The document provides information about the Haag-Streit BX 900 photo slit lamp, including its components and capabilities. It describes the microscope, illumination system, flash unit, and camera attachment. It also includes technical specifications, types of illumination, and guidelines for capturing high quality slit lamp photos of different eye structures.
The document discusses the slit lamp biomicroscope, an important tool in optometry. It describes the history and development of the slit lamp, including key contributors. The basic components and functioning of the slit lamp are explained, including the illumination and observation systems. Different types of slit lamps and various illumination techniques used with the slit lamp like diffuse, direct, retro-illumination and their applications are outlined. The document also mentions the clinical uses of the slit lamp for diagnostic and therapeutic purposes.
The document discusses slit lamp biomicroscopy, including its history, principles, types, instrumentation, filters, examination methods, and uses. Key points include that slit lamps allow high magnification views of the eye under controlled illumination and are critical for examining the anterior segment. They work like compound microscopes using objectives, eyepieces, and various illumination techniques. Filters and adjustment of the slit width, height, and angle aid examination.
The slit lamp allows examination of the anterior segment of the eye and provides magnified views. It has three main components: an illumination system using a slit beam of light, an observation system with microscope, and a mechanical system. Different illumination techniques like diffuse, direct, retroillumination are used to examine various structures. The slit lamp is used for diagnostic evaluation of many anterior segment diseases and procedures like gonioscopy, pachymetry and contact lens fitting. It provides detailed examination of structures like cornea, iris, angle and anterior chamber.
The document discusses the slit-lamp biomicroscope, which is used to examine the eye. It has three main components: the mechanical system to position the patient and microscope, the illumination system to provide a focused beam of light, and the observation system consisting of compound microscopes. Different illumination techniques such as direct, indirect, and focal illumination are used to examine different parts of the eye at various magnifications. The slit-lamp allows close examination of structures like the cornea, anterior chamber, and lens.
Slit lamp biomicroscopy and illumination techniquesLoknath Goswami
The document provides a history of the development of the slit-lamp biomicroscope from the early 19th century to modern versions. It describes the key parts of the slit-lamp including the observation system, magnification system, illumination system, and mechanical support system. Finally, it outlines various techniques for illumination using the slit-lamp such as diffuse, direct, indirect, retroillumination, specular reflection, and oscillating illumination and their uses in examining different structures of the eye.
This document provides guidance on examining the eye using a slit lamp and diagnosing common eye conditions:
1. It outlines the basic components and use of a slit lamp, including adjusting the illumination, magnification, and focusing the microscope.
2. Examination techniques are described, such as assessing the depth of corneal lesions using a thin beam of light and grading anterior chamber cells.
3. Common troubleshooting issues for the slit lamp are addressed, such as inability to turn it on or difficulty focusing. Guidance is provided on systematic examination of the eye and techniques like staining the cornea with fluorescein.
The document discusses the slit lamp biomicroscope, its components, uses, and techniques. It describes:
- The history and development of the slit lamp from the 1860s to present.
- The main components including the viewing arm, biomicroscope, illumination arm, and controls for slit size, shape, filters and intensity.
- Common techniques like varying slit width and lamp angle to illuminate different tissue depths and structures.
- Methods of illumination including direct, indirect, retro-illumination and their uses in examining different anterior segment structures.
The document discusses the slit lamp biomicroscope, an important tool in optometry. It describes the history and development of the slit lamp, including key contributors. The basic components and functioning of the slit lamp are explained, including the illumination and observation systems. Different types of slit lamps and various illumination techniques used with the slit lamp like diffuse, direct, retro-illumination and their applications are outlined. The document also mentions the clinical uses of the slit lamp for diagnostic and therapeutic purposes.
The document discusses slit lamp biomicroscopy, including its history, principles, types, instrumentation, filters, examination methods, and uses. Key points include that slit lamps allow high magnification views of the eye under controlled illumination and are critical for examining the anterior segment. They work like compound microscopes using objectives, eyepieces, and various illumination techniques. Filters and adjustment of the slit width, height, and angle aid examination.
The slit lamp allows examination of the anterior segment of the eye and provides magnified views. It has three main components: an illumination system using a slit beam of light, an observation system with microscope, and a mechanical system. Different illumination techniques like diffuse, direct, retroillumination are used to examine various structures. The slit lamp is used for diagnostic evaluation of many anterior segment diseases and procedures like gonioscopy, pachymetry and contact lens fitting. It provides detailed examination of structures like cornea, iris, angle and anterior chamber.
The document discusses the slit-lamp biomicroscope, which is used to examine the eye. It has three main components: the mechanical system to position the patient and microscope, the illumination system to provide a focused beam of light, and the observation system consisting of compound microscopes. Different illumination techniques such as direct, indirect, and focal illumination are used to examine different parts of the eye at various magnifications. The slit-lamp allows close examination of structures like the cornea, anterior chamber, and lens.
Slit lamp biomicroscopy and illumination techniquesLoknath Goswami
The document provides a history of the development of the slit-lamp biomicroscope from the early 19th century to modern versions. It describes the key parts of the slit-lamp including the observation system, magnification system, illumination system, and mechanical support system. Finally, it outlines various techniques for illumination using the slit-lamp such as diffuse, direct, indirect, retroillumination, specular reflection, and oscillating illumination and their uses in examining different structures of the eye.
This document provides guidance on examining the eye using a slit lamp and diagnosing common eye conditions:
1. It outlines the basic components and use of a slit lamp, including adjusting the illumination, magnification, and focusing the microscope.
2. Examination techniques are described, such as assessing the depth of corneal lesions using a thin beam of light and grading anterior chamber cells.
3. Common troubleshooting issues for the slit lamp are addressed, such as inability to turn it on or difficulty focusing. Guidance is provided on systematic examination of the eye and techniques like staining the cornea with fluorescein.
The document discusses the slit lamp biomicroscope, its components, uses, and techniques. It describes:
- The history and development of the slit lamp from the 1860s to present.
- The main components including the viewing arm, biomicroscope, illumination arm, and controls for slit size, shape, filters and intensity.
- Common techniques like varying slit width and lamp angle to illuminate different tissue depths and structures.
- Methods of illumination including direct, indirect, retro-illumination and their uses in examining different anterior segment structures.
Slit lamps are used to carefully examine the cornea, conjunctiva, and lids of the anterior eye segment. The microscope and light source are coupled so that the same part of the eye being examined is illuminated. This coupling facilitates examination. Main components include the slit lamp microscopes, illumination systems, and mechanical coupling. Attachments allow for fundus examination, gonioscopy, tonometry, laser photocoagulation, and measuring visual acuity in patients with hazy media. Magnification typically ranges from 6x to 40x.
