

<p>At a 90-degree angle to the eye (B)</p> Signup and view all the answers

Which of the following is NOT a typical filter used in filtered illumination?

<p>Infrared (C)</p> Signup and view all the answers

What is the primary purpose of a neutral density filter in ophthalmic examinations?

<p>To uniformly decrease the intensity of illumination (B)</p> Signup and view all the answers

What is the general angle of illumination used in retro-illumination procedures?

<p>30-45 degrees (B)</p> Signup and view all the answers

What is the main purpose of sclerotic scatter?

<p>To detect corneal abnormalities (D)</p> Signup and view all the answers

Which structure can be used to reflect light during retro-illumination?

<p>The retina (A)</p> Signup and view all the answers

When performing retinal retro-illumination, what is the specific angle of the illumination system?

<p>0-5 degrees (B)</p> Signup and view all the answers

What appearance indicates corneal abnormalities during sclerotic scatter?

<p>Gray or white light scatter (B)</p> Signup and view all the answers

What is the primary purpose of using a diffuser filter in slit lamp examination?

<p>To enhance the visibility of corneal details by reducing glare. (D)</p> Signup and view all the answers

Which of the following techniques uses a thin beam of light to examine the layers and depth of tissues?

<p>Optic section (C)</p> Signup and view all the answers

What is the typical angle between the observation and illumination systems during slit lamp examination?

<p>30-45 degrees (B)</p> Signup and view all the answers

Which of the following is NOT a component of the illumination system in a biomicroscope?

<p>Binocular eyepieces (C)</p> Signup and view all the answers

What is the primary purpose of a red-free filter in a slit lamp examination?

<p>To improve contrast and visualization of structures with minimal red fluorescence. (D)</p> Signup and view all the answers

What is the role of a cobalt blue filter in slit lamp examination?

<p>To improve visualization of structures with blue fluorescence, like corneal edema. (C)</p> Signup and view all the answers

Which of the following techniques is used to assess the depth of the anterior chamber?

<p>Van Herrick method (A)</p> Signup and view all the answers

What is the primary purpose of using diffuse illumination during a slit lamp examination?

<p>To obtain an overall view of the eye and its surrounding structures. (D)</p> Signup and view all the answers

What does a Van Herick Grade of II indicate regarding the depth of the anterior chamber?

<p>Depth anterior chamber is 1/4 of corneal thickness (D)</p> Signup and view all the answers

Which illumination method uses a slit beam with variable height and intensity?

<p>Diffuse Illumination (A)</p> Signup and view all the answers

In the Van Herick grading system, what ratio corresponds to a grade III?

<p>1/4 &lt; DAC / CT &lt; 1/2 (C)</p> Signup and view all the answers

What is the maximum angle between the slit lamp arms for the specular reflection method?

<p>45-60 degrees (D)</p> Signup and view all the answers

Which beam characteristics are maximal in the conical section illumination method?

<p>Height and intensity of the slit beam (D)</p> Signup and view all the answers

What describes the slit beam width used in the parallelepiped method?

<p>1-2 mm (D)</p> Signup and view all the answers

Which characteristic is true for the indirect illumination method?

<p>The angle between the slit lamp arms is 30-45 degrees (D)</p> Signup and view all the answers

What does a Van Herick Grade of I imply about the ratio of DAC to CT?

<p>DAC / CT is less than 1/4 (B)</p> Signup and view all the answers

Which observation technique utilizes a slit beam with maximal filter usage?

<p>Dispersion (A)</p> Signup and view all the answers

What is the minimum slit beam height used in the conical illumination technique?

<p>2 mm (C)</p> Signup and view all the answers

What is the primary purpose of the conical beam technique?

<p>To evaluate the clarity of the anterior chamber (B)</p> Signup and view all the answers

What is the key difference between direct and indirect observation methods?

<p>The relative positions of the observation and illumination systems (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic of the conical beam technique?

<p>A bright, focused light source directly illuminating the area of interest (B)</p> Signup and view all the answers

What is the significance of the anterior chamber being 'optically empty' when using the conical beam method?

<p>It means the anterior chamber is free of debris and cells (A)</p> Signup and view all the answers

When using the conical beam technique, why must the room be completely dark and the examiner dark-adapted?

<p>To enhance the contrast between the light and the dark areas of the anterior chamber (C)</p> Signup and view all the answers

In the indirect observation method, when the slit beam is off-set, what is the advantage of this technique?

<p>It allows for better visualization of fine details (C)</p> Signup and view all the answers

Why is the indirect observation method useful for examining the iris?

<p>It reduces glare and allows for better visualization of fine vascularization (A)</p> Signup and view all the answers

Why is the conical beam technique not typically used to assess for corneal edema?

<p>It is primarily designed for examining the anterior chamber (D)</p> Signup and view all the answers

Flashcards

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

The front part of the eye, including the cornea, iris, and lens.

Posterior Segment

The back part of the eye, including the retina, optic nerve, and vitreous humor.

Optic Section

A technique used to examine the eye's anterior segment, allowing visualization of different tissue layers and depths.

Signup and view all the flashcards

Diffuse Illumination

A technique used to examine the eye's anterior segment, providing a wide, general view.

Signup and view all the flashcards

Auxiliary Lens (78D or Hruby)

A specialized lens used with a slit lamp to examine the posterior segment.

Signup and view all the flashcards

Goldmann Tonometry

A procedure used to measure the pressure inside the eye.

Signup and view all the flashcards

Gonioscopy

A technique used to examine the angle between the iris and cornea, which helps assess the risk of glaucoma.

