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Slit Lamp Exam Findings. Components: Lids Adnexa Conjunctiva Cornea Anterior Chamber Iris Lens. Lids. Lids. Lids. Normal. Lids. Ectropion Eyelid turning outward Document with location (I.e. “ectropion LLL”). Lids. Entropion Eyelid turning inward - PowerPoint PPT Presentation
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Slit Lamp Exam
Findings
• Components:– Lids– Adnexa– Conjunctiva– Cornea– Anterior Chamber– Iris– Lens
Lids
Lids
Lids
Normal
Lids
Ectropion
• Eyelid turning outward
• Document with location (I.e. “ectropion LLL”)
Lids
Entropion
• Eyelid turning inward
• Document with location (I.e. “entropion LLL”)
Lids
Dermatochalasis
(D’chalasis)
• Redundancy of skin in eyelids
• Atrophy of elastic tissue
Lids
Upper Lid Folds
• Increased amount of folds
• Document as: “high UL folds”
Lids
Hooding
• When upper lid comes over lid margin
• Document as: “Hooding”
Lids
Ptosis
• Drooping of the upper eyelids
• Document with location (I.e. “Ptosis RUL”)
Lids
Papilloma
• Growth on eyelid• Document with
location (I.e. “papilloma RUL”)
Lids
Trichiasis
• Inward growth of eyelashes
• Document with location (I.e. “trichiasis RLL”)
Lids
Chalazion
• Inflamed lump in meibomian gland
Lids
Blepharitis
• Inflammation of eyelid margins
• Redness, swelling, itching, crusting
Lids
Ecchymosis
• Bruising• Document with
location (I.e. “ecchymosis RUL”)
Adnexa
Adnexa
Normal
Adnexa
Decreased Tear Lake
• Tear lake not smooth
• Also can have increased break up time
• Document as: “decreased tear lake”
• Misc – TBUT = 10 sec
Conjunctiva
Conjunctiva
Quiet
Conjunctiva
Injection
• Tissue redness and swelling
Conjunctiva
Sub-Conjunctival Hemorrhage (SCH)
• Blood below conjunctiva and above sclera
• Document as: “SCH” with location (i.e. “SCH OD temp, inf, nas”)
Conjunctiva
Hyperemia
• Congestion of blood vessels
• Causes redness
Conjunctiva
Bleb
• S/P trabeculectomy for glaucoma
• Document if flat or formed
Cornea
Cornea
Normal
Cornea
Arcus
• White deposit of cholesterol
Cornea
Edema
• Swelling of tissue from fluid accumulation
Cornea
Superficial Punctate Keratitis (SPK)
• Small superficial corneal lesions
• Often due to dryness• Usually seen with
staining
Cornea
Anterior Stromal Scarring
• Scarring on the Stroma (middle layer of the cornea)
Cornea
Amiodarone Whorls
• Deposits from long-term use of Amiodarone
Cornea
Abrasion
• Scraped area of corneal surface
• Accompanied by loss of epithelium
• Usually seen with staining
Cornea
Astigmatic & Radial Keratomtery (AK /
RK) cuts
• S/P AK or RK• Document with location
(I.e. “AK cuts OU”)
Cornea
Keratic Precipitates (KP)
• Inflammatory cells and white blood cells that enter aqueous and adhere to corneal endothelium
Cornea
Guttata
• Small whitish hyaline deposits on inner surface of cornea
Cornea
Lasik Flaps
• S/P Lasik• Location = direction
of flap opening• Document with
location (I.e. “Lasik flap inf. – healed”)
Cornea
Neovascularization
• New blood vessel growth
• Document location (I.e. “OD inf.”)
Cornea
Pinguecula
• Benign yellowish-brown elevation of sub-conjuntival tissue on either side of cornea
Cornea
Pterygium
• Wedge-shaped growth in bulbar conjunctiva
• May advance over the cornea
Cornea
PK
• S/P corneal transplant
• Note sutures:– None– 360*– Running 360*
Cornea
Suture
• occ. used S/P PEIOL• Document with
location (I.e. “suture temp.”)