The slit lamp bimicroscope allows for high-magnification examination and evaluation of the anterior segment of the eye. It has three main components: an illumination system using a slit of light, an observation system with binocular lenses, and a mechanical system to position the eye. Various illumination techniques like diffuse, direct, and indirect can be used to examine different ocular tissues. The slit lamp has a long history and continues to be the most important tool for anterior segment evaluation, enabling detection of many abnormalities. Accessories can further aid in examination of structures like the retina, angle, and measurement of eye pressure.
The slit lamp is an instrument used to examine the anterior segment of the eye. It provides stereoscopic, magnified views through illumination and observation systems. It is used for detailed examination of the cornea, anterior chamber, iris, and retina. The slit lamp allows for measurement of intraocular pressure and delivery of laser treatments. Examination techniques include diffuse, direct, indirect, and retroillumination to visualize different ocular structures.
The slit lamp is an instrument used to conduct biomicroscopy of the anterior segment of the eye. It consists of an observation system including eyepieces and objectives, an illumination system to illuminate the eye, and a mechanical support system. Various models exist with different configurations such as the Czapski scope with rotating objectives or zoom systems. The slit lamp can be used to examine the eyelids, conjunctiva, cornea, anterior chamber, iris, lens and vitreous humor. Different illumination techniques such as diffuse, direct focal, indirect, retroillumination and specular reflection allow visualization of different ocular structures. The slit lamp is useful for procedures such as foreign body removal and contact lens fitting examinations.
a comprehensive presentation on Slit-lamp in which i have described about the history, optics and also the uses of different illuminations by Dr. Paresh Nichlani
all about slit lamp. special features, basic designs, principal of observation system, principal of illumination, animations are done for the beginners for easy understanding,pitfalls.
The slit lamp is an instrument used to examine the outer eye that consists of a binocular microscope linked to an adjustable light source, allowing magnification and illumination of eye structures. It facilitates examination of the eyelids, cornea, iris, and other anterior eye structures through different lighting techniques. The slit lamp is an important tool in ophthalmic diagnosis, procedures such as intraocular pressure measurement, and therapies like laser treatment.
The slit lamp biomicroscope allows high-powered, stereoscopic examination of the eye. It has two main components: an illumination system that produces a thin slit of light using the Kohler principle, and an observation system consisting of binocular microscopes. There are two common types - Zeiss and Haag Streit - which differ in the position of the light source. Various illumination techniques like diffuse, direct, retro-illumination and specular reflection are used to visualize different ocular structures. The slit lamp enables in-vivo examination of the anterior segment in 3D and is invaluable for diagnostic and surgical procedures.
The document provides an overview of slit lamp biomicroscopy. It describes the basic design of the slit lamp microscope including the light tower, viewing arm, and central pivot. It discusses the slit lamp features of magnification, illumination, and examination techniques using direct and indirect lighting. The document outlines the proper procedure for patient setup and examination sequence, including lid eversion and removal of superficial ocular foreign bodies.
A Classroom presentation, showing the various types of slit-lamps, their parts, and other accessory instruments that can be used with it for enhanced optometric clinical examination.
The document discusses slit lamp examination, which allows detailed examination of eye structures using high magnification. It describes the three main components of a slit lamp: the observation system including lenses and eyepiece, illumination system including light source and filters, and mechanical system for adjusting positioning. Various illumination techniques are outlined including diffuse, direct focal, indirect, retro-illumination and specular reflection. Specific uses and methods for examining different eye structures are provided. Specialized uses of slit lamps for procedures like gonioscopy and laser treatment are also mentioned.
Slit lamp biomicroscopy performance and record-keeping - moc - 2014 - page 16-18Socrates Narvaez
This document describes the instrumentation and techniques used for slit-lamp biomicroscopy. It discusses the viewing arm, illuminating arm, base, and patient positioning frame of the slit lamp. It also covers various illumination methods including diffuse, direct focal, slit, tangential, indirect, retroillumination, and specular reflection. Additional devices that can be used with the slit lamp are also outlined, such as tonometry, gonioscopy tools, and lenses for examining the posterior segment.
The document provides details about slit lamp biomicroscopy. It describes the slit lamp as an important examination tool that allows ophthalmologists to examine the eye in 3 dimensions. The key components of a slit lamp are the observation system (microscope), illumination system, and mechanical support system. The microscope provides stereoscopic viewing and variable magnification. The illumination system provides a focused slit of light using a light source, lenses, slit and filters. The mechanical system allows positioning of the patient and adjustment of the microscope and illumination.
The slit lamp biomicroscope allows examination of the anterior segment of the eye at high magnification. It consists of an illumination system using a bright slit of light and an observation system using a binocular microscope. Different illumination techniques such as diffuse, direct, and retroillumination can be used to examine different structures. The slit lamp provides important information for diagnosing eye diseases and has been improved since its invention over 100 years ago to include features like variable magnification and filters. It remains a vital tool for comprehensive eye examinations.
Refraction and optical management of strabismus patientsboomback
1. This document discusses refraction and optical management techniques for patients with strabismus. It outlines refraction techniques, options for optical management including spectacles, contact lenses, and prisms, and how to approach specific types of strabismus like infantile esotropia and accommodative esotropia.
2. For accommodative esotropia, the document recommends initially prescribing full cycloplegic correction and considering bifocal spectacles if a residual deviation remains. It provides guidance on bifocal segment height and power. Prisms can also be used to relieve residual deviations.
3. For intermittent exotropia, the
The slit lamp biomicroscope allows high-powered examination of the eye. It has a binocular stereoscopic view, flexible illumination, and magnification. The slit lamp was invented in 1911 and has since been improved, with modern versions from Zeiss and Haag-Streit. It consists of mechanical, illumination, and observation systems. Different illumination types and filters help examine various ocular structures. Applications include tonometry, gonioscopy, and fundus exams.
The document provides instructions for performing a slit lamp examination to examine various ocular structures such as the lids, conjunctiva, cornea, iris, lens, vitreous humor, and anterior chamber. It describes the proper setup and positioning of the patient, and examines each structure using different illumination techniques including diffuse, direct focal, retro, and indirect illumination to observe details like inflammation, lesions, vascular changes, and post-operative evaluation of structures like the iris and anterior chamber.
The document provides an overview of the slit lamp biomicroscope, a microscope used to examine the eye. It describes the history, development, parts, optics, and various illumination techniques of the slit lamp. The slit lamp allows a magnified three-dimensional view of the eye for documentation and quantitative measurements. Examination with the slit lamp involves using different illumination methods like diffuse, direct, indirect, and retro-illumination to view different structures of the eye. Proper technique and understanding of slit lamp use is important for quality eye examinations.
The Haag-Streit BX 900 slit lamp combines the latest imaging technology with the proven versatility, optical brilliance and mechanical quality of the Haag-Streit tradition. The BX 900 is the leading slit lamp imaging device and is designed to assist the Ophthalmic Photographer in his demanding profession.