Signup and view all the flashcards

Parallelepiped Illumination

A technique using a narrow beam of light to examine the eye's anterior segment in layers, providing a 3-dimensional view.

Signup and view all the flashcards

Conical Beam Illumination

A technique using a small bright spot or square of light to assess clarity of the anterior chamber and detect debris.

Signup and view all the flashcards

Anterior Chamber

The area between the cornea and the lens, normally clear and dark.

Signup and view all the flashcards

Flare

A slight haze or cloudiness in the anterior chamber, often caused by inflammatory cells or proteins.

Signup and view all the flashcards

Cells & Flare

A debris found in the anterior chamber commonly composed of inflammatory cells and proteins.

Signup and view all the flashcards

Conical Beam

A beam of light produced by narrowing the vertical height of a parallelepiped shape, resulting in a small spot or square of light.

Signup and view all the flashcards

Conical Beam Examination

A method of examining the anterior chamber of the eye using a conical beam of light, to assess its clarity and identify any debris present.

Signup and view all the flashcards

Direct Observation

The technique where the observation and illumination systems are focused at the same point, allowing direct viewing of the illuminated area.

Signup and view all the flashcards

Indirect (or Proximal) Observation

The technique where the observation and illumination are not focused at the same point, creating a softer, less intense light and allowing better visualization of fine details.

Signup and view all the flashcards

Dark adaptation

The process of adapting the eyes to darkness, allowing them to become more sensitive to light.

Signup and view all the flashcards

Anterior Chamber Debris

Cells or other debris found in the anterior chamber, often associated with inflammation.

Signup and view all the flashcards

Retro-illumination

A technique that illuminates the object from behind, creating a 'softer' light that helps visualize fine details. It's particularly useful for viewing structures that are easily 'bleached out' by bright direct illumination.

Signup and view all the flashcards

Sclerotic scatter

A technique where a focused beam of light is directed at the edge of the cornea (limbus), causing the light to reflect within the cornea. Normal corneas reflect light freely, appearing clear. Abnormal corneas scatter light and appear gray or white, revealing subtle changes like edema or scars.

Signup and view all the flashcards

Retinal retro-illumination

Retro-illumination where the light source is positioned very close to the eye, usually at an angle of 0-5 degrees. This method allows for a detailed examination of the retina and its structures.

Signup and view all the flashcards

Retro-illumination angle

An angle of illumination used in retro-illumination that is generally between 30 and 45 degrees. This angle provides an optimal balance between visibility and minimizing blinding glare.

Signup and view all the flashcards

Slit lamp examination

This technique involves examining the eye's anterior segment by focusing a beam of light on different areas, allowing the examiner to see intricate details and structures.

Signup and view all the flashcards

Specular Reflection

A technique using a narrow beam of light to examine the eye's anterior segment in layers, providing a 3-dimensional view. It uses reflected light from the cornea to visualize the tear film and endothelium, helping to detect irregularities, deposits, or excavations in these structures.

Signup and view all the flashcards

Filtered Illumination

Using various filters to enhance the assessment of certain structures and abnormalities in the eye. These filters modify the light passing through the slit lamp, improving visibility depending on the structure being examined.

Signup and view all the flashcards

Van Herick Technique

A technique used to assess the depth of the anterior chamber, which is the space between the cornea and the iris.

Signup and view all the flashcards

Cobalt Blue Filter

Cobalt blue filter is used with fluorescein dye to visualize corneal staining. The blue light enhances the visibility of the green fluorescein, outlining areas of corneal damage or disease.

Signup and view all the flashcards

Yellow Wratten Filter

A barrier filter used with fluorescein eye dye to visualize corneal staining. It allows only specific wavelengths of light to pass through, improving the clarity of fluorescein staining.

Signup and view all the flashcards

Red-Free Filter

Used to make blood vessels and rose bengal stain appear black, enhancing the contrast between these structures and the surrounding tissue.

Signup and view all the flashcards

Neutral Density Filter

Uniformly decrease illumination intensity, minimizing glare and discomfort for the patient. This can be useful for sensitive eyes or when examining structures that are difficult to see under high intensity light.

Signup and view all the flashcards

Tear Film

A clear layer of fluid that covers the front of the eye, playing a crucial role in vision, lubrication, and protection.

Signup and view all the flashcards

Van Herick Grading System

The depth of the anterior chamber (DAC) is compared to the thickness of the cornea (CT) to assess the width of the angle of the anterior chamber. This ratio is used to classify the eyes into different grades based on the risk of angle closure glaucoma.

Signup and view all the flashcards

Van Herick Grading System

A grading system used to assess the width of the anterior chamber angle (the space between the iris and cornea) based on the ratio of anterior chamber depth (DAC) to corneal thickness (CT).

Signup and view all the flashcards

DAC/CT ratio

It establishes the relationship between the depth of the anterior chamber (DAC) and the thickness of the cornea (CT). This helps to determine the likelihood of angle closure glaucoma developing. This ratio is used to determine the size of the angle between the iris and cornea. A narrower angle increases the risk of angle closure glaucoma.

Signup and view all the flashcards

Optic Section Illumination

This lighting technique illuminates a thin section of the eye's anterior structures and allows for visualization of different tissue layers and depths. This is essential for examining the layers of the cornea, iris, and lens. It provides detailed views of the different structures of the eye.

Signup and view all the flashcards

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

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)

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Slit Lamp Biomicrospcopy PDF

More Like This

Slit Lamp Examination Techniques
45 questions

Slit Lamp Examination Techniques

EasyToUseWilliamsite1391 avatar
EasyToUseWilliamsite1391
Use Quizgecko on...
Browser
Browser