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Tomographic measurements of in vivo cataracts by slit-lamp photography.

A practical method for detecting in vivo cataracts has been developed using a commercially available slit-lamp camera and by utilizing a measuring grid photographic technique. The basis of the method is to photograph a series of slit-beam sections through a lens at varying angles to the optic axis. The areas of opacity show up as localized regions of light back-scatter where the opacities intersect the path of the beam. A set of measuring grids compensated for angle distortion have been prepared. These are superimposed on the appropriate photograph. By taking a sufficient number of sections through a cataractous lens, a tomographic representation of the opacities can be constructed using a lens map. An example of the procedure of three-dimensional mapping is presented using actual lens pictures. The photographic parameters used in this method are explained in detail. The method achieves the goals of ease of use, reproducibility, and applicability to research and clinical studies.

Aged↗

Photographic recording of slit-lamp appearances of the ocular fundus.

The four methods of illumination in the use of slit-lamp biomicroscopy of the anterior segment, described first by Vogt, are equally useful in the posterior part of the eye. Examination of the ocular fundus is more difficult. In particular, photography of the central and peripheral parts of the fundus demands additional technical arrangements if all the appearances of biomicroscopy are to be recorded.

Fundus Oculi↗

Role of slit-lamp biomicroscopy in the diagnosis of cystinosis.

The purpose of presenting this case is to emphasize the importance of the slit lamp examination in patients with complex symptoms and signs of growth retardation, organomegaly, and abnormal kidney function tests. As the clinical expression varies greatly from one patient to another and in spite of extensive and expensive work-up, final diagnosis of cystinosis may be established only by careful ophthalmologic examination.

Child, Preschool↗

[Cells on intraocular lenses. Comparison of specular and slit-lamp microscopy findings].

Examination with a specular microscope facilitates diagnostic evaluation of cells on the surface of intraocular lenses. Similarly, slit-lamp examination makes specular microscopic studies possible. However, image resolution and magnification are not achieved by using this method, though the amount of time and instrumental effort is minimal. Various types of cells can be differentiated. Fibroblast-like cells can only be demonstrated readily in the specular areas, whereas multinucleate giant cells can usually also be seen by using focal illumination. It is difficult to differentiate the smaller, mononucleated cells.

Fibrin↗

A portable slit lamp attachment for examination of donor cornea.

A new portable device is available for direct examination of donor cornea at the slit lamp. This attachment provides a clear view of the donor cornea and can be helpful to any corneal transplant surgeon, especially at medical centers that do not have an established eye bank.

Cornea↗

Clinical assessment of corneal endothelial cell density: an original system of grading using a slit-lamp biomicroscope.

An original system of grading of the corneal endothelial specular reflection, as assessed with a Haag-Streit 900 slit-lamp biomicroscope, has been shown to have a very highly significant relation to the endothelial cell density measured by contact specular photomicroscopy. The grading, though subjective and therefore not a substitute for the detailed record of photomicroscopy, is readily applicable to clinical practice and is a useful method of comparing and recording endothelial cell densities when assessed by the same observer. The intraobserver, but not the interobserver, variability has been examined, and the theoretical aspects of the grading system and a clinically applicable interpretation of the grading are presented.

Aged↗

Instant photography with the Polaroid SX-70 Alpha I camera mounted on a slit lamp.

A readily adjustable, quick-mounting attachment frame allows use of an unmodified Polaroid SX-70 Alpha I camera with several available ophthalmic slit lamps. Initial results with this arrangement have proved to be easily obtainable and of good quality. Several important uses for instant color photographs obtained with this sysetm are suggested here.

Eye Diseases↗

Donor corneal endothelium: slit-lamp examination of buttons in storage medium.

The integrity of the corneal endothelium is vital to the maintenance of a clear graft. The slit-lamp examination of the cornea from the endothelial surface, as described, allows the exclusion from transplantation of buttons with obvious endothelial trauma or disease. The use of this method at the Wilmer Institute during the last four years has been part of the preoperative assessment of all corneal donor buttons and has helped to reduce the rate of early graft failure.

Cornea↗

Slit-lamp fluorophotometry in intraocular lens patients.

