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PubMed1999

A slit-lamp eyepiece micrometer calibrated at 50-micron intervals.

Measurements of dimensions of various intraocular structures, both normal and abnormal, are both theoretically and clinically useful. The currently available standard Haag-Streit slit-lamp micrometer eyepiece is calibrated at 100 micron intervals. In order to achieve greater precision in measurement of smaller intraocular structures, the authors and Haag-Streit, Inc. (Kaniz, Switzerland) have developed an eyepiece calibrated in 50-micron intervals.

Calibration↗
PubMed1996

A comparison of slit-lamp supported versus hand-held biometry.

Biometry allows determination of the final refractive outcome following cataract extraction with intraocular lens implantation. We compared the accuracy of axial length measurement performed with the slit-lamp supported biometry probe versus a hand-held technique. The two methods of biometry were performed on 32 patients undergoing endocapsular cataract extraction with lens implantation. One of the methods was selected at random in order to predict implant power for a desired refractive outcome using the SRK-T formula. There was no difference in 'within-subject' variance of axial length measurement between the two methods (t = 1.74, p = 0.091), and there was no difference in refractive outcome when the power calculations for the two techniques were compared (t = 0.12, p = 0.906). The hand-held technique provides a useful alternative method of biometry in 'difficult' patients.

Biometry↗
PubMed1983

[Contact glass for the study of the corneal endothelium and epithelium in the slit-lamp radius].

Specular endothelioscopy can be improved by an appropriate contact glass in three ways: The blurring front reflex of the cornea disappears, a two-fold magnification permits the use of routine slit-lamps for observation at higher magnification, and the field of specular illumination is increased considerably. The posterior surface of the contact glass is made plane, which offers the following advantages: a fluid chamber in front of the cornea is created which avoids any deformation of the cornea through the contact glass; the reflex of the posterior surface can be deflected by tilting the contact glass slightly so that the weak specular reflex of the epithelium becomes visible.

Corneal Diseases↗
PubMed1984

Short-term effect of slit-lamp illumination and argon laser light on visual function of diabetic and non-diabetic subjects.

Visual acuity, colour vision, and contrast sensitivity of diabetic and non-diabetic subjects were measured before, 20 minutes after, and 24 hours after exposure to slit-lamp illumination either alone or during argon laser photocoagulation. In some instances a significant deterioration of these visual functions was noted when the tests were repeated 20 minutes after light exposure, but by 24 hours after light exposure visual function of all groups had returned to pre-exposure levels. The visual acuity was the most systematically affected by the procedure; there were wide interindividual differences in the changes observed in the other tests.

Argon↗
PubMed1990

Measurement of the posterior corneal radius using slit lamp and Purkinje image techniques.

A method for measuring the radius of the posterior corneal surface using the first and second Purkinje images has recently been developed. Values for the posterior corneal radius in the vertical meridian obtained using this method are compared with those obtained using a more conventional slit lamp method. A good correlation was found between values obtained using the two methods.

Anthropometry↗
PubMed1995

Ophthalmologic procedures in the emergency department--Part III: Slit lamp use and foreign bodies.

The emergency physician (EP) must be familiar with carrying out ophthalmologic procedures for evaluation and treatment of a multitude of eye complaints. This article is the last of three articles addressing ophthalmologic procedures of use by the EP. This article reviews the indications and the techniques for slit lamp examination of the eye and techniques of foreign body removal. Criteria for consultation also are addressed.

Emergency Medicine↗
PubMed1987

Noncontact retinal photocoagulation at the slit-lamp biomicroscope.

Four patients had either ocular conditions that made the use of a contact lens for retinal photocoagulation undesirable, or optical aberrations of the ocular media that made photocoagulation with a conventional contact lens difficult. A hand-held 90-diopter lens permitted retinal photocoagulation to be performed at a conventional slit-lamp biomicroscope laser without corneal contact and assisted in delivering laser burns under physical or optical circumstances that would be difficult or impossible with conventional contact lenses. Four patients without ocular surface or media abnormalities were also treated by this method.

Adult↗
PubMed1980

Retinal light exposure from ophthalmoscopes, slit lamps, and overhead surgical lamps. An analysis of potential hazards.

