Slit Lamp + Gonioscopy Flashcards

Question

Aside from SL, what other ways can we examine AC?

Answer 1

OCT Pachymetry Ultrasound

Answer 2

``` Indentation gonioscopy Evaluation of angle in sitting position High mag of angle by SL Laser treatment of angle Fundus & gonio view with same lens ```

Answer 3

Unintentional corneal indentation can open appositional occluded angle Need viscous coupling fluid, which reduces corneal clarity - Flange = viscous - No flange = viscous or saline solution

Answer 4

``` A: does not req. viscous medium static & dynamic optional flange view 4Q / minimal rotation req. easy removal (no suction) superior Px comfort ``` D: more difficult to master stability view inferior to 3 mirror/flange

Answer 5

A: produces stable clear image keeps central position versatile: retinal examination and angle evaluation at the same time (change mirrors) D: rotation required to view 360deg large, invasive looking lens - Central Hruby lens: posterior pole, optic n', macula - Trapezoid mirror is used to view the retina slightly posterior to the equator - Half Round mirror is used to view the peripheral retina from the equator out to the ora serrata - The Finger Nail mirror is used to view angle and the most anterior retina and ciliary body.

Answer 6

A: faster exam time with 360deg

Answer 7

Instructions Cleaning & disinfecting gonio Apply coupling medium to concave surface Place P on puncta to prevent anaesthetic and viscous media reaching systemic circulation Instil anaesthetic (1drop) each eye into conjunctival fornix (don't rub eyes) Position Px comfortably against SL chin/forehead rest, align canthus marker Illumination arm straight ahead, not blocking eyepieces M6-16X Vertical PPD BW, height encompasses lens diameter Low-medium intensity (dilation = narrower angle) Fixation target: top R ear for RE Square orientation of lens, Px looks up, lower inferior lid and tilt lens so that it contacts the cornea Straighten lens whilst maintaining contact Release lids once lens is straight and in contact with the cornea Px looks down / straight ahead also applicable Central mirror is taken up by iris. Top view (inferior angle) is the widest, most pigmented. I>T>N>S V beam for I/S H beam for N/T

Answer 8

Drops, [ ], time, amount, ensure no contraindications

Answer 9

Anaesthetic reaction (rare) Trauma (laceration of globe; hyphema) Pregnancy Corneal/conj infection/epithelial basement memb dystrophy

Answer 10

1. Bubble in lens - tilt lens towards bubble, reinsert if large 2. Corneal folds - ease P 3. Blinking - hold lids, more anaesthetic req. 4. Reflections - change incident beam angle/W/I/H 5. Poor/no view - lens centration, illum arm not blocking 6. No structures visible - centration, try tilting lens/corneal wedge/indentation 7. SchW L not visible - corneal wedge (OS) to differentiate from post. TrM, reduce width, inc. intensity, offset illum 8. Angle structures not visible - convex iris, tilt gonio away from observation mirror, if no additional struc vis = apposition - indent with gonio: open = apposition, closed = synechia

Answer 11

Iris processes: finger like projections that originate at periphery, bridge CB and insert into TrM - Prominent in childhood, wither with age - Diff to synechiae (inflam) Posterior embryotoxin: prominent, anteriorly placed SchWL (10% popn) - Also found in iridocorneal syndromes

Answer 12

Axenfield-Rieger syndrome: prominent Schwalbe's line with abnormal iris processes inserting into SchWL. High risk of glaucoma

Slit Lamp + Gonioscopy Flashcards

(36 cards)