These lectures has prepared for postgraduate student (Ophthalmology) according to the curriculum of Bangladesh College of Physician and Surgeons (BCPS) and Bangabondhu Sheikh Mujib Medical University (BSMMU) Bangladesh
Slit lamps are used to carefully examine the cornea, conjunctiva, and lids of the anterior eye segment. The microscope and light source are coupled so that the same part of the eye being examined is illuminated. This coupling facilitates examination. Main components include the slit lamp microscopes, illumination systems, and mechanical coupling. Attachments allow for fundus examination, gonioscopy, tonometry, laser photocoagulation, and measuring visual acuity in patients with hazy media. Magnification typically ranges from 6x to 40x.
The slit lamp bimicroscope allows for high-magnification examination and evaluation of the anterior segment of the eye. It has three main components: an illumination system using a slit of light, an observation system with binocular lenses, and a mechanical system to position the eye. Various illumination techniques like diffuse, direct, and indirect can be used to examine different ocular tissues. The slit lamp has a long history and continues to be the most important tool for anterior segment evaluation, enabling detection of many abnormalities. Accessories can further aid in examination of structures like the retina, angle, and measurement of eye pressure.
The slit lamp is an instrument used to examine the anterior segment of the eye. It provides stereoscopic, magnified views through illumination and observation systems. It is used for detailed examination of the cornea, anterior chamber, iris, and retina. The slit lamp allows for measurement of intraocular pressure and delivery of laser treatments. Examination techniques include diffuse, direct, indirect, and retroillumination to visualize different ocular structures.
The slit lamp is an instrument used to conduct biomicroscopy of the anterior segment of the eye. It consists of an observation system including eyepieces and objectives, an illumination system to illuminate the eye, and a mechanical support system. Various models exist with different configurations such as the Czapski scope with rotating objectives or zoom systems. The slit lamp can be used to examine the eyelids, conjunctiva, cornea, anterior chamber, iris, lens and vitreous humor. Different illumination techniques such as diffuse, direct focal, indirect, retroillumination and specular reflection allow visualization of different ocular structures. The slit lamp is useful for procedures such as foreign body removal and contact lens fitting examinations.
a comprehensive presentation on Slit-lamp in which i have described about the history, optics and also the uses of different illuminations by Dr. Paresh Nichlani
all about slit lamp. special features, basic designs, principal of observation system, principal of illumination, animations are done for the beginners for easy understanding,pitfalls.
The slit lamp is an instrument used to examine the outer eye that consists of a binocular microscope linked to an adjustable light source, allowing magnification and illumination of eye structures. It facilitates examination of the eyelids, cornea, iris, and other anterior eye structures through different lighting techniques. The slit lamp is an important tool in ophthalmic diagnosis, procedures such as intraocular pressure measurement, and therapies like laser treatment.
The slit lamp biomicroscope allows high-powered, stereoscopic examination of the eye. It has two main components: an illumination system that produces a thin slit of light using the Kohler principle, and an observation system consisting of binocular microscopes. There are two common types - Zeiss and Haag Streit - which differ in the position of the light source. Various illumination techniques like diffuse, direct, retro-illumination and specular reflection are used to visualize different ocular structures. The slit lamp enables in-vivo examination of the anterior segment in 3D and is invaluable for diagnostic and surgical procedures.
The document provides an overview of slit lamp biomicroscopy. It describes the basic design of the slit lamp microscope including the light tower, viewing arm, and central pivot. It discusses the slit lamp features of magnification, illumination, and examination techniques using direct and indirect lighting. The document outlines the proper procedure for patient setup and examination sequence, including lid eversion and removal of superficial ocular foreign bodies.
A Classroom presentation, showing the various types of slit-lamps, their parts, and other accessory instruments that can be used with it for enhanced optometric clinical examination.
The document discusses slit lamp examination, which allows detailed examination of eye structures using high magnification. It describes the three main components of a slit lamp: the observation system including lenses and eyepiece, illumination system including light source and filters, and mechanical system for adjusting positioning. Various illumination techniques are outlined including diffuse, direct focal, indirect, retro-illumination and specular reflection. Specific uses and methods for examining different eye structures are provided. Specialized uses of slit lamps for procedures like gonioscopy and laser treatment are also mentioned.
Slit lamp biomicroscopy performance and record-keeping - moc - 2014 - page 16-18Socrates Narvaez
This document describes the instrumentation and techniques used for slit-lamp biomicroscopy. It discusses the viewing arm, illuminating arm, base, and patient positioning frame of the slit lamp. It also covers various illumination methods including diffuse, direct focal, slit, tangential, indirect, retroillumination, and specular reflection. Additional devices that can be used with the slit lamp are also outlined, such as tonometry, gonioscopy tools, and lenses for examining the posterior segment.
The document provides details about slit lamp biomicroscopy. It describes the slit lamp as an important examination tool that allows ophthalmologists to examine the eye in 3 dimensions. The key components of a slit lamp are the observation system (microscope), illumination system, and mechanical support system. The microscope provides stereoscopic viewing and variable magnification. The illumination system provides a focused slit of light using a light source, lenses, slit and filters. The mechanical system allows positioning of the patient and adjustment of the microscope and illumination.
The slit lamp biomicroscope allows examination of the anterior segment of the eye at high magnification. It consists of an illumination system using a bright slit of light and an observation system using a binocular microscope. Different illumination techniques such as diffuse, direct, and retroillumination can be used to examine different structures. The slit lamp provides important information for diagnosing eye diseases and has been improved since its invention over 100 years ago to include features like variable magnification and filters. It remains a vital tool for comprehensive eye examinations.
Refraction and optical management of strabismus patientsboomback
1. This document discusses refraction and optical management techniques for patients with strabismus. It outlines refraction techniques, options for optical management including spectacles, contact lenses, and prisms, and how to approach specific types of strabismus like infantile esotropia and accommodative esotropia.
2. For accommodative esotropia, the document recommends initially prescribing full cycloplegic correction and considering bifocal spectacles if a residual deviation remains. It provides guidance on bifocal segment height and power. Prisms can also be used to relieve residual deviations.
3. For intermittent exotropia, the
The slit lamp biomicroscope allows high-powered examination of the eye. It has a binocular stereoscopic view, flexible illumination, and magnification. The slit lamp was invented in 1911 and has since been improved, with modern versions from Zeiss and Haag-Streit. It consists of mechanical, illumination, and observation systems. Different illumination types and filters help examine various ocular structures. Applications include tonometry, gonioscopy, and fundus exams.
