3.1.2 Uses Slit Lamp To Examine External Eye

Question 1

Requirements

Answer 1

• understands methods of illumination
• understands filters
• full slit lamp routine for the assessment of external eye and related structures

Question 2

Types of filter and their uses

Answer 2

Red-free
- blocks structures below RPE
- enhanced contrast of retinal blood vessels and haemorrhages
- helps identify nerve fibre layer drop out

Blue filter
- can enhance reactivity of optic disc drusen
- for use with flouroscein

Yellow filter
- reduces UV exposure

Question 3

Step by step approach

Answer 3

• wash hands
• clean SL
• set at correct height for px
• direct px gaze
• then assess each structure

Question 4

How to grade VH angle

Answer 4

G1 - <1:4
G2 - 1:4
G3 - 1:2
G4 - 1:1

Question 5

Angle closure suspect signs/sx and management

Answer 5

S%S
- High IOP
- no sx
- narrow angles
- Schaefer’s grade 1 or less

Mx
- laser iridotomy

Question 6

Intermittent angle closure signs/sx and management

Answer 6

S%S
- transient blurred vision
- haloes and headaches
- high IOP
- Corneal swelling

Mx
- laser iridotomy

Question 7

Acute angle closure Signs/sx and management

Answer 7

Signs/sx
- severe pain
- nausea
- blurred vision
- redness
- closed angles
- corneal oedema

Mx
- emergency referral
- oral acetazolamide if IOP above 40 mmHG

Question 8

What is Vogts Limbal Girdle

Answer 8

• insignificant corneal degradation

Question 9

Predisposing factors for closed angles

Answer 9

Anatomical
- female
- Chinese
- family Hx
- short axial length
- shallow AC
- hyperopes
- age

Drug induced
- adrenergic agents
- anticholinergic