Biomicroscopy Flashcards
(21 cards)
What are the 3 most important illumination techniques
Diffuse
Parallelpiped
Optic section
What do you use diffuse for
Large structures
What do you use parallepiped for
Cornea and lens eval
What do you use optic section for
Corneal endothelium and anterior chamber angle assessment
Examination routine
- imparts to develop a routine slit lamp examination protocol
- sequential observation
- nothing overlooked and all structures are examined for abnormality
- anterior to posterior
Logical sequence for examination routine
Most anterior aspect of eye and work your way back
-light source positioned to the left when examining structures to the examiners left of the midline
What light do you use for lids
Diffuse, low mag
How do you fully examine upper lids
Eversion
How do you invert upper lid
From the temporal side completely to the most nasal side
Technique of eyelid eversion
- pt look down
- grasp lashes
- pull down and slightly away from globe
- create crease above the tarsal plate and flip
- use thumb to firmly pin outer lid margin/lashes against the bony orbit
- complete version by moving temporal to nasal
- giv egood instructions
- do not alarm pt
- tell pt to look down art all times
Reasons for everything the upper lids
- Prospective and establishes contact lens patients (GPC)
- Irritation and seasonal allergies
- Removal of a lost or possible lost CL
- A forgein body location/removal
- Eval the apex of internal and external hordeolums
- Eval the internal apex of chalaxions
Documentation of an ocular lesion
- description
- location
- severity
Corneal lesions
Most corneal scars will appear whitish in color. Rust from a metallic body may have a reddish-orange hue
Neovascularization
Indicates trauma and or hypoxia
-not uncommon to see it on the superior portion of the cornea in contact lens wearers
What light for iris
Direct illumination
When is it best to look at iris
Before dilation
What angle does the light need to be at for van herrick angle estimation
60 degrees
Van herrick
Light at 60 degrees
High mag
High light
Optic section
Light for lens
Direct illumination or optic
Abnormal findings on slit lamp
- become familiar with what is normal
- describe and record appropriately
- WHAT WHERE SEVERITY
Grading scales and abnormal findings on slit lamp
- some variability in grading among different observers
- very subjective but must remain consistent for an individual examiner
