PEMERIKSAAN SLIT LAMP

BY: RIZKI AMALIA

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 orientasinya B- 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 arm : it has

A- oculars: dapat disesuaikan dengan kelainan refraksi pemeriksa B- magnification changer

Slit 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
Lids / lashes conjunctiva cornea

Type of slit lamp beam

diffuse parallelepiped Narrow parallelepiped

Angle of illumination arm

30 30 30 - 45

magnification

low low medium

Anterior chamber
Angle depth aqueous Iris Lens

Optic section
Conical beam Wide parallelepiped Narrow parallelepiped

60
30 30 - 45 20 - 30

medium
high medium 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 sudut Dilihat 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 4 3 2 1 Sudut slit Sudut tertutup Sudut Bilik Mata BMD= tebal kornea BMD= -1/2 tebal kornea BMD= tebal kornea BMD < tebal kornea BMD sangat sempit BMD perifer tidak ada

 ORBIS. 2003.

http://telemedicine.orbis.org/bins/content_page.as p?cid=1-1581-1604 . Introduction to slit lamp technique Buckley. 2008. Slit Lamp Training. http://www.docstoc.com/docs/90732699/1-basiccourse-slit-lamps