Ultra sound biomicroscopy.PDF
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UBM (ultrasound biomicroscopy) is a high-frequency ultrasound imaging technique that can generate images of ocular structures with resolutions approaching light microscopy to a depth of 4-5mm. It has three main components: a transducer, signal processor, and articulated arm. UBM uses immersion technique with fluid to image the cornea as a multilayered structure and measure anterior chamber depth, angle, iris thickness, and iridolenticular contact distance. It can be used to assess corneal and scleral diseases, tumors, glaucoma, trauma, and IOL complications by providing detailed images of angle structures, iris behavior, and IOL position.
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This document provides an overview of the anatomy of the anterior chamber of the eye, including its structures and clinical correlations. It discusses the anterior chamber angle and identification of its structures like the ciliary band, scleral spur, trabecular meshwork, and Schwalbe's line. Methods for grading the chamber angle like gonioscopy and Van Herick test are presented. The document also covers aqueous production and drainage system, intraocular pressure measurement, and clinical conditions like glaucoma.
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Bujo.2014.003
This document provides an overview of techniques for conducting a slit lamp examination of the eye. It describes how to set up the slit lamp microscope and properly position the patient. The examination should start with the outer eye and progress inward, assessing the lids, conjunctiva, cornea, anterior chamber, iris, lens, vitreous, and fundus. Various illumination techniques like diffuse, retro-illumination, and optical sectioning are discussed for thoroughly examining each area of the eye. Filters and stains can be used to enhance views of structures like blood vessels or epithelial lesions.
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UBM and ASOCT provide high-resolution cross-sectional images of the anterior segment including the cornea, anterior chamber, angle, and iris. ASOCT uses optical coherence tomography with a wavelength of 1310nm for improved penetration and reduced retinal damage compared to posterior segment OCT. It allows high-speed imaging of dynamic structures. ASOCT has applications in assessing corneal diseases and procedures, glaucoma (including angle anatomy and iridotomy evaluation), and intraocular lens implantation. Measurements of angle width parameters help evaluate angle closure risk. While valuable for objective angle assessment, ASOCT cannot image all anatomical structures involved in glaucoma.
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Optical coherence tomography in multiple sclerosis
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Confocal microscopy of the eye
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Macular function test
Macular function tests, Macula, Fovea centralis , Foveal avascular zone , Visual acuity , Contrast sensitivity , slit lamp biomicroscopy , photostress test, amsler grid test, two point discrimination , colour vision , microperimetry , flourescein angiography, Optical coherence tomography, maddox rod test, ERG , Maxwell ophthalmoscope, VEP, laser interferometry, potential acuity meter, entopic phenomenon,
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This document discusses approaches to congenital glaucoma and developmental glaucoma associated with ocular and systemic disorders. It covers signs and symptoms, diagnostic examinations including vision testing, tonometry, and imaging. Primary congenital glaucoma is described along with theories of abnormal development. Specific conditions like Axenfeld-Rieger syndrome are also outlined. Management options are mentioned including medical therapy, various surgical procedures, and postoperative care.
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This document discusses approaches to congenital glaucoma and developmental glaucoma associated with ocular and systemic disorders. It covers signs and symptoms, diagnostic examinations including vision testing, external examination, and specific tests like tonometry and gonioscopy. Etiology and theories of abnormal development are explained. Primary congenital glaucomas, Axenfeld-Rieger Syndrome, Peters Anomaly, and Aniridia are discussed in detail including clinical features, management, genetics, and histopathology where relevant. Surgical and medical management strategies are also outlined.
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Ultra sound biomicroscopy.PDF
- 2. What is UBM ? It Is a method of high frequency ultrasound imaging used to generate images approaching light microscopic resolution up to a depth of 4–5 mm from the surface.
- 3. Instruments There are 3 main components of the system: 1. The transducer 2. Signal processor and 3. A articulated arm to steady the scanning head and provide precise motion control.
- 4. UBM MACHINE
- 5. TECHNIQUE Technique used for examination is the immersiontechnique using a fluid standoff An eye cup permits evaluation avoiding distortion caused by the eyelids and permits the use of a coupling solution. The procedure is done in the supine position under topical anesthesia The eyecup is used to separate the lids and is filled with 1% methylcellulose or normal saline. The transducer is immersed in the solution and placed directly over the part to be scanned. As the arm can be tilted as well as rotated in the horizontal plane, various sections of the same area can be scanned. The cornea and anterior segment can be easily studied, and the conjunctiva, sclera and peripheral retina up to the limits of rotation of the eye in various directions.
- 6. UBM OF NORMAL OCULAR STRUCTURE The cornea is seen as a multilayered structure with a highly reflective epithelium, 1. The cornea is seen as a multilayered structure, with a highly high reflective line consisting of the endothelium and Descemet’s membrane. 2. UBM can measure 1. ACD (Anterior chamber depth) 2. anterior chamber angle 3. Iris thickness 4. iridolenticular contact distance. 3. The ciliarybody, ciliaryprocesses and the ciliarysulcus are well distinguished on UBM. The anterior lens surface can be seen, as well as the anterior zonules.
- 7. USES OF UBM ❑ CORNEAL AND SCLERAL DISEASES 1. The UBM performed in opaque corneas can be helpful in deciding the prognosis and planning surgery in eyes undergoing keratoplasty. 2. “Virtual gonioscopy” in these instances gives an idea of angle details. The lens status can also be assessed. 3. Depth of involvement in scleral and episcleral inflammation can help in diagnosis and evaluatingresponse to treatment.
- 8. A)UBM image of Edematous cornea B) Corneal dystrophy
- 9. ❑ TUMORS : 1. Cystic lesions of the cornea, iris and ciliary body Iris tumors and nevi Small ciliary body tumors as well as cysts, which can mimic tumors are best assessed on UBM 2. The UBM is useful in defining the posterior extent of ciliary body tumors as well as the anterior extent of peripheral choroidal tumors
- 11. ❑ GLAUCOMA : 1. UBM can image all the angle components, iris, and ciliary body complex. 2. It is also possible to study the behavior of the iris and angle under various conditions of illumination 3. Angle-closure can occur at four anatomic levels; 1. the iris (pupillaryblock), 2. the ciliarybody (plateau iris), 3. the lens (phacomorphic glaucoma) 4. The anterior vitreous face (malignant glaucoma). Narrow angle of the ciliary body
- 12. ❑ MALIGNANT GLAUCOMA : ➢ UBM - able to demonstrate anterior rotation of the ciliary processes to make a diagnosis of malignant glaucoma. ➢ UBM helps in deciding the course of management at an early stage.
- 13. ❑ TRAUMA : UBM can demonstrate anterior segment foreign bodies, cyclodialysis clefts, zonular damage and angle recession
- 14. Iridodialysis :separation of the iris root from its attachment to the anterior ciliary body
- 15. Cyclodialysis: Detachment of the ciliary body from its insertion at the scleral spur
- 16. ❑ INTRAOCULAR LENS COMPLICATION : 1. The UBM is useful in studying various IOL complications. 2. Optic and haptic locations can be assessed accurately by looking for a strong echo at their interface plane. 3. This ability to image the IOL helps in determining whether structural changes induced by the IOL are responsible for postoperative complications. 4. These can be due to retained cortex or contact of the IOL haptic with the iris or ciliary body.
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