Cornea
Descemets Folds
• Folds in the Descemet’s membrane
Cornea
Ulcer
• Area of epithelial loss
• Associated with inflammatory cells in cornea & AC
Cornea
Band Keratopathy
• Horizontal band of calcium deposits
• In superficial layer of cornea
Cornea
Haab’s Striae
• Breaks or tears in Descemet’s membrane
• Usually from forceps use during delivery
Anterior Chamber
Anterior Chamber
Deep & Quiet
• Deep = Large distance between both beams
• Quiet = No abnormal matter in AC
• Document as “D&Q”
Anterior Chamber
Shallow
• Minimal distance between both beams
• Document as “shallow”
Anterior Chamber
Moderate Depth
• Moderate distance between both beams
• Document as “moderate depth”
Anterior Chamber
Closed
• Irido-Corneal touch• Document as
“Closed”
Anterior Chamber
Cells
• White blood cells and protein in AC
Anterior Chamber
Flare
• Scatterings of light in AC from slit lamp beam
• Due to increased protein in aqueous
Anterior Chamber
Red Blood Cells (RBC)
• Red blood cells in AC
Anterior Chamber
Hypopyon
• Collection of pus in AC
Anterior Chamber
Hyphema
• Blood in AC
Anterior Chamber
Tube Shunt (may have stitch
blocking end)
• S/P glaucoma sx• Document with
location (I.e. “shunt s-t”)
Anterior Chamber
Gas bubble in AC
• S/P PPVx• Document as “gas
bubble”
Anterior Chamber
Silicone Oil bubbles in AC
• S/P PPVx with Silicone oil
• Document as “Sil. Oil”
Iris
Iris
Normal
Iris
Nevus (multiple = nevi)
• Freckle• Document with location
(I.e. nevus I-T”)
Iris
Neovascularization
• New blood vessel growth on iris
• May be florid (everywhere)
• Document with location
Iris
Atrophy
• Wasting away of cells or tissue
Iris
Peripheral Iridotomy (PI)
• For glaucoma• Note if closed or patent
(open)• Document with location
(I.e. “PI Sup”)
Iris
Posterior Synechiae
• When iris adheres to lens• May also have pigment
on lens from previous episodes of broken Post. Syn.
• Document with location (I.e. “post. Syn. I-N & S-T)
Iris
Pupillary Membrane
• Congenital
Iris
Ectropion Pupillae
• When the pupil margin folds out• Document with location•Usually due to iris nv contraction
Lens
Lens
Clear
Lens
Nuclear Sclerosis (NS)
• Cataract with increased hardening or density at center of lens
Lens
Cortical Spokes (CS)
• Radially arranged opacities on lens cortex
Lens
Posterior Sub-Capsule (PSC)
• Cataract on rear surface of lens
Lens
Posterior Chamber Intra Ocular Lens
(PCIOL)
• Usually edges cannot be seen through an undilated pupil
• Document as “PCIOL”
Lens
Pseudoexfoliation (PXF)
• Deposits of unknown material appearing on lens and iris
Lens
Subluxated IOL
• IOL that has fallen down
• Document as “Sublux. IOL”
• Misc. – a dislocated lens may not be visible since will be in PC
Lens
Aphakic
• Without a lens• Through a peaked
pupil, you can see there is no lens edge
Lens
Posterior Capsule Opacity (PCO)
• Scar tissue that forms after PEIOL
• Document as “PCO”
Lens
Yag Capsulotomy
• Done to make opening in PCO
• Might not be seen fully til eye is dilated
• Note if open or closed• Document as “Yag
open”
Lens
Feathering
• Opacity on posterior capsule, S/P PPVx/F-Gx
• Caused when gas hits lens surface
Lens
ACIOL
• Can be seen without dilation
• Document as “ACIOL”
Lens
Mature Cataract
• Can often be seen without use of the slit lamp
• Document as “white NS”
Lens
Elshnig’s Pearls
• Cystic growth of lens epithelial remnants
• Usually S/P PEIOL
Misc.
Misc.
Scleral Thinning
• Usually noted by a bluish tint to sclera
• Document as “Scleral thinning”
Misc.
Translucent Sclera (albinism)
• Lack of pigment• Sometimes more
than others