Stain Cornea• Use fluorescein (+/- do Seidel’s test) Corneal abrasions http://eyelearn.med.utoronto.ca/default.htm 37
Fluorescein• Absorbs light in blue wavelength• Emits green fluorescence 38
Tips - fluorescein• Don’t forget to use it eg. HSV• Measure size abrasion• Total vs nil staining - chemical injury• Fluorescein under lid – upper lid abrasion• Seidel’s + or –ve -document• Self sealing wounds• Apply fluorescein then wait for bit to see more subtle staining 39
Removal of corneal foreign body withneedle and with burr
Step by step guide – how to useslit lamp - summary1. clean2. practice turn on and using3. bring in patient - adjust chin rest, lat. canthus at line, forehead against band4. prepare microscope - interpupillary distance, oculars set at 0, low mag5. prepare light - low volt, 10% grey, wide beam 45
Step by step guide – how to useslit lamp - summary6. Examine lids, lashes, conj, sclera, cornea, iris, lens7. Use narrow beam to examine corneal lesion – measure depth8. Set up to look at anterior chamber - depth, cells, flare - bright/1mm beam/high mag9. Use fluorescein –measure size lesion10.Turn off and clean 46
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