The document discusses the slit lamp biomicroscope, which is an important tool used to examine the anterior segment of the eye. It works on the same principle as a compound microscope, with an objective lens facing the patient and an eyepiece facing the examiner. There are different types of slit lamps produced by Zeiss and Haag Streit. Examination involves properly positioning the patient and adjusting the instrument, then using various illumination methods like diffuse, direct, and retro illumination to view the different structures of the anterior eye segment. The slit lamp is used for both diagnostic evaluation of ocular diseases and performing procedures.

1. SLIT LAMP BIOMICROSCOPE
By – Mushahid Raza
B.Optom

2. Indroduction
• SLIT lamp are used in the examination of the anterior segment of the
eye .
• Slit lamp is most important piece of equipment in the present day
ophthalmologist’s armamenterium .
• slit lamp biomicroscope was invented by Gullstrand in 1911.

3. Optics of slit lamp
• It works on the same principle as a compound microscope .
• The objective lens is towards the patient , whose eyes form the
object.
• The eyepiece is +10 to +14 D and it towards the examiner .
• The objective lens constis of two plano – convex lenses with their
convexities put together providing a composite power of + 22 D.

4. Principle
A narrow beam of very bright light produced by lamp this beam is
focused on to the eyes which is then viewed under magnification with
control illumination.

5. Types of slit lamp
• Zeiss slit lamp biomicroscope
• Haag streit slit lamp biomicroscope
ZEISS SLIT LAMP BIOMICROSCOPE
➡️

6. Haag streit slit lamp

7. Parts of slit lamp
INSTRUMENTATION
1- observation system [ microscope ]
2- illumination system [ Slit lamp ]
3- mechanical system [ Engineering support ]

8. Observation system–
• Binocular eyepiece
• camera and vedio adapter
• Observation tube
Machenical system –
• forehead rest
• Chin rest
• Fixation target
• Power supply unit
• Locking unit

9. Illuminationsystem –
• lamp nousing unit
• Slit width and high control
• Neutral density filter
• Cobalt Blue filter
• Red free filter
• Field size control
• Diffusion
• Prism

10. Slit lamp routine
• Patient adjustment
• Instrument adjustment
• Beginning slit lamp examination

11. Patient adjustment–
Patient should be positioned comfortably in front of the slit lamp and his /
her chin resting on the chin rest and forehead opposed to headrest.
Instrument adjustment –
• the Hight of table housing the slit lamp should be adjust according to
patient’s Hight.
• The microscope illumination systemshould be aligned to the pt.eye to be
examined.
• Fixation target should be placed at the required position.

12. Beginning slit lamp examination –
• Examination should be carried out in semi dark room so that the
examiner’s eyes are partially dark adapted to ensure sensitivity to low
intensities of light .
• Medication like ointments and anesthetics eye drops produce
corneal surface disturbance.
• There should be a minimum exposure of retina to light .

13. Methods of illumination
1> Diffuse illumination
2> Direct illumination
3> Indirect illumination
4> Retro illumination
5> Specular reflection
6> Sclerotic scatter
7> Oscillatory illumination of koeppe

14. Diffuse illumination–
• A diffuse board beam of light is used and a general view of
the anterior segment of the eye is observed.
• Approximately 30-45° between light and microscope.
Direct illumination –
• Observation and illumination system are focused at the
same time .
• Medium to high illuminationis used here .

15. Indirect illumination –
• Observation and illumination system are not focused at the
same point.
• Low , Medium and high illumination is used
• 30°-45° angle between light and illumination.
Retro- illumination –
• The objectiv of interest is illumination by a light reflected from
the structure behind it.
• Vary angle between light and microscope
• Moderate beam used .

16. Specular illumination –
• Angle of incidence is equal to angle of reflection
• 60° angle between light & microscope.
Sclerotic scatter –
• Illumination of cornea by total internal reflection of a wide angle light
source.
• The light beam is directed at the limbal region.

17. Use of slit lamp biomicroscopy –
DIAGNOSTIC –
• Anterior & posterior segment disease
• Dry eye
Procedure –
• Applanation
• Tear evaluation
• Gonioscopy
• Contact lens fitting

18. Therapeutic –
• Foreign body removal
• Epilation