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

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. 

2019 ◽  
Vol 6 (1) ◽  
pp. 3-9
Author(s):  
Virginia Mares ◽  
Marcio B. Nehemy ◽  
Diva R. Salomão ◽  
Shannon Goddard ◽  
Jaime Tesmer ◽  
...  

Objective: To demonstrate the multimodal imaging and histopathology of Berger’s space. Methods: We conducted a retrospective in vivo analysis of 4 patients demonstrating Berger’s space with intraocular pathological conditions, documented by slit-lamp biomicroscopic photography and, in 2 patients, also by optical coherence tomography (OCT). Additionally, we carried out a retrospective histological study of 7 enucleated eyes with retinoblastoma demonstrating Berger’s space. A review of the literature was also performed. Results: Two eyes had slit-lamp photographs. One case showed Berger’s space surrounded by vitreous hemorrhage. In the other case, amyloid was trapped within Berger’s space. In another 2 eyes that were pseudophakic, Berger’s space was visible on anterior segment OCT. One had amyloid trapped in Berger’s space that could be seen with OCT. The histological review of the 7 enucleated eyes with advanced retinoblastoma demonstrated the presence of pyknotic cells in Berger’s space. Conclusions: Berger’s space is an actual space in pathological conditions and can be an important site of pathology. Additionally, to our knowledge, this is the first time that Berger’s space has been documented by anterior segment OCT in a clinical setting.


2009 ◽  
Vol 71 (6) ◽  
pp. 21
Author(s):  
Marie-Eve Corbeil

A first eye examination is performed on a two and a half month old patient who presents with no visual response to fixation or to pursuing a target or a light despite an unremarkable ocular health assessment. This temporary eye condition is known as Delayed Visual Maturation (DVM). Conclusion: A subsequent eye examination was performed at age five and a half months only to reveal that the child’s visual behaviour was now considered to be appropriate for his age. The diagnosis of DVM remains a diagnosis of exclusion and requires a comprehensive eye examination, electrodiagnostic testing and imaging techniques which may eventually include MRI.


2022 ◽  
pp. 236-269
Author(s):  
Alanna Khattar

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.


2018 ◽  
Vol 24 (27) ◽  
pp. 3276-3281 ◽  
Author(s):  
Dorota Raczyńska ◽  
Katarzyna A. Lisowska ◽  
Krzysztof Pietruczuk ◽  
Joanna Borucka ◽  
Mateusz Ślizień ◽  
...  

Objective: The objective of the study was to compare cytokine levels in the vitreous body of patients with proliferative diabetic retinopathy (PDR) undergoing posterior vitrectomy. Patients and methods: The study included 39 patients (39 eyes) undergoing pars plana vitrectomy (PPV). Patients were divided into three groups: patients with proliferative diabetic retinopathy (PDR) without aflibercept injection prior to the surgery, PDR patients administered aflibercept injection prior to the surgery, and patients without diabetes mellitus (control group). All patients underwent a comprehensive eye examination one day before and 3 weeks after the surgery, including measurements of: best-corrected visual acuity (BVCA) and intraocular pressure (IOP), slit-lamp examination and spectral domain optical coherence tomography (SOCT). Concentrations of cytokines: IL-6, IL-8, IL-12p70, TNF, IL-10, IL-1β were measured in the vitreous body of patients with BD™ Cytometric Bead Array (CBA) Human Inflammatory Cytokines Kit. Results: PDR patients who received pretreatment with aflibercept injection showed significantly lower concentrations of IL-12p70, TNF, IL-10 and IL-1β in the vitreous body compared to the control group. Meanwhile, patients without prior aflibercept injection had a significantly higher concentration of IL-8. There was also a significant positive correlation between IOP before PPV and IL-8 concentration in both PDR patients’ groups. Conclusion: Findings of our study suggest an important role of IL-8 in the development of severe PDR. Aflibercept administration on the day before elective vitrectomy facilitated the surgery.