The projected beam radiance of several common ophthalmologic instruments was measured, and potential hazard to the patient from light exposure was analyzed with reference to safety standards for coherent light. The indirect ophthalmoscopes tested appear to be "safe" under moderate voltage settings, provided exposure is reasonably brief. Slit-lamp biomicroscopy of the fundus, however, merits caution. It produces a three-times-higher retinal irradiance than the indirect ophthalmoscope. Overhead surgical lamps produce a retinal irradiance about one-third that of the indirect ophthalmoscope (for clear media and dilated pupil). This could be dangerous, since an operation may take long enough to exceed the maximal permissible exposure by several orders of magnitude. Major design changes are indicated for surgical illuminators to extend the "safe time" to the 40 to 60 min range.

Animals↗
PubMed1985

Slit-lamp microscopic appearance of corneal wound healing after radial keratotomy.

Radial keratotomy offers a unique opportunity to study corneal wound healing because the corneas are normal, the fine knife blades disrupt adjacent tissue minimally, no sutures are used, there is minimal inflammation, and few postoperative drugs are administered. We studied corneal wounds with a slit-lamp microscope as they healed from two weeks to three years after radial keratotomy in 84 eyes of 51 consecutive patients enrolled in the Prospective Evaluation of Radial Keratotomy (PERK) Study. One day after surgery, the incisions were surrounded by edema. At two weeks, a dense, gray, diffusely marginated opacity occupied 0.1 mm on both sides of the incision. At three months, the area adjacent to the incision was filled with discrete, fine, gray spicules that protruded at right angles from the incision. At six months, the gray cloudiness had completely disappeared, and the individual spicules were more prominent. By one year, the spicules were disappearing from the anterior portion of the incision and were concentrated primarily in the posterior part of the incisions. At two and three years, the incision scar was fainter and the spicules had disappeared from all but the deep posterior part of the wound. We believe that these spicules correspond to the reorganization of the stroma along the edges of the corneal incision. The persistence of the spicules suggests that wound healing in radial keratotomy may not be complete until two years or more after surgery.

Cicatrix↗
PubMed1985

Slit-lamp fluid-gas exchange and other office procedures following vitreoretinal surgery.

Many complicated postoperative vitreoretinal cases require reoperations. It is possible to perform some of these procedures outside the operating room. We describe examining room techniques for fluid-gas exchange, fluid and gas aspiration, and adherent vitreous strand removal. We also discuss a slit-lamp technique for using sodium hyaluronate (Healon) following fluid-gas exchange to eliminate optical distortion from endothelial striae.

Anesthesia, Local↗
PubMed1993

[Findings from slit lamp and histological examination of the anterior capsule in patients with severe anterior capsular shrinkage and opacities after implantation of intraocular lenses].

Seven pseudophakic patients with severe anterior capsular shrinkage and opacities after continuous curvilinear capsulorhexis as a severe anterior capsular shrinkage group and seven pseudophakic patients without the complication as control group were studied in a slit lamp examination of zonular fibers and anterior vitreus body with an indentation mirror. A light and electron microscopic study of the shrunken anterior capsular edge was performed in one case of the severe anterior capsular shrinkage group. No morphological findings suggesting weakness of zonular fibers such as cleavage or scarceness were observed, but reduction in elasticity of the zonular fibers was surmised and degeneration and liquefacation of the anterior vitreus body was observed in the severe anterior capsular shrinkage group. Histological study revealed several layers of proliferated spindle cells and also abundant extracellular matrix, consisting of collagen types I, III and IV, under the monolayer of lens epithelium attached to the anterior capsule. Spindle cells were epithelial cells and considered to be derived from lens epithelium, because the spindle cells were connected by junctional apparatus, which is a feature of epithelium. Severe anterior capsular shrinkage and opacities were due to low ability of the lens supporting system of zonular fibers and anterior vitreus and severe scarring and shrinkage at the anterior capsular edge.

Aged↗
PubMed1986

Goniodysgenesis in elderly glaucoma and non-glaucoma patients. A masked slit-lamp and gonioscopy study.

