Slit Lamp

Summary

This video provides a comprehensive guide on how to use a slit lamp for eye exams, focusing on essential steps and machine adjustments. It covers the initial setup, patient positioning, and crucial adjustments like beam width, height, and light intensity. The tutorial also explains how to use the cobalt blue light for fluorescein exams, offering tips on avoiding false positives and maintaining comfort for patients. Ideal for anyone unfamiliar with slit lamp exams, the video simplifies the process and emphasizes practical techniques for accurate eye assessments.

Takeaways

• 😀 Start by turning on the slit lamp, typically using the light switch located under the forward part of the table.
• 😀 Adjust the black pieces of the slit lamp like binoculars for your comfort and use the dials for eye settings (set to 0 if not wearing glasses).
• 😀 Position the patient by adjusting the table height and ensuring their forehead touches the white strip. Align their eyes with the black mark by adjusting the chin rest.
• 😀 Use the joystick to adjust the light direction (up, down, front, back) to focus on different areas of the eye.
• 😀 Adjust the beam width using a dial to make it narrower or wider, and use the height dial to move the beam vertically.
• 😀 Maxing out the height dial will activate the cobalt blue light necessary for a fluorescein exam.
• 😀 The machine may have horizontal and vertical beam adjustments, useful for special cases but not commonly needed in the ER.
• 😀 Be cautious with the filter switch, which may turn the light teal green. This is not the same as the cobalt blue light used for the fluorescein exam.
• 😀 The machine may also have a magnification setting. Start with the lowest magnification and adjust as needed during the exam.
• 😀 Adjust the beam intensity to make the light brighter or dimmer, especially for patients with photophobia.
• 😀 For the fluorescein exam, place the strip in the lower lid or on the side to avoid causing false abrasions on the eye.
• 😀 Review the key settings: turn on the power, adjust the patient’s position, use the joystick for light adjustments, and remember that the height dial enables cobalt blue for fluorescein exams.

Q & A

What is the first step when using a slit lamp?

The first step is to turn the slit lamp on. The light switch is usually located underneath the forward part of the table facing you.

How do you adjust the slit lamp for your own eye comfort?

You can adjust the black pieces on the slit lamp like binoculars to suit your eye comfort. Additionally, adjust the dials on the front to match your eye prescription—set it to zero if you don't wear glasses or are wearing your current glasses.

What adjustments should be made for the patient's comfort?

The first adjustment is to modify the table height using the lever at the front to ensure the patient is comfortable.

How do you position the patient for an accurate slit lamp exam?

Ensure the patient's forehead is touching the white strip on the slit lamp and that the black mark on the side is even with their eyes. Adjust the patient's chin using the chin rest dial for proper alignment.

What is the purpose of moving the slit lamp machine forward and backward?

Moving the machine forward or backward helps to focus on different parts of the patient's eye, such as the lashes and lids, conjunctiva, cornea, anterior chamber, iris, and lens.

What is the role of the joystick in the slit lamp exam?

The joystick is used to make fine adjustments to the position of the light, allowing you to move it up and down, and side to side to focus on different parts of the eye.

How do you adjust the beam for the slit lamp exam?

The beam can be adjusted in width using a dial at the bottom of the machine. The height of the beam is controlled by a switch at the top. The beam will turn cobalt blue when the height dial is maximized, which is important for a fluorescein exam.

What should you do when the beam turns cobalt blue?

When the beam turns cobalt blue, it indicates that the correct light for the fluorescein exam has been activated. This is achieved by maximizing the height dial.

What is the function of the green filter on the slit lamp?

The green filter on the slit lamp is used to help ophthalmologists identify red blood vessels and cells. However, it is not the same as the cobalt blue light needed for a fluorescein exam.

How should the slit lamp's magnification settings be adjusted?

Start with the lowest magnification setting. You can adjust it as needed, but it's recommended to begin with the lowest for a clearer view.

What precautions should be taken during a fluorescein exam?

When using fluorescein strips, be careful not to cause false positive abrasions on the eye. It is advisable to apply the strip to the lower lid or off to the side to avoid potential issues.