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OD1 Semester 2 - Integrated Ophthalmic Sciences and Preclinical Optometry > Slit Lamp 1+2- Week 3/4 > Flashcards

Slit Lamp 1+2- Week 3/4 Flashcards

1
Q

List the ocular structures examined by direct:

A

Mostly surfaces

  • lashes
  • lids (bulbar, palpebral)
  • conjunctiva (bulbar, palpebral)
  • cornea
  • pupil
  • iris

*can I last in painting cat I’s (eyes)

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2
Q

What ocular structures are examined with parallelopiped (ppd)?

A 
All layers of the cornea 
Also surfaces such as: 
- tear film 
- corneal epithelium
- corneal endothelium 
- iris and lens layers
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3
Q

Which technique is best for measuring corneal endothelium: PPD or Spec Reflecc?

A

Spec Reflecc

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4
Q

What ocular structures are examined by Optic section?

A

Examines cornea and lens in cross sections

Also looks at:

  • lens
  • ant. Vitreous
  • corneal epithelium + stroma
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5
Q

What slit lamp technique is used with Van Herrick?

A

A very thin optic section

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6
Q

What ocular structures are examined with small spot? What is it used to look for?

A

Small bit of a cross section (e.g) small bit of cornea

Look for:

  • uveitis
  • cells and FLARE
  • inflammation

Examine anterior chamber
- detect floating debris + ant. Chamber flare/cells

Meme idea: flare as in a firework. Or rick. Woo.

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7
Q

What ocular structures are examined with indirect illumination?

A
  • faint irregularities
  • deeper areas of tissue
  • foreign bodies (e.g in cornea)
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8
Q

What ocular structures are examine with retroillumination?

A
  • iris, lens, and cornea (in light reflected from other structures)
  • useful for looking at cataract
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9
Q

What ocular structures are examined with specc reflecc?

A
  • tear film quality
  • corneal endothelium
  • ant. lens surface (looks like an orange peel. So looks yellow-ish)
  • corneal epithelium
  • lens capsule
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10
Q

What does sclerotic scatter identify?

A

changes in corneal transmittance (which may occur with corneal oedema, scarring, deposits, degeneration)

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11
Q

What is sclerotic scatter useful for detecting?

A
  • stromal oeddema

- particles/foreign bodies

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12
Q

Why do we use Lissamine Green staining?

A

To diagnose lid wiper epitheliopathy

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13
Q

Why do we use Sodium Fluoroscein staining?

A

use when you suspect ocular surface abnormalities

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14
Q

Describe the setup for direct ophthalmoscopy.

A

width: 3-5mm
angle: 30-60deg (no it’s 0deg because direct)
height: max (so 12mm)
mag: low (6-10x)
Illuminance: moderate
click stop: in

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15
Q

What ocular structures are examined by Diffuse illumination?

A

general observation of the lids, conjunctiva, cornea and lashes

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16
Q

Describe the setup for Diffuse ophthalmoscopy.

A

width: max
angle: 60deg
height: max
mag: low (6-10x)
Illuminance: low-medium
click stop: in

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17
Q

Describe the setup for Parallelopiped.

A

width: 1-2mm (2mm really)
angle: 30-60deg
height: max
mag: moderate (10-16x)
Illuminance: increased from diffuse. moderate
click stop: in

18
Q

When we start slit lamp examination, what technique should we do first?

A

Diffuse generally (though this can also be done without slit lamp)

19
Q

Describe the setup for Optic Section

A

width: as narrow as possible
angle: 30-60deg
height: max
mag: moderate (10-16x) to high (16-25x)
Illuminance: max
click stop: in

20
Q

Describe the setup for Small Spot

A

width: 1mm
angle: 30-60deg
height: 1mm
mag: high (more than 16x)
Illuminance: max
click stop: in

21
Q

Describe the setup for Indirect Illumination

A

width: 1mm
angle: 60deg
height: max
mag: moderate (10-16x)
Illuminance: medium
click stop: OUT!!! Oh wow the click stop is OUTTTTTT

22
Q

Describe the setup for retroillumination

A

width: 1mm
angle: 60deg
height: max
mag: moderate (10-16x)
Illuminance: medium
click stop: in

23
Q

Describe the setup for specc reflecc

A

width: 1 or 2-3mm (just 2 then isn’t it)
angle: 45deg
height: max
mag: 40x
Illuminance: medium
click stop: in

(Angle of Incidence = Angle of observation)

24
Q

Describe the setup for sclerotic scatter

A

width: 1mm
angle: 60deg
height: max
Illuminance: medium
filter: no
click stop: in

(according to my notes, magnification doesn’t exist for this technique)

25
Q

Describe the setup for Van Herrick

A

just like optic section except angle MUST BE 60deg (also use high mag 16-25x)

26
Q

What is the most common slit lamp method to assess cornea?

A

PPD - parallelopiped

27
Q

Indications for slit lamp use?

A
  • anterior segment imaging (e.g. if an eye condition requires it)
  • to facilitate ocular foreign body removal
  • also in routine stereoscopic view of fundus
  • and is also a must for CL fitting and aftercare
  • used in tonometry
  • used for gonioscopy
28
Q

In a slit lamp exam: what lid abnormalities might you see?

A
  • meibomianitis
  • blepharitis (eyelid infl.)
  • hordeolum (bacterial infection of oil gland in lid)
  • ectropian
29
Q

In slit lamp exam: what eyelash abnormalities may you see?

A
  • trichiasis (introversion/ingrowth of lashes)
  • pediculosis (infestation with lice)
  • distichiasis (abnormal lash growth)
30
Q

In slit lamp: what tear abnormality might you see?

A

Dry eye

31
Q

Slit lamp: What conjunctiva abnormality might you see?

A

conjunctivitis

32
Q

Slit lamp: What cornea abnormality may appear?

A

infiltrates, pannus, pterygium

33
Q

Slamp: what pupil abnormalities may appear?

A

anomalous pupillary responses, irregular pupil

34
Q

Slamp: iris abnormalities?

A

iris atrophy, transillumination

35
Q

Slamp: ant. chamber abnormalities?

A

narrow angle, cells and flare

36
Q

Name the typical filters for the slit lamps illumination system

A

Neural density: decrease brightness of light (more px comfort)
Polarizing: increase visibility of subtle defects
Diffusor: to give even illumination
UV and heat filters: usually built in for safety to prevent phototoxic damage with extended exposure
Red-free: enhance blood vessel contrast
Cobalt-blue: for viewing fluoroscein

37
Q

What is the purpose of red-free filter?

A
  • enhance contrast when looking at blood vessels, haemorrhages, microaneurysms, SVP (esp. for CVD)
  • cornea or iris neovascularisation
  • RNFL
  • layer of pigmentation
38
Q

What is the purpose of cobalt-blue filter?

A

for viewing fluoroscein

  • look at damage to corneal or conjunctival epithelial cells
  • TBUT (tear break up time)
  • seidel test
  • also useful for viewing Keyser Fleischer ring in keratoconus
39
Q

What is the rule of thumb for the slit-lamp magnification system?

A

Always start with low mag and then increase when you see something interesting

(also refine focus when you change mag)

40
Q

Can diffuse illumination discern depth?

A

No

OD1 Semester 2 - Integrated Ophthalmic Sciences and Preclinical Optometry (49 decks)

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