Slit Lamp Examination on Pediatric Patients

2022 ◽  
pp. 236-269
Author(s):  
Alanna Khattar
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Health Examination ◽  
Pressure Measurements ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Examination Techniques ◽  
Ocular Health

Slit lamp examination is an important component of a pediatric eye exam. The slit lamp instrument, also known as a biomicroscope, is used to provide a stereoscopic magnified view of the ocular structures. The slit lamp facilitates the examination of both the anterior segment as well as the posterior segment of the eyes. For posterior segment examination, handheld lenses are used in conjunction with the slit lamp. Different tools and examination techniques are often needed to examine infants, toddlers, and other pediatric patients who cannot be positioned in the slit lamp. This chapter discusses the techniques and equipment used to facilitate the ocular health examination, including anterior segment structures, posterior segment structures, and intraocular pressure measurements in the pediatric population.

scholarly journals Simultaneous Angiography for the Anterior Segment and Posterior Fundus of Eyes with Anterior Segment Neovascularization using Heidelberg Retina Angiograph 2

2019 ◽  
pp. 93-98
Author(s):  
Yuji Sakino ◽  
Yoshihiro Noda ◽  
Maho Itotani ◽  
Takako Nakamuro ◽  
Kunihiro Kiyosaki ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Indocyanine Green ◽  
Indocyanine Green Angiography ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Fluorescein Sodium ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Central Retinal Vein ◽  
Heidelberg Retina Angiograph

Objective: To present a method of indocyanine green angiography (IA) and fluorescein sodium angiography (FA) for simultaneously evaluating anterior segment neovascularization and fundus abnormality.Participants: We examined 19 eyes of 19 patients suspected of having neovascularization in the anterior segment of the eye. Seventeen eyes of 17 patients suffered from proliferative diabetic retinopathy, and two eyes of 2 patients had central retinal vein occlusion.Methods: Using Heidelberg Retina Angiograph 2 (HRA2), we performed angiography of the anterior and posterior segment of the eye.Results: Of the 19 cases, anterior segment neovascularization was clearly observed with slit-lamp examination and gonioscopy in 12 eyes (63.1%). However, anterior segment neovascularization was detected by HRA2 angiography in 18 eyes (94.7%). Posterior segment angiography revealed non-perfusion area in 16 eyes (84.2%) and retinal neovascularization in 10 eyes (52.6%). In one case, the posterior segment findings were not obtained due to vitreous hemorrhaging.Conclusion: Simultaneous anterior and posterior segment HRA2 angiography using indocyanine green andfluorescein sodium is a useful technique for detecting neovascularization in the anterior segment of the eye as well as non-perfusion areas and neovascularization of the retina.

scholarly journals Anterior Segment Examination with Slit-Lamp Biomicroscope: What Should be Highlighted?

2021 ◽  
Vol 3 (5) ◽  
pp. 14-19
Author(s):  
Fazella Kirara Sakti
Keyword(s):  
Pathological Condition ◽  
Anterior Part ◽  
Anterior Segment ◽  
Health Assessment ◽  
Slit Lamp ◽  
Pathological Conditions ◽  
Ocular Disorders ◽  
Eye Examination ◽  
Illumination Source ◽  
Ocular Health

Ocular health assessment consists of various types of examinations that aim to find pathological conditions in the eye so that it helps ophthalmologists to diagnose and provide therapy for ocular disorders suffered by the patients. Slit-lamp biomicroscope is one of the most important eye assessments and has become the standard in assessing the pathological condition of the anterior part of the eye. This examination is performed using a stereoscopic biomicroscope instrument in combination with a bright illumination source. The results of the anterior segment examination using slit-lamp biomicroscope may provide more detailed ocular findings, such as the abnormalities of the eyelid, conjunctival lesions, abnormalities of the cornea, lens, or other parts of the anterior ocular segments. Therefore, the ability to examine slit-lamp biomicroscope is essential for the ophthalmologist. This review will discuss the eye examination using slit-lamp biomicroscope and the findings that will make it easier for clinicians to determine the direction of diagnostic approach in ocular patients. 