2021 ◽  
Vol 22 (5) ◽  
pp. 2301
Author(s):  
Yoshikai Fujita ◽  
Tatsufumi Murakami ◽  
Akihiro Nakamura

Diabetic neuropathy is one of the most common complications of diabetes. This complication is peripheral neuropathy with predominant sensory impairment, and its symptoms begin with hyperesthesia and pain and gradually become hypoesthesia with the loss of nerve fibers. In some cases, lower limb amputation occurs when hypoalgesia makes it impossible to be aware of trauma or mechanical stimuli. On the other hand, up to 50% of these complications are asymptomatic and tend to delay early detection. Therefore, sensitive and reliable biomarkers for diabetic neuropathy are needed for an early diagnosis of this condition. This review focuses on systemic biomarkers that may be useful at this time. It also describes research on the relationship between target gene polymorphisms and pathological conditions. Finally, we also introduce current information on regenerative therapy, which is expected to be a therapeutic approach when the pathological condition has progressed and nerve degeneration has been completed.


Author(s):  
T.N. Savranova ◽  
◽  
V.U. Rozukulov ◽  
A.F. Yusupov ◽  
◽  
...  

Purpose. To study the ocular manifestations in patients with pseudophakia who underwent COVID-19 during the rehabilitation period after surgery. Material and methods. 46 patients with Phaco with implantation of IOL who underwent COVID-19 in the period from 1 week to 2 months after surgery. Of the examined patients, there were 28 men (61%), 18 women (391%). The average age of the patients was 63±1,2 years. Results. In 78% of cases, vascular pathology of the anterior and posterior segments of the eyeball was observed in patients who underwent COVID-19 in the early postoperative period after Phaco with implantation of IOL. Conclusions. The main ocular symptoms from the anterior segment of the eyeball in patients in 17% of cases were the occurrence or intensification of previously existing manifestations of the «dry eye» syndrome, as well as inflammatory phenomena from the anterior part of the uveal tract. From the posterior segment of the eye, in 70% of cases, there was a progression of vascular disorders, as well as the appearance of complications associated with manifestations of hypercoagulation syndrome and systemic vasculopathy. Key words: Covid-19, cataract phacoemulsification, pseudophakia.


PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 92-100 ◽  
Author(s):  
Jane Schaller ◽  
Carl Kupfer ◽  
Ralph J. Wedgwood

Eight of 70 children with juvenile rheumatoid arthritis have developed iridocyclitis. This complication occurred more frequently in patients with monoarticular and pauciarticular disease (29%) than in patients with polyarticular disease (2%). Seven of eight patients with iridocyclitis have monoarticular or pauciarticular disease; none has had prominent systemic manifestations or evidence of ankylosing spondylitis. Iridocyclitis preceded joint manifestations in two of the patients and followed arthritis by 1 to 10 years in six of the patients. Activity of iridocyclitis and arthritis seemed unrelated; four patients developed iridocyclitis while arthritis was inactive. In seven children iridocyclitis began insidiously without acute symptoms. Eye involvement has remained unilateral in six patients. Six children have had significant decrease in visual acuity, and six continue to have active ocular inflammation despite therapy. Iridocyclitis is potentially a major cause of disability in juvenile rheumatoid arthritis. Early signs and symptoms may be minimal. Patients at risk are those with limited forms of joint disease. Early detection and therapy are crucial for prevention of permanent ocular damage. Careful eye examination should be a routine part of physical examination of children with rheumatoid arthritis, and periodic slit lamp examinations should be performed even when arthritis is in remission.


