OPTICAL PRINCIPLES OF SLIT LAMP

BIOMICROSCOPE
CHAIRMAN : PROFESSOR DR. MD. ANISUZZAMAN
DEPARTMENT OF CATARACT
NIO&H
MODERATOR : DR. MD. FARID HOSSAIN
ASSISTANT PROFESSOR
NIO&H
PRESENTER : DR. MD. MEZBAH UDDIN
DO Resident,
NIO & H
 Modern slit lamp with its auxiliary devices not only
provides magnified views of every part of eye from
cornea to retina. But also allows quantitative
measurements like IOP, Endothelial cell counts, Pupil
size, corneal thickness, AC depth etc.

 Uses a binocular, stereoscopic view, a wide range of

magnification and illumination of various shapes and
intensities to highlight ocular tissues
Why the name “Slit” lamp?

 The illumination which is used is so that a

narrow vertical slit of light is projected on to
the eye.

Basically it is a misnomer since slit is only one

of the various other diaphragmatic openings
present in the instrument.
 Optics of slit lamp biomicroscope

 1. Compound Microscope
 2. Slit Lamp
Parts of a compound microscope
2 convex lenses:
1.The objective lens
2.Eye piece lens
How does a compound microscope work?
The object AB is placed just outside the anterior focal point,Fo, of the objective lens.

A real, inverted and magnified image A’B’ is formed some distance behind the
objective lens

The eyepiece lens is placed so that the image formed by the objective lens falls at or
close to it’s principal focus,Fe

The eye piece lens acts as a loupe and further magnifies the image seen by the
observer

The final imageA”B” is vertically and horizontally inverted and very much magnified
 2 compound microscopes are mounted at an angle
of 13-14 degree to each other to give binocular
stereoscopic view
 Each lens is replaced by a system of lenses to
reduce spherical and chromatic aberration.
Optical principle of a slit lamp

 The alignment of the microscope and the illumination

system is such that the point on which the microscope is
focused corresponds to the point on which the light is
focused
 The microscope and the lighting system have a common
focal point
 Their common axis of rotation also lies in this focal plane
Observation system
 Objective lens
 Eye piece lens
 Prism
 Parts of Illuminating system
 Light source
 Condenser lens system
 Slit and other diaphragm
 Filters
 Projection lens
 Reflecting mirror
 Illumination system (cont.)
 Light source : Halogen lamp is used
Provides illumination 2x10 to 4x10 lux

 Condenser lens system : 2 Plano convex lenses

In Zeiss type illumination comes from below
In Haag Streit type illumination comes from above
Slit and other diaphragm :

 the height and width of the slit can be changed.

 Stenopaeic slit of 2mm and 0.5mm to provide conical

beam of light.
Projection lens
 Keeps the aberrations of the lens down

 increases the depth of focus and provide a better optical

section
Illumination system (cont.)
 Reflecting mirror :

to reflect the along the horizontal axis

Method of illumination
1.Direct : Diffuse illumination
Direct lateral illumination
Specular reflection
2.Indirect : Indirect lateral illumination
Retroillumination
Sclerotic scatter
Diffuse illumination :

For an overview of ocular surface tissue

Full height ,broad beam is directed from nasal or
temporal side
Uses :
a.An overview of : Eye lids
Conjunctiva
Cornea
Sclera
b.Any gross defect
c.Anterior capsule of lens
Direct focal illumination
The slit beam is regulated until it coincides with the exact
focus of microscope

• Optical section:
Corneal optical section
Optical section of the lens
Optical section of the anterior 1/3 of vitreous

• Parallelopiped of the cornea

• Conical beam
 Use
 Details of cornea,lens,and anterior third of vitreous
 Infiltrate
 Cells and flare
 Opaque lesion
Specular reflection
A medium to narrow beam of light is directed from the
temporal side

Angle of illumination should be wide (50 – 60 degrees)

 Short slit and high magnification

 Use
1.Endothelial cell count
2. Endothelial dystrophy
Transillumination / Retroillumination
 Backlight tissues are examined

 To examine the cornea the light is projected on the iris

while the examiner’s view is focused on the cornea

 The iris may be examined by directing the light on to the

surface of lens
 Use
 Iris transillumination defect : PI,PXS

 Posterior subcapsular cataract

 INDIRECT LATERAL ILLUMINATION
The light is directed just to the side of the lesion to be examined.
 Uses :
 Corneal infiltrate
 Corneal microcyst
 Coneal vacuoles
Sclerotic scatter
light directed at the limbus (when light is directed at 9 o’clock
position 3o’clock position will have maximum glow)
 Uses :
 Corneal oedema
 Nebulae
 Corneal opacity
Mechanical support system :
Up and down arrangement :
Joystick
Table
Stand screw
Patient support arrangement :
Chin rest
Head band
Hand rest
Fixation target
 Uses
 To see the anterior segment (from eyelids up to anterior third of
vitreous)
 As a measuring device, by changing the height of the beam
 Removing foreign body from the cornea
 Accessories
A. Fundus examination:
1.condensing lens(78 D,90 D)
2. 3 mirror goniolens
3. hruby lens
4. panfundoscopic lens

B. Gonioscopy:
3 mirror /4 mirror goniolens

C. Goldmann Applanation Tonometry

 Accessories :
D.Pachymetry

E.Endothelial cell count

F. Ocular photography

G. Slit lamp as delivery system of laser

THANK YOU