Pre-Fit Slit Lamp Biomicroscopy Flashcards
Set up:
- Focus Eyepiece
- Clean head and chin rest
- Position patient
Slit lamp evaluation procedure
START
- set the microscope magnification to the lowest power.
- Place the illumination system about 45° to the temporal side of the eye to be examined.
- position the slit lamp light by moving the slit lamp base, so that the light beam will focus on the outer limbis.
- adjust intensity to low and turn on the slit lamp
- adjust the slit wide to a medium width, and the slit height to the maximum.
- look into the bio microscope. Make fine adjustments in height and focus with the high evaluation control and the joystick.
1
Place the beam on the outer canthus of the patient.
The beam should be 1 to 2 mm wide.
2
Sweep the beam along the bottom eyelid, keeping the top of the beam just above the eyelid.
Remember to move the light source midway across the eyelid.
OBSERVE:
Blepharitis Ectropia Entropia Trichiasis Lacrimal Lake Plugged Meibomian Glands Hordeoluems Chalazions
3
Sweep across the upper eyelid, this time keeping the bottom of the beam on the upper eyelid.
Don’t forget to switch the lamp again when you reach the halfway point.
OBSERVE:
Ectropia Entropia Trichiasis Blepharitis Hordeoleums Chalazions
4
After washing your hands, evert the lower eyelid.
Ask the patient to look up as far as they can.
Sweep both the lower palpebral and bulbar conjunctiva.
The top of the beam should just cross the lower limbus.
OBSERVE:
injection Hemorrhaging Conjunctivitis Cysts Papillae Follicle Nevus
5
As the client to look away from their nose.
Sweep the nasal bulbar conjunctiva.
OBSERVE:
Pinguecula Pterygium Trichiasis Limbal Injection Nevus
6
Hold the upper eyelid.
Have the patient look downward.
Sweep the superior bulbar conjunctiva.
Remember to switch the light source.
OBSERVE:
Injection
Limbal Injection
Nevus 
7
Have the patient look towards their nose.
Sweep the outer bulbar conjunctiva.
OBSERVE:
Pinguecula Pterygium Injection Limbal Injection  Nevus
8
Move the beam towards and over the limbus.
A circumcorneal halo should appear around the iris.
The microscope is typically not used.
OBSERVE:
Full Even Halo ( closed angle)
Corneal Edema and Opacities
Lens Defects
9
Starting from the outer canthus, sweep across the cornea using a 1 to 2 mm direct focal, parallelepiped.
Remember to switch the light source.
OBSERVE:
Tear Film ( movement of debris with blink) Scare Abrasions Vertical Striae Neovascularization 
Slit lamp evaluation procedure
END
- Record findings on the patient record form and repeat the process for the other eye.
- using a cotton tipped applicator, you vert the patient’s eyelid. Hold up or lashes with your thumb while observing with medium width direct focal illumination.