The document provides instructions for performing a slit lamp examination to examine various ocular structures such as the lids, conjunctiva, cornea, iris, lens, vitreous humor, and anterior chamber. It describes the proper setup and positioning of the patient, and examines each structure using different illumination techniques including diffuse, direct focal, retro, and indirect illumination to observe details like inflammation, lesions, vascular changes, and post-operative evaluation of structures like the iris and anterior chamber.
The document provides an overview of the slit lamp biomicroscope, a microscope used to examine the eye. It describes the history, development, parts, optics, and various illumination techniques of the slit lamp. The slit lamp allows a magnified three-dimensional view of the eye for documentation and quantitative measurements. Examination with the slit lamp involves using different illumination methods like diffuse, direct, indirect, and retro-illumination to view different structures of the eye. Proper technique and understanding of slit lamp use is important for quality eye examinations.
The Haag-Streit BX 900 slit lamp combines the latest imaging technology with the proven versatility, optical brilliance and mechanical quality of the Haag-Streit tradition. The BX 900 is the leading slit lamp imaging device and is designed to assist the Ophthalmic Photographer in his demanding profession.
These lectures has prepared for postgraduate student (Ophthalmology) according to the curriculum of Bangladesh College of Physician and Surgeons (BCPS) and Bangabondhu Sheikh Mujib Medical University (BSMMU) Bangladesh
The BQ 900 stands for excellent optics, versatility and ease-of-use. It is recognised as the standard for those requiring advanced slit lamp microscopy.
A modular system, offering digital video and still photography and a wide range of accessories include teaching scopes, inclined eyepieces and, for retinal specialists, the unique stereo variator.
The document provides instructions for assembling and using a Celestron PowerSeeker 50 telescope. It includes descriptions of key parts like the altazimuth mount, eyepieces, and finderscope. It provides step-by-step instructions for setting up the tripod, attaching the telescope and accessories, focusing, and aligning the finderscope. It also discusses magnification calculations and includes safety warnings, specifications, and information about optional accessories.
Here is a Fujinon Binocular training presentation I created a few years back to explain some of the major differences and features of Fujinon Binoculars.
The stereo microscope is an optical microscope variant designed for low magnification observation of surface samples. It has three key parts: a viewing head/body that houses optical components, a focus block that attaches the head to the stand, and a luminous stand that supports the microscope. Stereo microscopes provide an erect, three-dimensional perspective and are used for applications like insect dissection, microsurgery, watchmaking, and commercial inspection tasks.
The document provides an overview of basic endoscopic equipment, including:
- Flexible endoscopes consist of a control head connected via umbilical cord to a light source, with tubes transmitting air, water, and suction, and a suction channel for diagnostic and therapeutic devices.
- Fibreoptic endoscopes transmit images via tightly packed bundles of glass fibers, providing flexibility but lower image quality than rigid lenses.
- Video endoscopes use a CCD chip at the tip instead of an optical bundle, allowing digital images and simultaneous viewing without quality loss.
- Proper illumination is crucial and provided by external light sources transmitted via light bundles to the tip.
This document provides instructions for operating and maintaining Dukane SunSplash overhead projectors. It describes the key features and specifications of the projectors. Important safety instructions are provided, including never operating the projector with a damaged cord or if it has been dropped. The document reviews how to set up the projector, operate it, replace the lamp, and clean it. Troubleshooting tips and service information are also included.
The document describes a pill camera, which is a capsule-sized device that can be swallowed to examine the gastrointestinal tract. The pill camera contains fibers, LEDs, a camera, batteries, and a transmitter to capture and transmit images as it passes through the digestive system. These images are received by a sensor array worn by the patient and recorded for physicians to review. The pill camera provides a non-invasive alternative to traditional endoscopy exams and allows doctors to more easily diagnose digestive diseases.
. Introduction Biomicroscope derives its name from the fact that it enables the practitioner to observe the living tissue of eye under magnification. It not only provides magnified view of every part of eye but also allows quantitative measurements and photography of every part for documentation.
3. • The lamp facilitates an examination which looks at anterior segment, or frontal structures, of the human eye, which includes the –Eyelid –Cornea –Sclera –Conjunctiva –Iris –Aqueous –Natural crystalline lens and –Anterior vitreous.
4. Important historical landmarks De Wecker 1863 devised a portable ophthalmomicroscope . Albert and Greenough 1891,developed a binocular microscope which provided stereoscopic view. Gullstrand ,1911 introduced the illumination system which had for the first time a slit diapharm in it Therefore Gullstrand is credited with the invention of slit lamp.
Various laser lenses have been introduced following Goldmann 3- mirror and Goldmann fundus contact lens for retinal photocoagulation.
Below described some of the time-tested lenses in widespread use. Precise knowledge of these lenses is necessary for safe retinal photocoagulation.
This document discusses the slit lamp biomicroscope, including its history, components, uses, and examination technique. Some key points:
- The slit lamp allows examination of the eye's structures in 3D using stereoscopic binocular observation, directional illumination, and an adjustable slit shape.
- Modern slit lamps have observation microscopes, illumination systems, and mechanical systems to position the patient and adjust the device.
- Innovators throughout history contributed to its development, but Gullstrand introduced the first slit diaphragm in 1911 and Henker and Vogt created the first adjustable slit lamp design.
- Examination involves properly positioning the patient beneath the device and using its controls to illumin
Lenses of slit lamp biomicroscope & indirect ophthalmoscope.Ayat AbuJazar
This document discusses different lenses used for ophthalmic examination, including Volk double aspheric lenses, Goldmann three mirror lenses, and indirect ophthalmoscope lenses. Volk lenses come in 60D, 78D, and 90D powers and are used for slit lamp biomicroscopy. The 60D provides high magnification of the posterior pole, while the 78D is for general diagnosis and the 90D is for small pupils. Goldmann three mirror lenses provide a 3D view of the anterior chamber and fundus and require a coupling agent. Indirect lenses act as condensing lenses, with higher powered lenses providing less magnification but wider field of view.
Educational compound microscope comes with siedentopf type binocular viewing head. With the help of coarse and fine focusing adjustment,
LED source of illumination, it is possible to obtain clear and sharp images of the specimen.
It is specially designed for examination & demonstration purpose. It can be used for advanced applications in schools and colleges.
Cytotoxic Safety Cabinet comes with Safety Height 200 mm (8 inches) of test opening, 440 mm (17 inches) of maximum opening, 465 m3/h (273 cfm) of exhaust
volume and 0.73m3 of internal work area. Maintaining cleanliness within the work zone for patient safety and product cleanliness.
Rac Exports is one of the largest manufacturers,exporters and wholesale suppliers of scientific & laboratory instruments dealing in Radiometer,Orsat App,Lab Jack,Geissler Tube in Case,Vacuum Flask,Weighing Bottles and lots more. For more info about our products and pricing please visit our website http://www.exportersindia.com/racexports/
Driven for teaching & research applications,
the incor porates CCIS plan BXL PENTEX
achromatic objectives to produce crisp, flat
& high contrast images at all magnifications
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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2. Preamble
On August 3rd
, 1911, Alvar Gullstrand introduced the first rudimentary model of the slit lamp
illuminator.
