Slit Lamp Exam Rated A+

Slit Lamp Exam Rated A+ Slit Lamp - Answer- - Ventricular Binocular with a completely adjustable light - Provides a detailed look of the eye unlike any other piece of equipment. - The width, angle, and brightness of the light can all be changed to improve the view of the eye - Has a head rest and an adjustable chin rest - To help keep the patient's eye focused there is an adjustable fixation device for them to look at during the exam. - The examiner looks through the slit lamp like a pair of regular binoculars. - The oculars can be adjusted for the examiner's refractive correction and PD. Which will enhance depth perception and enhance whatever is being viewed. - Magnifications range from 6x to 40x - Intensity of the light can be changed from being completely open from a slit or pinpoint. - The improve view, the beam can also be rotated and the angle is adjusted. - The light can also be filtered to produce a green or cobalt blue color. - The Blue filter is used in conjunction with fluorescein to highlight areas of disruption on the cornea and to evaluate the lens to cornea relationship when fitting GP contact lens - The green light is a red free filter and helps to highlight areas of red, like blood vessels. Silt Lamp Exam - Answer- - Before the patient is seated, adjust the oculars for your pupillary distance and refraction - clean the headrest and chin rest with alcohol in front of the patient - Make sure the patient is comfortable in the chair - Position their head on the head rest and their chin in the chin rest firmly - Move the head and chin rest to get the best position - Begin the exam with low magnification and narrow beam - Use the joystick to move the slit lamp beam forward, backward, and from side to side. - This not only centers the image but also acts as the focusing mechanism by moving the eyepiece slightly forward and back. - Various illuminations are available to get the best view of the patients eye. Each has a unique purpose and provides specific information - Most slit lamp illuminations use an angle of 45 to 50 degrees between the beam or light source and the oculars of the microscope. Slit Lamp Illuminations Direct or Focal - Answer- - Direct or focal illumination is used to directly look at something so the light source and oculars are focused in the same spot. Direct illumination - Answer- - Used to observe corneal staining, corneal opacities, deposits, and or surface scratches on a contact lens and when it is used with fluorescein and the blue cobalt filter, it can hight light a GP contact lens to cornea relationship. Diffuse illumination - Answer- - When the light source is spread out over a large area over the cornea surface. - Gives an overall view but no specific detail. - Large general look at the cornea, structures of the eye, and tear film - Also used to evaluate position and movement of both soft and GP lenses. Indirect Illumination - Answer- - Light is focused next to the area being examined and the examiner will look off to the side of the lighted area. - Most often used when what is being observed is easily washed out by the silt lamp beam. - Often used to evaluate neovascularization (new blood vessels that are formed due to ischema) - Also can be used for an inspection of eyelashes, lids, sclera, conjunctiva and contact lens Retro Illumination - Answer- - Used to back light the area being studied. - The light is bounced off the iris so that the object or condition on the cornea is lit from behind. - Can be quite dramatic in how it displays the pathology or object being observed. - Subepithelial changes and diffuse edema are most easily observed using the retro illumination technique of the silt lamp. Sclerotic Scatter Illumination - Answer- - 2 to 3mm slit beam is directed at the limbus at a ninety degree angle to the observer. - The light from the slit lamp is now scattered back and fourth through the cornea. - Can be used to find out where the cornea lacks transparency - Most often used to locate areas of corneal edema. - Oculars are not used in this process. Contact lens Use - Answer- - Examines overall health of the eyes prior to fitting - Once fit with the lenses, this magnified view provides the examiner with the ability to monitor the ongoing health of the cornea, the underside of the eyelids as well as the position and movement of the contact lens. - When the tear film under a GP lens is being observed to determine the fit of the lens, fluorescein is used with a blue cobalt filter on the silt lamp. - Adding a handheld wratten #12 yellow filter will definitely enhance the pattern as it excites the fluorescein - Many of today's gas permeable materials have a UV filter incorporated into them and the yellow filter is the only way to accurately view the fluorescein beneath the lens.