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BY: RI ZKI AMALI A

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
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

magnification Angle of
illumination
arm
Type of slit
lamp beam
Ocular
structure
low 30 diffuse Lids / lashes
low 30 parallelepiped conjunctiva
medium 30 - 45 Narrow
parallelepiped
cornea
medium 60 Optic section Anterior
chamber
high 30 Conical beam Angle depth
aqueous
medium 30 - 45 Wide
parallelepiped
Iris
medium 20 - 30 Narrow
parallelepiped
Lens
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 Sudut Bilik Mata
4 BMD= tebal kornea
3 BMD= -1/2 tebal kornea
2 BMD= tebal kornea
1 BMD < tebal kornea
Sudut slit BMD sangat sempit
Sudut tertutup 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-basic-
course-slit-lamps