Two hundred and sixty-four patients who had unilateral implant surgery and normal contralateral unoperated eyes were studied by slit-lamp anterior segment fluorophotomety. Patients tested five weeks to six months after surgeryb averaged 22% more fluorescein in the operated than in the unoperated eye, while those tested after six months averaged only 12% more fluorescein. Patients receiving topical indomethacin demonstrated an 11% increase in fluorescein, while those taking a placebo averaged a 33% increase. Patients with cystoid macular edema averaged a 46% increase in fluorescein compared with a 17% increase in the other patients. Twenty-seven control patients with unilaterally aphakic eyes and normal contralateral unoperated eyes, tested on an average of two years after surgery, showed essentially no increase in fluorescein in the operated eye. Fluorophotometry may be a valuable clinical tool in testing the effect of drugs on the blood-aqueous barrier and to screen patients for cystoid macular edema.

Aqueous Humor↗

Office slit lamp discissions in artiphakic eyes.

What is believed to be the first reported series of discissions in artiphakic eyes done in the office with a standard examination slit lamp is reported. Adequate optical openings were obtained in 22 of 24 eyes. No major complications such as vitreous wick, endophthalmitis, epithelial implantation, or lens dislocation occurred in this small series. It is felt to be a safe, inexpensive alternative to operating room discissions.

Ambulatory Surgical Procedures↗

Slit-lamp needle revision of failed filtering blebs using mitomycin C.

PURPOSE: The purpose of the study is to determine the efficacy and safety of Mitomycin C (MMC) augmented slit-lamp needle revision of failed filtration surgery. METHODS: The authors retrospectively reviewed the charts of 62 patients (62 eyes) (age, 72 +/- 15 years) with failed filtration surgery who underwent needle revision using MMC. A mixture of 0.01 ml of MMC (0.4 mg/ml) and 0.02 ml of bupivacaine with epinephrine was injected subconjunctivally. Twenty to 30 minutes later, a 30-gauge needle was used to perforate the area of subconjunctival fibrosis and re-establish flow. RESULTS: Overall, 118 needing procedures (mean, 1.9 +/- 1.4 revisions per eye; range, 1-7) were performed on 62 eyes (mean follow-up, 9.9 +/- 3.7 months; range, 4.5-20.1 months). Thirty-six patients (58.1%) were needled once and 26 patients (41.9%) underwent more than 1 needling procedure. Intraocular pressure decreased from 24.1 +/- 6.4 mmHg (range, 18-44) before surgery to 11.5 +/- 4.8 mmHg (range, 1-26) at last follow-up (P = 5.51 x 10(-21)). Antiglaucoma medications decreased from 1.6 +/- 1.0 to 0.3 +/- 0.6 (P = 3.8 x 10(-14)). Successful single-needling procedure was highly correlated with race (white) and past conventional glaucoma filtration surgery of more than 4 years. Complications included serous choroidal detachment (10 eyes), suprachoroidal hemorrhage (1 eye), bleb leak (5 eyes), iris blocking sclerostomy (2 eyes), hyphema (2 eyes), corneal abrasion (2 eyes), and hypotony (1 eye). CONCLUSION: Mitomycin needle revision appears to be an extremely effective way to revive failed filtration surgery. The incidence of complications compares favorably to trabeculectomy with MMC.

Adult↗

Slit-lamp studies of the rhesus monkey eye: III. The zones of discontinuity.

The rhesus monkey lens exhibits two zones of discontinuity, one anteriorly and one posteriorly. They are first discernible by slit-lamp photography as performed in this study at around age 7 years in iridectomized eyes, and become more distinct with increasing age. Their thickness and distance from each other along the polar axis are independent of lens age, but their distance from the lens surface increases with increasing age. Upon accommodation, the distance between the two zones increases while all other distances along the polar axis remain unchanged, indicating that, as in the human, overall alterations in rhesus lenticular shape and thickness with accommodation primarily reflect changes in the shape of the central region. The curvature of each zone becomes sharper in a linear fashion with accommodation, with the slope of the relationship being similar to those for lens surfaces.

Accommodation, Ocular↗

Armrest support for the slit-lamp delivery argon laser system.

We designed a new armrest for use at the argon laser. The arm support can be used on either the right- or left-hand side of slit-lamp tables of varying thicknesses. The continuous screw adjustment allows for easy height adjustment of the arm support. The construction of the armrest facilitates the adjustment and manipulation of a fundus contact lens, which is so necessary to the successful performance of argon laser photocoagulation.

Arm↗