Graphite Particle in Cornea- An Incidental Finding

2021 ◽  
Author(s):  
Iva Rani Kalita
Keyword(s):  
Graphite Particle ◽  
Incidental Finding ◽  
Anterior Segment ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Active Intervention ◽  
The Past ◽  
Entry Wound ◽  
History Of ◽  
Temporal Quadrant

An eleven years old female came to Ophthalmology OPD for normal checkup. Her vision was 6/6 in BE's. On Slit Lamp Examination of Anterior Segment, LE Cornea showed crystalline greyish deposits scattered in infero-temporal quadrant mostly suggestive of Pencil Graphite. The rest details were absolutely normal. No entry wound could be made out. The patient and her parents gave no History of any pencil trauma in the past even after. As the particles were inert and patient had no symptom, no active intervention was done (Figures 1 and 2).

scholarly journals Bilateral Iris Atrophy after the Femtosecond Assisted Laser In Situ Keratomileusis Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Kenan Olcay ◽  
Akin Cakir ◽  
Sercan Koray Sagdic ◽  
Eyup Duzgun ◽  
Yildiray Yildirim
Keyword(s):  
Anterior Segment ◽  
Laser In Situ Keratomileusis ◽  
Slit Lamp ◽  
Vascular Plexus ◽  
Case Presentation ◽  
Slit Lamp Examination ◽  
Corrected Visual Acuity ◽  
Direct Light ◽  
Iris Atrophy

Purpose. To report an unknown complication of laser in situ keratomileusis (LASIK) surgery.Case Presentation. A 28-year-old female presented with photophobia and glare to our eye service. She stated in her medical history that she had undergone femtosecond assisted LASIK surgery in both eyes 15 months ago and her symptoms started just after this surgery. On admission, her best-corrected visual acuity was 10/10 in both eyes. She had mydriatic pupils with no direct light reflex. Examination of the anterior segment revealed bilateral iris atrophy projecting within the LASIK ablation zone and a transillumination defect was remarkable on the slit lamp examination.Conclusion. We hypothesized that this condition may have been caused by the abnormally increased IOP that resulted in ischemia in the iris vascular plexus during the suction process of surgery.

scholarly journals Anterior Segment Imaging in Combat Ocular Trauma

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Denise S. Ryan ◽  
Rose K. Sia ◽  
Marcus Colyer ◽  
Richard D. Stutzman ◽  
Keith J. Wroblewski ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Anterior Segment ◽  
Case Series ◽  
Ocular Injury ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Ocular Imaging ◽  
Ocular Injuries ◽  
Anterior Segment Imaging

Purpose. To evaluate the use of ocular imaging to enhance management and diagnosis of war-related anterior segment ocular injuries.Methods. This study was a prospective observational case series from an ongoing IRB-approved combat ocular trauma tracking study. Subjects with anterior segment ocular injury were imaged, when possible, using anterior segment optical coherence tomography (AS-OCT), confocal microscopy (CM), and slit lamp biomicroscopy.Results. Images captured from participants with combat ocular trauma on different systems provided comprehensive and alternate views of anterior segment injury to investigators.Conclusion. In combat-related trauma of the anterior segment, adjunct image acquisition enhances slit lamp examination and enables real timeIn vivoobservation of the cornea facilitating injury characterization, progression, and management.

scholarly journals A Study to Analyse the Presentation of Autoimmune and Idiopathic Serpiginous Choroiditis in Indian Population

2021 ◽  
Vol 8 (04) ◽  
pp. 224-229
Author(s):  
Arvind Babu ◽  
Narayanan Balakrishnan ◽  
Uma Maheshwari ◽  
Praveena V ◽  
Dharssana Periyathambi
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Correct Diagnosis ◽  
Anterior Segment ◽  
Inflammatory Disorder ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Serpiginous Choroiditis ◽  
Vitreous Haze