An occasion of tremendous significance to ophthalmology had just taken place. Gullstrand
described a device with the potential to advance the understanding of the eye and its problems as
profoundly as did the direct ophthalmoscope 50 years earlier. By 1916, Henker had developed a
practical combination of Gullstrand's illuminator and Czapski's corneal microscope, marking the
first major advance in methods of examining the external eye in more than a century. In 1936
Comberg established the co-pivotal and iso-centric relationship between the microscope and slit
illuminator and, in 1938, Goldmann’s collaboration with Haag-Streit produced the first par-focal
instrument which also featured the single control lever design in use to this day. Goldmann also
influenced the shift to Köhler illumination, greatly improving the efficiency of the slit lamp illumi-
nator, the very heart of this marvelous device.
These significant milestones, with contributions from
a host of other individuals, have coalesced into the highly sophisticated instruments that are placed
at our disposal today. In light of such capabilities in instrumentation, it follows that our results in
slit lamp examination and slit lamp photography will rest on the level of sophistication we apply
to the practice of these challenging and stimulating art forms.
Csaba L. Mártonyi, COPRA, CRA
Emeritus Associate Professor
University of Michigan, Ann Arbor
BX User Guide
This guide is intended to assist all those who seek to capture images of the eye using the slit
lamp to improve the quality of their photography by using simple to follow illumination dia-
grams and high quality image examples. We hope this book provides inspiration and motiva-
tion to anyone who is involved the art of documenting the unique properties and pathologies
of the eye and through Haag-Streit we offer a number of instruments to help you.
The Haag-Streit BX900 slit lamp marries the latest imaging technology with the proven versa-
tility, optical brilliance and build quality of the Haag-Streit tradition. The BX900 is the leading
slit lamp-imaging device that is designed to assist the Ophthalmic Photographer with his
demanding job. Furthermore it will also provide a valuable asset for all Eye Cap Specialists who
demand the highest clinical and educational standards.
Haag-Streit greatly appreciates and thanks all those who have contributed to this publication
with special thanks to Cees van Beek of Leyenburg Hospital, Den Haag who provided many of
the images.
Steve Thomson
Haag-Streit AG
4. BX 900®
PHOTO SLIT LAMP
The Haag-Streit Photo-Slit Lamp BX 900®
is based on the Slit Lamp BQ 900®
. It is therefore pos-
sible to use the same instrument both for ocular examination and documentation. A photo-slit
lamp is a combination of a biomicroscope, and illumination system and the photo attachment.
The Photo-Slit Lamp BX 900®
and the Slit Lamp BQ 900®
share the same microscope. The illu-
mination system of the photo-slit lamp has in addition a flash unit and a background illumina-
tion. Two different light sources are available: the flash illumination and the modelling light. On
the following page the different components will be explained.
1. Cable guide
2. Flash housing
3. Flash intensity changer
for background illumination
4. Objective tube
5. Camera body
6. Eye-piece with double cross
hair reticle
7. Mirror housing
8. Background illumination
9. Mirror and Diffusion filter
10. Cold light source
11. Shutter release bar
12. Photo control unit
1
2
3
4
5
7
6
8
10
11
12
4
9
5. 1. The cable guide contains the high voltage cable for the
flash light.
2. The flash housing contains the flash tube. Firing the BX900
trigger will simultaneously deliver a flash through the illu-
mination system and, via a glass fibre cable, the fill back-
ground illumination while synchronising with the camera
shutter.
3. The background illumination changer has seven settings:
These selections are only for the fill flash of the background
illumination. The modelling light is controlled by the cold
light source.
4. The camera body is mounted on the top of the biomicroscope
allowing full visibility of the patient’s eyes from either side of
the microscope. Not all cameras available on the market can
beused.Haag-Streithasselectedanumberofmodelsandhas
made the necessary adaptations. The correct function of the
photo-slit lamp is guaranteed only by the use of cameras that
are recommended by Haag-Streit. A list of current camera
models is available at: www.haag-streit.com. Note that
the camera has to be in the «MANUAL» operating mode and
the shutter speed should be set to 1/90 sec. The recommended
ISO rating for general use is 200 and colour temperature of
the flash is 6000k but users have the option to apply other
setting as required.
5. The 12.5x eyepiece with double cross hair reticule is inserted
intotherightocularofthemicroscope.Thismustbecorrectly
focused for the user’s eye to ensure sharp images are cap-
tured. Note that this setting is not the user’s refractive error.
6. The principal component of the Haag-Streit Photo-Slit Lamp
BX 900®
is the mirror housing with its built-in diaphragms.
It mounts between the magnification changer and the binoc-
ular tube. When capturing an image all light is directed, via
a mirror, to the camera. This allows the maximum utilisation
of the available light: 100% for the examination and 100% for
the image. The built-in diaphragm setting with five apertures
is applied automatically on image capture. For the aperture
intervals: Step 1 = largest aperture, Step 5 = smallest aperture.
The small knobs on each side of the mirror housing can be
used during examination to quickly activate the diaphragms
to the pre-set position. This allows a preview prior to capture
so that the image subject and depth of field may be checked.
7. The background illumination is swivel-mounted on a hori-
zontal level and is illuminated through two glass fibre cables.
The flash fill light comes from the flash housing and the mod-
elling light comes from the cold light source. The modelling
light is used to show where any reflection of the fill flash will
fall.
8. The cold light source is mounted under the table and it pro-
vides the background modelling illumination.
9. With the diffusion filter the slit beam can be covered allow-
ing overview pictures with diffuse illumination.
10. The shutter release bar is conveniently positioned in front of
the joystick on the cross-slide. It can be used either right or
left-handed.
11. The photo control unit is mounted under the left hand side of
the table and has the main switch for the power supply. On
the front side there are two switches and four error light indi-
cators. With the main power switch it is possible to turn off
the entire electrical system of the slit lamp. The camera may
be turned off separately. The power switch on the front side
is only for the photo control unit. With the flash-intensity
switch in the high position, the flash light increases by one
aperture step. Optical and acoustic warning signals will be
activated in the case of an error when the shutter release bar
is pressed. Once the cause of the problem has been removed,
press the shutter release bar and the optical warning signal
will be cancelled and the camera will be ready for use.
