Advanced Slit Lamp

Question 1

Sometimes a _ of multiple lighting techniques will achieve the best examination. Remember to consider lighting, filters ect

Answer 1

combination

Question 2

Diffuse illumination

Answer 2

When you have a second light source found on slit lamp cameras that gives overall lighting of a large general area. ( fill light)

Question 3

Direct illumination

Answer 3

When the light is shining directly shining on area or object of interest

Question 4

Indirect illumination

Answer 4

Is a technique that uses another structure to transfer or reflect light to highlight or focus on another structure ( which would be the area of interest)

Question 5

Slit lamp illumination

Answer 5

Light from the slit beam that comes into sharp focus at the same distance the biomircoscope is focused on the object

Question 6

Slit beam width options

Answer 6

8mm

Question 7

Forms of direct illumination include

Answer 7

Optical sectioning
Broad beam illumination 
Tangential illumination 
Pinpoint illumination 
Specular reflection

Question 8

Optical sectioning

Answer 8

Use of narrow slit beam at 30-45 degree angels to produce a cross section of the cornea

Question 9

Methods of assessing angels

Answer 9

1. van Hedrick
2. Anterior chamber depth estimate
3. Penlight
4. Gonioscopy

Question 10

Van herick angle evaluation

Answer 10

Optical section
Adjust angle to 60 degrees ( oculars straight ahead)
Both temporal and nasal sides

Question 11

Gonioscopy

Answer 11

Is a test that uses a gonio lens to view a pt angle structure/ the aqueous drainage system

Question 12

Broad beam illumination

Answer 12

Can be used to view dystrophies or degeneration affecting large areas of cornea to examine the width and extent of corneal ulcer or defect

Question 13

Tangential illumination

Answer 13

Shows texture and depth using varying slit beam width.

Question 14

Pinpoint illumination

Answer 14

Reduces slit beam to a very short narrow beam of light directed at an angle across the pupil onto the iris to assess reflection in the A/C from cells and flare

Question 15

Forms of indirect illumination

Answer 15

Proximal illumination
Sclerotic scatter
retro illumination from iris and fundus
Iris trans illumination

Question 16

Proximal illumination

Answer 16

Uses light shone next to pathology scattering around and behind pathology increasing its contrast producing a silhouette effect

Question 17

Sclerotic scatter

Answer 17

Used a broad slit beam that is decentered and directed at the limbus scattering light through the cornea and out the other side at limbus

Question 18

Inflammatory cells in A/C from uveitis

Answer 18

Cells

Question 19

Protein in A/C from uveitis

Answer 19

Flare

Question 20

Specular reflection

Answer 20

Where the angle of the slit beam is equal to the angle of the oculars reflecting the light off smooth surface like the corneal endothelium or anterior lens capsule

Question 21

Retro illumination from the fundus

Answer 21

Bounces light off the fundus silhouetting abnormalities in the anterior vitreous, lens, anterior chamber and cornea in silhouette form

Question 22

Iris trans illumination

Answer 22

Detects defects in the iris pigmented epithelium by mid dilating the pupil and using retro illumination techniques with a slit beam no bigger than the pupil

Question 23

Direct retro illumination from the iris

Answer 23

Bounces light at an angle off the iris to view corneal pathology in front of the light while in focus on the cornea

Question 24

Indirect retro illumination from the iris

Answer 24

Bounces light at an angle off the iris to view corneal pathology not directly in front of the reflected light but off the side

Question 25

Documentation

Answer 25

Injection: redness
Chemosis: swelling
Ecchymosis: bruising

Question 26

Advanced slit lamp exam

Answer 26

Correctly focuses each ocular and adjust for binocular vision
Correctly positions pt
Lid/lashes broad beam illumination
Palpebral and bular conjunctiva with broad beams
Cornea with optical section illumination and broad beam
Angles with optical section illumination @60 degrees temp and nas
A/C depth with optical section illumination centrally
Anterior chamber for cells and flare with pinpoint
Iris with tangential illumination and broad beam illumination
Lens capsule with specular reflection
Lens with optical section illumination