The aim was to elucidate whether goniodysgenesis is more frequently observed in elderly patients with glaucoma, and furthermore, which signs of goniodysgenesis are of importance and most unanimously detected. Thus, 3 examiners evaluated 21 glaucoma patients and 19 non-glaucoma patients in a masked fashion. None of the patients had a first-degree heredity. Gonioscopy, slit-lamp examination and measurements of the corneal and pupillary diameter were performed, in all 26 variables. Significantly (P less than 0.05) more frequent in glaucoma were an increased corneal diameter, scleral overriding, hypoplasia of the pupillary seam, abnormal Schwalbe's line and an opaque pretrabecular membrane (one examiner). Less frequent were a peripupillary yellow pigment ring and pigment stars on the lens. Inter-observer variation was small regarding e.g. corneal diameter but rather large regarding e.g. the pretrabecular membrane.

Aged↗
PubMed1999

A slit-lamp needling filtration procedure for uncontrolled glaucoma in pseudophakic and aphakic eyes.

In one aphakic and one pseudophakic patient without previous filtration surgery, a transconjunctival needling procedure similar to that used for failed filtration procedures was performed to create a filtering bleb. In both cases, intraocular pressure was successfully lowered for 6 months until the occurrence of bleb encapsulation, which was relieved by transconjunctival needling. There were no complications. In selected cases, this minimally invasive slit-lamp needling procedure provides successful filtration.

Aged↗
PubMed1987

Slit-lamp studies of the rhesus monkey eye: II. Changes in crystalline lens shape, thickness and position during accommodation and aging.

Changes in crystalline lens shape and axial thickness, anterior chamber depth and anterior cornea-posterior lens distance during accommodation induced by corneal iontophoresis of carbachol or electrical stimulation of the Edinger-Westphal nucleus were studied in 25 living, surgically aniridic rhesus monkey eyes, aged 1-25 years. Intraocular distances and anterior and posterior lens surface curvatures were evaluated from slit-lamp Scheimpflug photographs; distances were also determined by A-scan ultrasonography. With increasing accommodation, both lens surfaces become more sharply curved, the lens thickens and the anterior chamber shallows, while the posterior lens surface remains fixed relative to the cornea. Within statistical limits, the respective curvature and distance changes are the same for a given dioptric accommodation induced by either stimulation technique. The respective intraocular distance-accommodation relationships are identical whether derived from photographic or ultrasonographic measurements. Temporal and contralateral reproducibility of all measurements is excellent. Each parameter-accommodation relationship is strikingly linear in all eyes, although above 20 D the slopes of the lens surface curvature-accommodation relationships may have decreased. The curvature change per D of accommodation averages approximately 20% more for the posterior than for the anterior lens surface. There is relatively little interindividual variation in the slope of each relationship despite the significant interindividual differences in age and accommodative amplitude, indicating that the relationships are independent of age. However, when extrapolated back to the non-accommodated resting state, the data indicate that the lens thickens, both its surfaces become more sharply curved, and the anterior chamber shallows with age in adult greater than 5 years, while opposite trends are seen in younger animals.

Accommodation, Ocular↗
PubMed1987

Multiple dosing of prostaglandin F2 alpha or epinephrine on cynomolgus monkey eyes. II. Slit-lamp biomicroscopy, aqueous humor analysis, and fluorescein angiography.

Prostaglandin (PG) F2 alpha (250 micrograms in 50 microliters saline) or epinephrine 2% solution (50 microliters) was topically applied twice daily for 2 weeks to one eye of six cynomolgus monkeys for each agent. Contralateral control eyes received their respective vehicles. A trace aqueous humor flare response occurred in some PGF2 alpha-treated eyes, which reached significance (P less than 0.05) only when observed 4 hr after the first or seventh dose. No significant anterior chamber cellular response was observed in treated as compared to control eyes. Slit-lamp biomicroscopic evaluation of the cornea, iris, and lens showed no differences in treated as compared to control eyes throughout the study. Aqueous humor samples were obtained from all eyes 4 hr after the ninth consecutive dose. Soluble protein concentration was significantly (P less than 0.01) greater in the PGF2 alpha-treated eyes (1.22 +/- 0.30 mg/ml) as compared to control (0.56 +/- 0.17 mg/ml) or to epinephrine-treated eyes (0.59 +/- 0.18 mg/ml). Microscopic examination of sediments obtained after centrifugation of the aqueous humor revealed no cells in experimental or control samples. Both PGF2 alpha and PGE2 levels were significantly (P less than 0.025) greater in PGF2 alpha-treated eyes, and showed a trend towards being greater in epinephrine-treated compared to control eyes. Neither cystoid macular edema nor other retinal abnormalities were evident by fluorescein angiography in any eyes during the second week of treatment. Multiple dosing of PGF2 alpha in monkey eyes does not appear to produce clinically significant adverse effects in either the anterior or posterior segment which would contraindicate its use in a multiple-dose clinical trial in glaucoma patients.