5
= 100 % = 50% = 25%
= 10% = 5% = 0% = blue filter
6. Size of field
in mm
24x36 mm
Mono
Chip dimensions
15x22.5 mm
Mono
24x36 mm
Stereo
BIOMICROSCOPE
Magnification Changer 6.3 x 10 x 16 x 25 x 40 x
Ocular Magnification 12.5 x
Range of Adjusting Oculars +8 to -8 dioptres
Reticle right ocular
Inter-pupillary Distance 52–78 mm
SLIT LAMP ILLUMINATOR
Slit Height 1–8 mm
Slit Width 0–8 mm
Spotlight 0.2, 1, 2, 3, 5, 8 mm diameter
Horizontal Arc +/- 90°
Vertical Arc 5°, 10°, 15°, 20°
Filters blue, green (red free), N. D. 10%
Slit Beam Diffuser yes
Light Source Illumination Device 6V 4.5A Tungsten
Light Source Background Illumination Halogen
PHOTO ATTACHMENT
Image Delivery Quick Return Mirror 100% light for examination or
photography
Objective Tube Focal Length 170 mm
Light Source Flash Light normal 200 Ws, high 400 Ws
DEPTH OF FIELD
dependent on magnification and aperture
Values will be increased by 35% in transparent media of the eyes
1 2 3 4 5
6.3x 1.3 1.8 2.6 3.6 5.2
10 x 0.5 0.7 1 1.4 2
16 x 0.2 0.3 0.4 0.5 0.8
25 x 0.1 0.1 0.15 0.2 0.3
40 x 0.05 0.05 0.05 0.1 0.15
Magnification Extent of depth of focus (+/- in mm)
with aperture
IMAGE AND MAGNIFICATION DATA
Circles: visible field of the eye-piece
6.3x 0.63x 38x57 23.8x35.7 0.63x 38x28.5
10 x 1x 24x36 15x22.5 1x 24x18
16 x 1.6x 15x22.5 9.4x14.1 1.6x 15x11
25 x 2.5x 9.5x14 6x9 2.5x 3.5x7
40 x 4x 6x9 3.88x5.6 4x 6x4.5
Setting at
magnification
changer
Magnifi-
cation in
plane of
the chip
Magnifi-
cation in
plane of
the chip
TECHNICAL DATA
6
7. PHYSICAL AND OPTICAL CONDITIONS
TYPES OF ILLUMINATION
The binocular examination of the eyes with the slit lamp takes
place in a three-dimensional space with great depth of field.
Normal slit lamp imaging is a two-dimensional documenta-
tion with a very small depth of field. The difference between
stereo viewing and monocular imaging can sometimes prove
troublesome. However, viewing monocularly can help. Note
only the image through the right eyepiece is recorded.
Thephotographer’sviewthroughtheeyepiecesisnotthesame
as the recorded image. Through the eyepieces a circular image is
visible whereas the image captured is rectangular (see page 6).
The Haag-Streit BX900 has no measurements for the light-
intensity and no automatic exposure system. It is therefore use-
ful to take notes in the early stages of using the BX. Down-
loading images into EyeCap or a suitable image viewer will
enable instant evaluation and will enable adjustments to be
madethatoptimisetheimage.Thepracticalexampleswillhelp,
but they are only starting-points.
The BX900 has a clear screen with a cross hair reticule. The
accommodative abilities of the photographer’s own eye are
normally not noticeable during an examination: It is important
that the photographer must establish the correct eye-piece set-
ting (see page 5) to neutralise any accommodation. Only by
viewingasharpimageofthereticuleoverlyingafocusedimage
of the eye will sharply focused images be captured.
It should also be considered that the examiner’s attention is
focused on the details that are of interest and by selective view-
ing the brain suppresses certain artefacts. The camera however
does not!
The correct illumination will allow optimal recording of ocular
pathology.
DIFFUSE ILLUMINATION
The slit lamp beam should be completely opened and covered
bythediffusingfilter.Thebackgroundilluminationcanbeused
inconjunctionwiththeslitilluminationformoreuniformlight-
ing.Thediffuseilluminationisnormallyusedforoverviewpic-
tures with low magnification (10x and 16x).
DIRECT FOCAL ILLUMINATION
Direct focal illumination refers to projecting the light on the
subject at the plane of focus. Unlike diffused light concentrat-
ed light penetrates transparent structures. With a centred slit
beam there is always direct focal illumination.
INDIRECT ILLUMINATION
With indirect illumination the light does not fall directly on the
pathology. The slit beam is decentred and projected just adja-
cent to the subject area and it is illuminated by scattered inter-
nally reflected light.
RETROILLUMINATION
Retroillumination is an indirect illumination too. Light reflect-
ed from the fundus or iris illuminates the pathology from
behind. If the slit beam is decentred and higher magnification
is used, unwanted reflections can be minimised.
PHOTOGRAPHY WITH THREE-MIRROR CONTACT
LENS OR 90-DIOPTER LENS
With these instruments there are more optical interfaces (air /
glass and glass / cornea). All interfaces cause reflexes and
therefore it is better to take images without the background
illumination. Furthermore any scratches or damage to the lens
will increase the number of image artefacts.
If the space between the diagnostic contact lens and the slit illu-
minator is very small, the background illumination can be
locked in the centre position.
7
8. Moderate Slit
Beam:
Narrow Slit
Beam:
STANDARD SETTING
Background
Illumination:
Slit Beam with
Diffused Filter:
Wide Slit Beam:
Slit Beam
Centered:
Slit Beam
Decentered:
Microscope:
The BX900 has many different adjustments and its correct use
can give optimal illumination and exposure. It is advantageous
toalwaysstartwithastandardsettingandtomakeadjustments
after each image captured.
An example for a standard setting is the diffuse illumination:
1. Main switch on, photo control unit POWER ON and
camera body on.
2. Afterwaitingafewseconds,settheflashintensityonHIGH.
3. 100% Background illumination
45°Anglebetweenmicroscopeandbackgroundillumination
Slit beam vertical
Slit beam fully open (slit width and height)
Slit beam centred (screw tightened)
100% slit illumination (without filter)
Slit beam covered with the diffusion filter
Anglebetweenmicroscopeandilluminationdevice30°–45°
Magnification 10x
Aperture 4 with a sensor rating ISO 200
4. Define the image field, close the left eye (note the difference
between eye-piece and photo tube picture)
5. Focus control (eye-piece setting correct?)
6. Capture Image.
ILLUMINATION AND EXPOSURE SETTINGS
PICTOGRAMS
The following table shows the different settings of illumina-
tion and exposure adjustments. This table is also used for prac-
tical examples and will give a starting point.
ISO: 200
Flash Intensity: high / normal
Background: 100%, 50%, 25%, 10%, 0%, blue filter
Angle: 0° – 90°
Slit Beam: 0 (= closed) to 8 mm (= full open)
Filter: blue, red free (green), grey (10% N. D.), diffused
Angle: 0° – 90°
Magnification: 10x 16x 25x 40x
Aperture: 1 – 5 1 – 5 1 – 5 1 – 5
8
9. DIFFUSE ILLUMINATION WITH SLIT ILLUMINATION AND BACKGROUND ILLUMINATION
The diffuse illumination with slit beam and background illumination gives a shadow-
free illumination with natural colours and two light reflexes. This is most useful for
low magnification overview images.
