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