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Slit-lamp exam

Biomicroscopy

 

The slit-lamp examination looks at structures that are at the front of the eye.

How the Test is Performed

 

The slit-lamp is a low-power microscope combined with a high-intensity light source that can be focused as a thin beam.

You will sit in a chair with the instrument placed in front of you. You will be asked to rest your chin and forehead on a support to keep your head steady.

The health care provider will examine your eyes, especially the eyelids, cornea, conjunctiva, sclera, and iris. Often a yellow dye (fluorescein) is used to help examine the cornea and tear layer. The dye is either added as an eyedrop. Or the provider may touch a fine strip of paper stained with the dye to the white of your eye. The dye rinses out of the eye with tears as you blink.

Next, drops may be placed in your eyes to widen (dilate) your pupils. The drops take about 15 to 20 minutes to work. The slit-lamp examination is then repeated using another small lens held close to the eye, so the back of the eye can be examined.

 

How to Prepare for the Test

 

No special preparation is needed for this test.

 

How the Test will Feel

 

Your eyes will be sensitive to light for a few hours after the exam if dilating drops are used.

 

Why the Test is Performed

 

This test is used to examine the:

  • Conjunctiva
  • Cornea
  • Eyelids
  • Iris
  • Lens
  • Sclera

 

Normal Results

 

Structures in the eye are found to be normal.

 

What Abnormal Results Mean

 

The slit lamp exam may detect many diseases of the eye, including:

  • Clouding of the lens of the eye (cataract)
  • Injury to the clear tissue (cornea) that covers the front of the eye
  • Dry eye syndrome
  • Loss of sharp vision due to macular degeneration
  • Separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers (retinal detachment)
  • Blockage in a small artery that carries blood to the retina (retinal vessel occlusion)
  • Damage of the retina (retinitis pigmentosa)
  • Swelling and irritation of the uvea (uveitis), the middle layer of the eye

This list does not include all possible diseases of the eye.

 

Risks

 

The dilating drops may cause increased pressure in the eye with nausea and pain. This is very rare, but you should return to your doctor's office right away if you experience either of these symptoms.

 

 

References

American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation -- 2010. Available at one.aao.org/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation--octobe. Accessed February 22, 2015.

Colenbrander A. Principles of ophthalmoscopy. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 1, chap 63.

Fellman RL, Grover DS, Spaeth GL. Gonioscopy. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 44.

Miller D, Thall EH, Atebara NH. Ophthalmic instrumentation. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 2.8.

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        Review Date: 2/23/2015

        Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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