pemeriksaan slit lamp
DESCRIPTION
mataTRANSCRIPT
BY: RIZKI AMALIA
PEMERIKSAAN SLIT LAMP
Apa Itu Slit Lamp?
Slit Lamp (Lampu celah) adalah instrumen yang terdiri dari sumber cahaya intensitas tinggi yang dapat difokuskan untuk bersinar menjadi lembaran tipis dari cahaya ke mata
Hal ini digunakan dalam hubungannya dengan biomicroscope.
Memfasilitasi pemeriksaan segmen anterior, atau struktur frontal dan segmen posterior, dari mata manusia, yang meliputi kelopak mata, sklera, konjungtiva, iris, lensa kristal alami, dan kornea
Pemeriksaan celah-lampu teropong memberikan pandangan diperbesar stereoskopik dari struktur mata secara rinci, memungkinkan diagnosis anatomi harus dibuat untuk berbagai kondisi mata.
Komponen Dasar Slit Lamp
Illumination arm: terdiri dari sistem iluminasi dan sudutnya bisa diganti dari 0-90
Terdiri dari:A- slit controls: untuk mengatur lebar slit dan
orientasinyaB- click stop: mengubah posisi cermin
pemantul untuk mengubah sudut dari balok terhadap sistem penglihatan
C- filters: merubah penambilan balok menjadi cobalt blue, filter green, or red free filter
Microscope armMicroscope arm : it has A- oculars: dapat disesuaikan dengan kelainan
refraksi pemeriksaB- magnification changer
Slit lamp position controlsSlit lamp position controls :
- Joystick ( elevation knops )
Examination methods A- direct illumination : angle between the
light source and microscope is about 40-50 and both microscope and light will direct to the focusing area , different type of direct illumination can be used
1- wide-beam direct illumination use to evaluate large area
2- parallelepiped it is constructed beam occur by narrowing the beam to 1-2 mm in width use for examined the layered of cornea and lens especially in the depth and extent of the corneal abrasions , scarring and foreign bodies
3- optic section it is when the parallelepiped reduced in width to an extremely thin , it is use for evaluated the layer of cornea and the depth of the foreign body
4- conical beam produce by narrowing the vertical height of a parallelepiped to produce a small circular or square spot of light , used to examined the transparency of the anterior chamber for floating cells
B-Indirect illumination :Formed by narrowing the beam to 1-2
mm in width the beam focused on an area adjacent to ocular tissue observed this will give somewhat illumination to give better definition of the structural tissue like in foreign body
Retro illumination ( vertical slit beam 1-4 mm)
Is formed by reflecting light beam from structure more posterior than the structure under observation, the purpose of it is to place the object of regard against a bright background allow the object to appear dark or black ,use estimate the corneal endothelium and lens
Sclerotic scatter: it is formed by focusing a bright and
narrow (1mm) beam on limbus and using the microscope on low magnification the angle between the light and microscope about 40-60
Ocular structure
Type of slit lamp beam
Angle of illumination
arm
magnification
Lids / lashes diffuse 30 low
conjunctiva parallelepiped 30 low
cornea Narrow parallelepiped
30 - 45 medium
Anterior chamber
Optic section 60 medium
Angle depth –
aqueous
Conical beam 30 high
Iris Wide parallelepiped
30 - 45 medium
Lens Narrow parallelepiped
20 - 30 medium
Procedure :- Patient will examined without glasses - Room illumination is dim - Adjust the height of the slit lamp table to the comfort
position for patient and examiner - Instruct the patient to place his chin on chin rest and
his forehead against forehead rest - Adjust the chin rest to align the patient canthus - Set the magnification in low setting ,remove all filters - Open the both eyes of you ( examiner) and set the IPD - Use one hand to use the joystick and the other hand to
control the angle between the microscope and light
Fluorescein staining:Fluorescein is an orange colored dye , it is
instilled into the eye and a fine film over the corneal surface , it will appear by using ultra – violet light as green color, it use in detected F.B and corneal abrasion
Uji Besar Sudut dengan Lampu Celah
Teknik Pemeriksaan dilakukan di kamar gelap dengan lampu celah dengan sinar diarahkan pada kornea tegak lurus didaerah limbus
Kemudian liat keadaaan suatu sudutDilihat secara potongan optik tebal kornea
dan dalam bagian perifer sudut bilik mata.Dibandingkan dengan sudut bilik mata yang
dilihat dengan ketebalan kornea
Interpretasi
Menurut kriteria Becker and Shaefer
Tingkat sudut Sudut Bilik Mata
4 BMD= tebal kornea
3 BMD= ¼-1/2 tebal kornea
2 BMD= ¼ tebal kornea
1 BMD < ¼ tebal kornea
Sudut slit BMD sangat sempit
Sudut tertutup BMD perifer tidak ada
ORBIS. 2003. http://telemedicine.orbis.org/bins/content_page.asp?cid=1-1581-1604 . Introduction to slit lamp technique
Buckley. 2008. Slit Lamp Training. http://www.docstoc.com/docs/90732699/1-basic-course-slit-lamps