1. Check set
up of machine.
2. Observe the patient before examination. Obvious signs
may be missed on
slit-lamp such as different corneal
diameter or heterochromia.
3. Position the patient comfortably.
a
4. Examine the anterior segments and then the posterior segments
unless told
otherwise.
5. Remember to examine the fornix (scars, adrenochrome
etc) and superior
bulbar conjunctiva for abeculectomy.
6. Special note:
-
Learn direct, diffuse illumination, scleral scatter, specular
reflection
-
Look for iris transillumination
-
If asked, formal AC depth measure:
-
set slit beam mounting at 60 degrees to microscope
-
use horizontal slit beam
-
adjust slit beam to join corneal and iris reflections measure
slit length and multiply by 1.4 for AC depth in mm.
Clinical signs which may be easily missed:
-
pigmented lesions of the bulbar conjunctiva
-
deposits on cornea such as ferritin line or
pigments on the endothelium
-
iris transillumination
-
small corneal scar
-
peripheral iridotomy
-
Montelo's tube
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