The College of Optometrists

It is good to get an efficient slit lamp technique sorted. One that flows and does not miss anything. Do it the same way on everyone and you will then make sure your routine will not miss anything. If you are on broadband - you can watch a video on slit lamp use at

http://www.med.uottawa.ca/procedures/slamp/preparing.htm

Here is what you can do: (but use this to develop your own style)

WASH YOUR HANDS first - and WIPE DOWN the slit lamp

Start with broad light and low magnification.

Look Out to In - swinging lamp nazaly as you go. (you swing the lamp at the mid point - so lamp left to look at right eye temporal area, and lamp right to look at the right eye nazal area)

They look up down in and out. (checks eye ball and tear prism)

They close lids (check closure and collarettes)

They open again and you roll back lower lid with cotton wool bud and evert upper lid with same bud.

Next Smaller slit of light (3mm) and higher magnification (flourescen now inserted)

Look at cornea and limbus generally. Check tear prism, get them to look up to check for prism drop (seen only in dry eye)

Change to green light and (indirect illumination ie: bounce the light off the iris surface into the cornea where you would expect to see the neovascularisation) - check for neov.

Tiny slit (white) look for VH angle both in and out - and also look at endothelium.

Tiny dot light - look for flare Straight on - look at lens and ant vitreous. (so you finish on small slit of light and big magnification) -steve