Animals↗
PubMed1989

Field test reliability of a new lens opacity rating system utilizing slit-lamp examination.

A field test of a lens opacity rating system was run. Findings were graded in 7 categories: Cortex: (1) Waterclefts, Vacuoles, & Flakes (WVF, 4 grades), (2) Wedges & Spokes graded by number of Quadrants affected (WS-Q), and (3) Inward extent of Wedges & Spokes (WS-I, 3 grades); Nucleus: (4) Opacification (NUC-O) and (5) Coloration (NUC-C), each using 4 grades; and Subcapsular areas: (6) Anterior (SUB-A) and (7) Posterior (SUB-P) opacification, each using 5 grades. An instruction booklet with corresponding guidelines, sketches, and photographs was developed. Reproducibility of grading was tested in 3 clinics using 16 ophthalmologist-examiners. At each clinic, examiners were randomly paired. They independently performed slit-lamp exams of assigned patients (9 on average) on the same day (inter-examiner) and 1-2 weeks later (intra-examiner). To test intra-examiner reliability, examiners were divided into two groups (one from each pair), with gradings analyzed by group. For each group, 53 to 58 patients had evaluable examinations. Intra-examiner concordance for each lens category (defined as at most one grade difference in one lens) was as follows (for examiner groups 1 and 2, resp.): WVF: 98% & 97%; WS-Q: 96% & 100%; WS-I: 100% & 100%; NUC-O: 98% & 100%; NUC-C: 100% & 98%; SUB-A: 90% & 100%; and, SUB-P: 92% & 100%. Inter-examiner concordances were slightly lower than those found for intra-examiner. Grading lens findings in the manner described above appears to have potential utility in large scale studies.

Aged↗
PubMedDate not supplied

Light scattering in normal and cataractous lenses of farmed Atlantic salmon (Salmo salar): a slit lamp and Scheimpflug photographic study.

To investigate normal light scattering and cataract formation, the anterior eye segments of farmed Atlantic salmon (Salmo salar) reared in fresh water and sea water were documented in vivo for the first time with a Topcon SL-45 Scheimpflug camera. A total of 40 fish from the fresh-water-rearing period, obtained from 2 groups of identical age but showing a different growth rate, and 24 fish from the sea-water-rearing period, sampled from 2 groups with identical age but being fed different food brands, were included in this study. The fish were anaesthetized before examination. Due to the naturally wide pupil, no mydriatic compound was applied. All fish were removed from the water for photography, which was performed for each eye in 0 degrees = vertical slit position. Images were recorded on Kodak Tmax 400 black-and-white film. Microdensitometric image analysis of all negatives was performed using a Joyce-Loebl online microdensitometer. In spite of the virtual absence of an anterior chamber gap between cornea and lens and very little light scattering in the normal fish lens, a small number of distinct layers could be reproducibly identified in the lens. While there was little abnormal light scattering which could point to cataract development in young fish from the fresh water period, the evaluation of the lenses from the 2 sea water groups showed the presence of specific forms of cataract especially in the cortical and supranuclear layers. There were significant differences between the groups fed different food brands at the sea water site. In conclusion, Scheimpflug photography proved to be applicable to eye research in fish in vivo. It is suggested that this method should be employed for reproducible documentation as an extension to slit lamp monitoring in experimental research to reveal causative factors for cataracts in farmed fish.

Animals↗