BACKGROUND Serpiginous choroiditis (SC) is an intraocular inflammatory disorder displaying a geographic pattern of choroiditis, extending from the juxtapapillary choroid and intermittently spreading centrifugally. It involves the overlying retinal pigment epithelium (RPE), the outer retina including the choriocapillaries and the choroid.1,2,3 Infectious diseases like tuberculous (TB) uveitis, herpes simplex virus (HSV) uveitis whose fundus changes mimic SC are termed as serpiginous-like choroidopathy (SLC). On slit lamp examination, anterior segment usually appears quiet, non-granulomatous anterior uveitis with mild vitritis and / or fine pigmented cells within the vitreous can be seen. The pattern of fundus involvement varies between the two groups. Fundus fluorescein angiography and indocyanine green angiography (FFA and ICG) are important modalities of investigation that help in differentiating the pattern of involvement and confirming clinical findings. The duration of follow up, reactivation of lesions and complications vary. Hence, it is important to differentiate between SC and SLC for proper diagnosis and appropriate management. The aim of this study is to highlight important features of serpiginous choroiditis and serpiginous like choroidopathy that will aid in the correct diagnosis of these two entities. METHODS This is a retrospective study of 40 patients. Following variables were analysed - age, gender, laterality, visual acuity, and intraocular inflammation through slit lamp examination, pattern of involvement, choroidal-neovascularization, reactivation, clinical investigations and diagnosis. RESULTS 32 patients had serpiginous choroiditis (SC) and eight patients had serpiginous like choroiditis (SLC). Mean age was 50 and 51 years (SC and SLC respectively). Males were predominantly affected (65.5 % in serpiginous choroiditis and 62.5 % in serpiginous like choroiditis). Bilaterality was 80 % in SC-group and 46 % in the SLC-group. Vitreous haze was lesser than or equal to 1 + in SC group. The juxtapapillary-area was involved in 90 % in SC eyes and 0 % in SLC-group. Midperiphery of fundus was involved in 54 % of SLC-group. Reactivation is more common in SLC group than in SC group in a follow up period of one year. Choroidal-neovascularisation was found in two patients only in SLC-group. CONCLUSIONS In cases where vitreous haze is greater than 1 + with unilateral involvement and disease free peripapillary area is present, an infectious aetiology has to be strongly suspected, as an immunomodulatory therapy could have severe consequences. KEYWORDS Serpiginous Choroiditis, Serpiginous like Choroiditis, Autoimmune

Elevated IOP with a Deep Anterior Chamber

2013 ◽  
Author(s):  
Annie K. Baik ◽  
James D. Brandt
Keyword(s):  
Anterior Chamber ◽  
Postoperative Bleeding ◽  
Anterior Segment ◽  
Early Postoperative Period ◽  
Slit Lamp ◽  
Scleral Flap ◽  
Slit Lamp Examination ◽  
Subconjunctival Hemorrhage ◽  
Digital Manipulation ◽  
Early Fibrosis

Early postoperative elevation of intraocular pressure (IOP) in the setting of a deep anterior chamber following trabeculectomy can generally be attributed to either mechanical obstruction or underfiltration. A careful clinical exam will almost always reveal the cause of elevated IOP and guide the clinician to logical, step-wise management. First, one should confirm that the anterior chamber is deep and the conjunctival wound is intact. Further investigation is directed by clinical signs, such as blood or fibrin in the anterior chamber, the pupil configuration, the appearance of the filtering bleb, internal obstruction of the sclerostomy, blood under the scleral flap, or subconjunctival hemorrhage. In the absence of such findings, underfiltration is most likely due to an inadequately sized sclerostomy, tight sutures on the scleral flap, or early fibrosis of the external sclerostomy site. Gonioscopy, in conjunction with anterior segment slit-lamp examination, is crucial in the evaluation of elevated IOP in the early postoperative period. Although adequate flow may have been established at the time of surgery, continued patency of the trabeculectomy should be confirmed to distinguish between underfiltration and obstruction. Obstruction of the sclerostomy site by blood, fibrin, vitreous, iris tissue, or fragments of Descemet’s membrane should be visible on gonioscopy examination. If the trabeculectomy site appears internally patent, examination of the scleral flap may further demonstrate causes for elevated IOP. Intraoperative or postoperative bleeding may lead to development of subconjunctival hemorrhage. Even in the absence of subconjunctival hemorrhage, blood and fibrin can occlude the trabeculectomy flap. If there is no evidence of physical obstruction, intrinsic properties of the trabeculectomy itself (such as ostium size and/or tension on the scleral flap sutures) may be contributing to elevated IOP. Gentle massage or digital manipulation serves both diagnostic and therapeutic purposes. If gonioscopy has not yet been performed and the bleb is unresponsive to digital manipulation, an internal obstruction may be present. Since internal obstruction of the ostium may not be readily apparent on routine slit-lamp examination, the threshold for gonioscopy should be low.

scholarly journals Pole to Pole Intraocular Transit of Tarantula Hairs—An Intriguing Cause of Red Eye

2009 ◽  
Vol 2009 ◽  
pp. 1-2 ◽  
Author(s):  
Hiten G. Sheth ◽  
Patricio Pacheco ◽  
Ahmed Sallam ◽  
Sue Lightman
Keyword(s):  
Case Report ◽  
Topical Steroid ◽  
Posterior Segment ◽  
Healthcare Personnel ◽  
Slit Lamp ◽  
Medium Term ◽  
Ocular Complications ◽  
Slit Lamp Examination ◽  
Red Eye ◽  
Repeated Questioning