ISO: 200
Flash Intensity: high
Background: 100%
Angle: 30°–45°
Slit Beam: fully open
Filter: diffused
Angle: 30°
Magnification: 10x 16x 25x 40x
Aperture: 4 4 3 2
DIFFUSE ILLUMINATION WITH BACKGROUND ILLUMINATION ONLY
The diffuse illumination with only the background illumination increases the con-
trast. The structures of the iris are more visible and there is only one light reflex.
ISO: 200
Flash Intensity: high
Background: 100%
Angle: 30°–45°
Slit Beam: closed
Filter: –
Angle: –
Magnification: 10x 16x 25x 40x
Aperture: 4 3 3 2
OVERVIEW
9
10. NARROW SLIT
Acentred, narrow slit beam projected at a 45° angle demonstrates surface topography
and trans-illumination of the lesion. The background illumination gives the position
of the slit beam.
ISO: 200
Flash Intensity: high
Background: 25%
Angle: 30°–45°
Slit Beam: 0.1 mm
Filter: –
Angle: 45°
Magnification: 10x 16x 25x 40x
Aperture: 3 2 2 1
DIFFUSE ILLUMINATION
Diffuse illumination provides evenly balanced lighting. Exposure control is more
varied due to increased reflectivity.
ISO: 200
Flash Intensity: low
Background: 50%
Angle: 30°–45°
Slit Beam: fully open
Filter: diffused
Angle: 30°
Magnification: 10x 16x 25x 40x
Aperture: 5 5 4 3
10
CONJUNCTIVA
DIFFUSE ILLUMINATION
Diffuse illumination provides evenly balanced lighting. ISO: 200
Flash Intensity: low
Background: 50%
Angle: 30°–45°
Slit Beam: fully open
Filter: diffused
Angle: 30°
Magnification: 10x 16x 25x 40x
Aperture: 4 4 3 2
LIDS
11. INDIRECT ILLUMINATION
A moderately wide and decentred slit beam is projected just adjacent to the border of
the lesion. The light penetrates conjunctiva and illuminates the clear fluid below. In
the presence of blood or scar tissue, the light is absorbed.
11
DIFFUSE ILLUMINATION
This illumination technique can only be used in the presence of dense corneal patholo-
gies because diffuse light does not penetrate very well through the cornea. Dilating
the pupil can enhance pathology by creating a darker background.
ISO: 200
Flash Intensity: high
Background: 100%
Angle: 30°–45°
Slit Beam: fully open
Filter: diffused
Angle: 30°
Magnification: 10x 16x 25x 40x
Aperture: 4 4 3 2
WIDE SLIT BEAM – TANGENTIAL ILLUMINATION
This technique can provide more information as the oblique illumination is reflected
andrefractedbythecorneaandanypathology.Experimentwiththeilluminationangle
slit beam width for optimum results.
ISO: 200
Flash Intensity: high
Background: 0%–25%
Angle: 45°
Slit Beam: open
Filter: 10%
Angle: 60°–80°
Magnification: 10x 16x 25x 40x
Aperture: – 4 3 2
CORNEA
ISO: 200
Flash Intensity: high
Background: 10%
Angle: 30°–45°
Slit Beam: 2–4 mm
Filter: –
Angle: decentred
Magnification: 10x 16x 25x 40x
Aperture: 2 2 1 1
12. DIRECT RETROILLUMINATION FROM THE IRIS
A moderate slit beam is decentred and angled to project onto the iris directly behind
the pathology. The light reflects and backlights the cornea. If there is some cataract
present the lens can also be used to reflect light directly onto the area of interest.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 1–2 mm
Filter: –
Angle: decentred
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
NARROW SLIT BEAM – OPTICAL SECTIONING
A narrow focal slit beam is projected at a 45° to 60° angle. It cuts an optical section
through the cornea like a knife. With this technique it is possible to locate the layer
of the pathological changes. These examples demonstrate endothelial and surface
pathology.
ISO: 200
Flash Intensity: high
Background: 0–10%
Angle: 45°
Slit Beam: 0.1 mm
Filter: –
Angle: 45°–60°
Magnification: 10x 16x 25x 40x
Aperture: – 1 1 –
12
MODERATE SLIT BEAM WITH SEPARATION OF ILLUMINATED EPITHELIUM AND ENDOTHELIUM
The moderate beam produces two different layers of illumination, one on the
epithelium and one on the endothelium. Note the corneal changes are closer to
the posterior reflection and therefore they lie deep in the cornea.
ISO: 200
Flash Intensity: high
Background: 0%–25%
Angle: 30°
Slit Beam: 2–3 mm
Filter: –
Angle: 45°
Magnification: 10x 16x 25x 40x
Aperture: – 3 3 2
13. INDIRECT RETROILLUMINATION FROM THE IRIS
The moderate slit beam is now decentred even more and angled to project onto the
iris adjacent to the area behind the area of interest. The background is dark and the
edges of non-pigmented lesions are well defined by the diffuse light reflecting from
the iris.
13
SCLEROTIC SCATTER
The wide decentred slit beam is projected onto the limbus. The light striking the lim-
bus is internally reflected through the corneal tissue like a fibre optic. Corneal changes
or abnormalities can be visualised by reflecting the scattered light. Careful post cap-
ture cropping can enhance images.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 2 mm
Filter: –
Angle: decentred
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
TOPICAL ADMINISTRATION OF SODIUM FLUORESCEIN
Sodium fluorescein is applied gently to the bulbar conjunctiva. The patient should
blink once or twice for the dye to be dispersed over the eye. If the epithelium of the
conjunctiva or the cornea is damaged, the fluorescein stains the underlying tissue. The
remainingdyefluorescesayellowgreencolourwhenexcitedbythebluelight.Healthy
epithelium does not stain.
Rose Bengal is a dye that can be used to demonstrate abnormal epithelial cells. The
dye is applied like sodium fluorescein and is usually imaged using direct white light.
ISO: 200
Flash Intensity: high
Background: blue filter
Angle: 30°
Slit Beam: fully open
Filter: blue filter
Angle: 60°–80°
Magnification: 10x 16x 25x 40x
Aperture: 3 3 2 1
ISO: 200
Flash Intensity: high
Background: 0–10%
Angle: –
Slit Beam: 1–2 mm
Filter: –
Angle: decentred
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
14. CHAMBER ANGLE – GONIOPHOTOGRAPHY
The desired mirror of the gonioscopy lens is positioned opposite to the area of pathol-
ogy. A wide slit beam is projected in the desired mirror from a near coaxial position to
the biomicroscope. Light reflections can be eliminated by tilting the lens.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 2 mm
Filter: –
Angle: 10°
Magnification: 10x 16x 25x 40x
Aperture: – 5 5 4
14
AQUEOUS FLARE – TYNDALL’S PHENOMENON
Cells, pigment or proteins in the aqueous humour reflect the light like a faint fog. To
visualise this the slit illuminator is adjusted to the smallest circular beam and is pro-
jected through the anterior chamber from a 42° to 90° angle. The strongest reflection
is possible at 90°.
