Biomicroscopy: Examination external and anterior structures

Question 1

stereoscopic view
varying magnification
varying illuminations
camera/video recording or teaching tube adapters for documentation
hand held models available for bed ridden patients or screenings
different lamp models

Answer 1

Biomicroscopy advantages

Question 2

composed of 3 systems

Answer 2

observation system
mechanical system
illumination (koehler) system

Question 3

oculars and eyepieces

Answer 3

observation system

Question 4

patient adjustment, mechanical locks, joystick, etc

Answer 4

mechanical system

Question 5

the filament is imaged to the objective lens and the mechanical slit is imaged to the patients eye

Answer 5

illumincation Koehler system

Question 6

biomicroscope
adjustable focus eyepieces
magnification dial

Answer 6

viewing arm

Question 7

slit size, slit shape, and filter controls

variable size, shapes, color, and brightness

Answer 7

illumination arm

Question 8

illumination comes from above

Answer 8

Haag-streit type

Question 9

illumination comes from below

Answer 9

zeiss

Question 10

2 convex lenses are placed one in front of the other, separated by the distance of their focal length
provides inverted image

Answer 10

astronomical telescope system

Question 11

for higher and changable magnification a __________ telescope system is used
a convex and concave lens is used in line, separated by their focal length

Answer 11

galilean telescope

Question 12

telescope systems produce an inverse image of the object therefor a ____ is needed to make the image erect

Answer 12

Prism

a porro-abbe prism is used: 2 triangular prisms

Question 13

the point at which the microscope is focused, which corresponds to the point on which the light is focused (coupling effect)

Answer 13

parfocality

Question 14

bright, even, finely focused illuminatgion with adjustable slit 
components: 
light source
condenser lens system 
slit and other diaphragms 
filters
projection lens 
reflecting mirror or prism

Answer 14

illumination system

Question 15

Answer 15

controls slit width

Question 16

Answer 16

red: aperture size
yellow: filter

Question 17

vary the position of the reflecting mirror, allowing for a change in the angle of the light beam with respect to the viewing system

Answer 17

click stop

Question 18

optical elements provide enlarged stereoscopic images
mag changes for better details )10x,16x 25x32x 40x)
provides larger working distance in front of patient which allows for manipulation

Answer 18

observation system

Question 19

used to decrease patient discomfort
more comfortable
but makes light dimmer so doctors don’t really like

Answer 19

heat absorbing

Question 20

used to enhance the view of blood vessels and hemmorages

also helps differentiate between retinal and choroidal lesions (choroid will disappear with this filter)

Answer 20

red-free filter

Question 21

used for general viewing

75-80% of time used

Answer 21

white light

Question 22

important filter
by itself or used with additional filters
used for corneal lesions and contact lens fitting
used with tonometry

Answer 22

cobalt blue

Question 23

used w cobalt blue
either built into slit lamp or hand held
commonly used for contact lens evaluations

Answer 23

wratten yellow filter

Question 24

clean forehead band and chin rest 
make sure patient an examiner are comfortable 
counsel patient on what to expect 
provide a fixation target 
adjust eyepieces 
room elimination to dim

Answer 24

steps before performing slit lamp evaluation

Question 25

light beam and microscope are focused on the same object

Answer 25

direct illumination

Question 26

used w direct illumination for an overall view

Answer 26

direct diffuse illumination

Question 27

broad views of one plane

Answer 27

parallelpiped

Question 28

“cut through” a tissue for thickness and depth

Answer 28

optical section

Question 29

wide beam
used for general observation of anterior segment
good for: lashes, lids, caruncle, bulbar conj, etc

Answer 29

diffuse illumination

Question 30

procedure:
use a wide beam (slit open completely)
illumination angle of 45 degrees
low magnification
adjust angle of illumination to observe the whole corena
use joystick to bring the slip lamp into focus

Answer 30

diffuse illumination

Question 31

used to determine the depth or elevation of a defect in the corena to conjunctiva
good for:
assessing depth of FB, scars, opacities
locating which layer has an opacity
identifying the anatomical location of cataracts in the lens
etc

Answer 31

optic section