This intriguing case report provides novel images and a description of the anterior and rarer posterior segment findings seen in ocular inflammation associated with tarantula spider hair exposure. We present an interventional case report of a 9-year-old boy who presented with a red, sore eye. Slit lamp examination revealed right eye injection, multiple small hairs at differing levels of the cornea with associated opacities and inflammation within the anterior and posterior segments of the eye. Only after detailed and repeated questioning did the aetiology become apparent. Conservative management in the form of topical steroid and antibiotics was commenced and he did well with no obvious sequelae in the medium term. Healthcare personnel (and indeed pet shop owners, arachnid enthusiasts and even parents) should be aware of the potential ocular complications of tarantula hair exposure and clinicians should perhaps specifically ask about pet-keeping when presented with an unusual red eye.

scholarly journals Long-term Results of Topical 0.02% Tacrolimus Ointment for Refractory Ocular Surface Inflammation in Pediatric Patients

2021 ◽  
Author(s):  
Kyungmin Koh ◽  
Ikhyun Jun ◽  
Tae-im Kim ◽  
Eung Kweon Kim ◽  
Kyoung Yul Seo
Keyword(s):  
Ocular Surface ◽  
Pediatric Patients ◽  
Anterior Segment ◽  
Long Term Results ◽  
Slit Lamp ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Long Term Treatment

Abstract Background: To investigate the efficacy and safety of long-term treatment with topical 0.02 % tacrolimus ointment for ocular inflammation in pediatric patients. No studies have been reported on the outcome of long-term (≥12 months) use of topical tacrolimus in pediatric patients for treatment of ocular surface diseases. Methods: A total of 144 eyes of 72 pediatric patients who were prescribed topical 0.02% tacrolimus ointment between January of 2010 and March of 2018 for anterior segment inflammatory disorders refractory to conventional steroid therapy were included. Patients completed questionnaires and underwent slit-lamp examinations for evaluation of symptoms and signs at baseline. Patients were followed 1, 2, 3, 6, 9 and 12 months after initiation of tacrolimus treatment. After 12 months, patients were followed every 3 months for monitoring of possible adverse events and clinical outcomes. Changes in ocular surface parameters during slit-lamp examination, clinical symptoms and concurrent steroid use were graded with a scoring system. The presence of side effects was also verified.Results: Among 72 patients (56 % males, age 10.79 ± 3.96 years), 25 patients (48% males, age 11.42 ± 3.91 years) fully recovered, resulting in discontinuance of the ointment treatment before 12 months. Six patients experienced intolerable burning sensation, which required treatment cessation. Cessation days of those who quit were 1,5,14,20,26, and 35 days. Seven patients were lost during follow-up. Thirty-four patients (56% males, age 11.20 ± 4.21 years) were treated with tacrolimus ointment for over 12 months (average 23.12 ± 19.07 months). During the follow-up period, all patients showed improved clinical signs and symptoms, and no adverse reaction was noted. Conclusions: Long-term maintenance of topical tacrolimus 0.02% ointment is safe and effective in improving refractory ocular surface inflammatory diseases in pediatric patients.

Iridocorneal endothelial syndrome: Short report

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Benchakroun S ◽  
◽  
Taouri N ◽  
Tagmouti A ◽  
Cherkaoui LO ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Edema ◽  
Posterior Segment ◽  
Specular Microscopy ◽  
Short Report ◽  
Slit Lamp ◽  
Blurred Vision ◽  
Slit Lamp Examination ◽  
Iridocorneal Endothelial Syndrome ◽  
The Right

We report a case of a 42-year-old-woman, who presented to the ophthalmic consultation for decreased visual acuity complaints of blurred vision, altered pupillary shape since few months of her right eye. The clinical examination found a reduced visual acuity to counting fingers in the right eye and 20/20 in the left eye. intraocular pressures was 38 mm Hg OD and 14 mm Hg OS. Slit lamp examination of the right eye found: Corneal edema, iris atrophy with a deformation of the iris architecture and pupillary anomalies, with polycoria (Figure 1). The evaluation of the angle by gonioscopy found areas of broad synechiae anterior to Schwalbe’s line (Figure 2). While the examination of the left eye was normal (Figure 1B). The posterior segment examination was normal in both eyes. Specular microscopy confirmed the presence of unilateral endothelial pleomorphism and polymegathism. In our case of the retained diagnosis was iridocorneal endothelial syndrome

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