ISO: 200
Flash Intensity: high
Background: 0%–25%
Angle: 30°
Slit Beam: 0.1–1 mm
Filter: –
Angle: 50°
Magnification: 10x 16x 25x 40x
Aperture: – 1 1 1
ANTERIOR CHAMBER, CHAMBER ANGLE
15. WIDE SLIT BEAM - TANGENTIAL ILLUMINATION
The wide slit beam is projected at an oblique angle of 80° – 90° onto the iris. This illu-
mination creates strong shadows and the surface texture is enhanced. If the headrest
doesn’t allow a wide oblique angle it is sometimes necessary to turn the patient’s head
a little away from the light.
ISO: 200
Flash Intensity: high
Background: 0%–10%
Angle: 45°
Slit Beam: open
Filter: –
Angle: 80°
Magnification: 10x 16x 25x 40x
Aperture: 5 5 4 4
IRIS TRANSILLUMINATION
The slit illuminator is positioned coaxially to the biomicroscope and adjusted to pro-
vide a small circular beam of light. This beam is projected through the pupil which
should be at mid dilation. The light reflects from the fundus and backlights the iris.
Normally the iris pigment absorbs the light, but pigmentation defects let the red fun-
dus light pass through..
15
IRIS, IRIS-ANGIOGRAPHY
IRIS ANGOIGRAPHY
The illumination technique of the iris angiography is like the tangential illumination
with the background illumination opposite the slit beam. Both slit illuminator and
background illumination have a blue excitation filter. The yellow barrier filter is posi-
tioned between the magnification changer and the mirror housing. The barrier filter
only works on the image from the right eyepiece which is directed to the camera. Con-
trol of the focus of the image during the angiography is possible through the left eye-
piece.
ISO: 800
Flash Intensity: high
Background: blue filter
Angle: 45°
Slit Beam: open
Filter: blue filter
Angle: 45°–60°
Magnification: 10x 16x 25x 40x
Aperture: – 1 – –
ISO: 200
Flash Intensity: high
Background: 0%–10%
Angle: 45°
Slit Beam: Ø 1–2 mm
Filter: –
Angle: coaxial
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
16. MODERATE SLIT BEAM – TANGENTIAL ILLUMINATION
A moderate to wide slit beam is projected at an angle greater then 45 degrees to pro-
vide oblique tangential illumination that can enhance detail by providing shadows.
Pupil dilation will aid this illumination technique.
ISO: 200
Flash Intensity: high
Background: 10%
Angle: 45–60°
Slit Beam: 2–6 mm
Filter: –
Angle: 45°–60°
Magnification: 10x 16x 25x 40x
Aperture: – 2 2 1
16
MODERATE SLIT BEAM – DIRECT ILLUMINATION
A moderate slit beam is projected at a 45° angle to the lens pathology and is directly
illuminated. Dilation of the pupil is required for effective imaging.
ISO: 200
Flash Intensity: high
Background: 10%
Angle: 45°
Slit Beam: 2–4 mm
Filter: –
Angle: 45°
Magnification: 10x 16x 25x 40x
Aperture: – 2 2 1
NARROW SLIT BEAM – OPTICAL SECTIONING
A narrow focal slit beam is projected at a 45° angle to the lens as an optical section is
made. Because of the problematic depth of field it is not possible to photograph the
entire lens section in focus. It is therefore necessary to focus on the anterior or the pos-
terior lens surface.
ISO: 200
Flash Intensity: high
Background: 25%
Angle: 45°
Slit Beam: 0.1 mm
Filter: –
Angle: 45°
Magnification: 10x 16x 25x 40x
Aperture: – 1 1 –
LENS
17. RETROILLUMINATION FROM THE FUNDUS – RED-REFLEX PHOTOGRAPHY
The slit illuminator is positioned in an almost coaxial position with the biomicroscope.
Awide slit beam is decentered and adjusted to a half circle by using the slit width and
height controls. The decentred slit beam is projected near the pupil margin through a
dilated pupil. Careful composition can minimise the direct reflection.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 2 mm
Filter: –
Angle: decentred
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
NARROW SLIT BEAM
Without diagnostic lenses it is only possible to examine and to document the anterior
part of the vitreous. Anterior Vitreous pathology can be seen with a narrow slit beam.
Only when the dioptric power of the eye is reduced is it possible to focus more
posteriorly.
17
VITREOUS
ISO: 200
Flash Intensity: high
Background: 0%–10%
Angle: 45°
Slit Beam: 0.1–1.0 mm
Filter: –
Angle: 45°
Magnification: 10x 16x 25x 40x
Aperture: – 1 1 –
18. 18
CENTRAL RETINA PHOTOGRAPHS WITH A 90-DIOPTER LENS
Diagnostic contact lenses are sometimes contraindicated after intra-ocular surgery. In
such cases the use of the 90- dioptre lens is necessary. The handling of this lens is more
difficult because there is no physical contact with the eye. A moderate slit beam in the
almost coaxial position gives the best results.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 2 mm
Filter: 10%
Angle: 5°–10°
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 –
CENTRAL RETINA PHOTOGRAPHS WITH THE THREE-MIRROR CONTACT LENS
The posterior pole can be documented with the centre of the three-mirror contact lens.
The slit lamp illuminator is in an almost coaxial position. If the slit beam is too wide
disturbing light reflections may occur.
ISO: 200
Flash Intensity: high
Background: 0%
Angle: –
Slit Beam: 2 mm
Filter: 10%
Angle: 5°–10°
Magnification: 10x 16x 25x 40x
Aperture: – 2 1 1
FUNDUS
19. Recommended Reading
Clinical Slit Lamp Biomicroscopy and
Photo Slit Lamp Biomicrography
Martonyi, Bahn & Meyer
Time One Ink, Ltd.
Sedona, AZ
This book is currently in revision.
An expanded Third Edition is
expected late 2005.
Copies of the Third Edition and other books
of interest to the Ophthalmic Photographer can
be found at;
http://www.twinchimney.com
Photos by:
Cees van Beek
Leyenburg Hospital, Den Haag, Netherlands
Tarek Shaarawy
University Hospiral of Geneva, Switzerland
Steve Thomson
Haag-Streit, Bern, Switzerland