PC - Slitlamp Biomicroscopy 1 - Week 3

Question 1

Is slit-lamp biomicroscopy examination done routinely as part of an eye exam, or not?

Answer 1

It is a must for all routine eye exams for the anterior segment.

Question 2

What other instruments allow the examination of the structures as a slit-lamp would?

Answer 2

None, no other instrument provides the same scope for the anterior segment.

Question 3

Would a slit-lamp be needed for fitting contact lenses, or is there another instrument better suited to this?

Answer 3

It is a must for contact lens fitting.

Question 4

Name 6 uses for a slit-lamp.

Answer 4

Contact lens fitting
Fundus exam
Tonometry (goldmann)
Gonioscopy
Anterior segment imaging
FB removal

Question 5

Name 4 uses for the red-free filter on a slit-lamp.

Answer 5

• Enhances contrast when looking at blood vessels, haemorrhages, microaneurysms, and SVP
• Corneal or iris neovascularisation
• Retinal nerve fibre layer
• Layer of pigmentation

Question 6

Name 4 uses for using the cobalt-blue filter.

Answer 6

For viewing fluorescein.

• Damage to epithelial corneal/conjunctival cells
• Tear break-up time (TBUT)
• Seidel test
• Viewing the Keyser-Fleischer ring in keratoconus

Question 7

Name 10 slit-lamp techniques

Answer 7

-Diffuse illumination
-Optic section
-Parallelepiped
-Specular reflection
-Indirect illumination
-Retroillumination
-Sclerotic scatter
-Vital staining (fluorescein)
-Van Herrick
Small spot

Question 8

Describe direct illumination.

Name the beam illumination, angle, width, and height.

Answer 8

Any technique where the slit-lamp and viewing system are focussed coincidentally.
Angle - 30-60
Width - 1mm
Height - 2mm
Broader for general screening
Illumination max

Question 9

What 7 structures are viewed using direct illumination.

Answer 9

Eyelids, lashes, cornea, lens, conjunctiva, iris, and AC

Question 10

Describe diffuse illumination.

Name the beam illumination, angle, width, and height.

Answer 10

Uses a wide, low intensity beam, or a ground glass filter is used to diffuse the focussed light.
Angle ~60
Width max
Height max
Illumination low-med

Question 11

What 7 structures are viewed using diffuse illumination.

Answer 11

Corneal deposits
CL deposits
CL fit
External eyelid/lash abnormalities
Conjunctiva
Cornea

Question 12

Can diffuse illumination be used to discern depth?

Answer 12

No.

Question 13

Describe optic section.

Name the beam illumination, angle, width, and height.

Answer 13

Illumination source is oblique, not always 60.
Structures behind are in darkness.
Angle ~60
Width thinnest
Height max
Illumination medium

Question 14

Can optic section be used to discern depth?

Answer 14

Yes, that is its main use for lesions

Question 15

Which technique gives maximum contrast?

Answer 15

Optic section

Question 16

Describe parallelepiped.

Name the beam illumination, angle, width, and height.

Answer 16

Narrow vertical slit used to illuminate a block of the cornea.
Is like an optic section, but wider, for a general scan, before switching to optic section if something is found.
Angle ~60
Width 2-3mm
Height max
Illumination medium

Question 17

What 6 structures are viewed using parallelepiped.

Answer 17

Cornea/lens epithelium
Cornea/lens endothelium
Corneal integrity
Depth and extent of corneal abrasion
CL fit and surface
Tear flim

Question 18

What is the most common technique to assess the cornea?

Answer 18

Parallelepiped

Question 19

Describe small spot.

Name the beam illumination, angle, width, and height.

Answer 19

Like direct illumination with a small spot, producing a cylindrical beam.

Question 20

Name 2 uses for the small spot technique.

Answer 20

Examination of the anterior chamber

Detection of floating debris and anterior chamber cells/flares

Question 21

Describe indirect illumination.

Name the beam illumination, angle, width, and height.

Answer 21

Light is focussed just to the side of the object to be observed.
Angle ~60
Beam 1mm
Height max
Illumination medium

Question 22

Name 3 uses for indirect illumination.

Answer 22

Detecting faint irregularities
Deeper areas of tissue
Foreign bodies

Question 23

Describe retroillumination.

Name the beam illumination, angle, width, and height.

Answer 23

Two types
Direct and indirect (just next to the reflected light)
Light is focussed at the edge of the pupil.
Angle 60
Width 1mm
Height max
Illumination medium