1916 ◽  
Vol 23 (3) ◽  
pp. 353-375 ◽  
Author(s):  
Martha Wollstein

Cats injected into the parotid gland and testicle with a bacterial sterile filtrate of the salivary secretion of children in the active stage of parotitis or mumps can be made to develop a pathological condition having several points of resemblance to the condition present in mumps in human beings. After an incubation stage of from five to eight days definite changes have been noted in the temperature, blood leukocytes, and inoculated organs. The temperature rise begins within twenty-four hours of the inoculations and reaches a maximum in from seven to fourteen days. The febrile rise fluctuates between 1° and 2.5° C. The white blood cells begin to increase on the second day following the inoculation. The first change is a polymorphonuclear leukocytosis which precedes the glandular swellings. This initial rise is followed by a decline, after which the lymphocytes increase. The increase is confined to the small lymphocytes, which increase to from 7 to 10 per cent of their initial number. The inoculated glands become swollen and tender. The swelling and tenderness become apparent from the fifth to the ninth days and persist for a variable period. The parotid changes are less constant or less obvious than are the testicular. The latter are constant and endure from eight to twelve days. The rise of temperature and the leukocytosis precede the glandular swelling, but all the changes reach the maximum at about the same time, after which they decline gradually. What may be regarded as normal conditions are reestablished in four weeks or less. The intraparotid and intratesticular injections of extracts of normal parotid gland and testicles may cause a mild rise of temperature and leukocytosis of brief duration, but swelling and tenderness are absent. The white cells increased are the polymorphonuclears and not the lymphocytes. The intraparotid and intratesticular injections of filtrates of normal saliva may cause a mild rise of temperature of very brief duration, but leukocytosis, swelling, and tenderness do not appear. The histological changes in the parotid gland when present consist chiefly of edema of the interlobular connective tissue with mononuclear interstitial infiltration about the ducts and elsewhere. In cases of long duration the ducts may be dilated. But in some instances the swollen gland while showing congestion and edema in gross showed inconspicuous changes under the microscope. The histological changes in the testicle are of two kinds: inconstant changes of cellular invasion between the tubules and swelling or even multiplication of the interstitial cells, constant ones consisting of degeneration of the epithelium and interference with spermatogenesis, a condition to which we have applied the term "spermatorrhexis." The pathological conditions set up by the filtrate derived from the salivary secretion of cases of acute parotitis are intensified by successive transfers through a small series of cats of the extract and emulsion of the parotid gland and testicle previously inoculated. The pathological changes are also prevented or reduced when the extract or emulsion is previously incubated with a quantity of blood serum obtained from a cat which has survived inoculation. Normal serum, on the other hand, has no such inhibiting effect. The deduction from these experiments is to the effect that the salivary secretion in parotitis or mumps contains a filterable substance capable of setting up a series of definite pathological conditions when inoculated into the testicle and parotid glands of cats. Whether this active material is a microorganism and if so whether it is the specific microbic cause of parotitis or mumps remains to be ascertained.


2021 ◽  
Vol 62 (12) ◽  
pp. 1667-1671
Author(s):  
Seongmi Kim ◽  
Hye Jin Lee ◽  
Ahnul Ha ◽  
Jong Young Lee ◽  
Jinho Jeong

Purpose: We report a case of keratitis that improved after removal of a causative plant foreign body from below the posterior surface of an opaque cornea. The foreign body was revealed by anterior segment optical coherence tomography (AS-OCT) and gonioscopy.Case summary: A 79-year-old woman was referred with an impression of left-eye keratitis; the eye had been injured by a branch of a tangerine tree 1 month prior. She had been given the usual topical antibiotics by a local clinic, but they were ineffective. At her initial visit, her visual acuity was only hand motion in the left eye; slit-lamp examination revealed a 3 × 3-mm corneal infiltration with a hypopyon in the anterior chamber. Despite administration of strong topical antibiotics on an hourly basis, the corneal lesion worsened. AS-OCT and gonioscopy revealed a small foreign body below the posterior surface of the cornea; this was surgically removed. The corneal opacity and corneal epithelial defects dramatically improved, and the hypopyon disappeared.Conclusions: The possibility of a residual foreign body should be considered if trauma precedes infectious keratitis that does not improve with conventional treatment and the posterior surface of the cornea is not visible because of corneal opacity. In such a case, AS-OCT and gonioscopy can be useful.


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