) is a detailed study of the structures of the eye, carried out using a special optical device - a slit lamp. The main part of the device is a diaphragm in the form of a narrow slit, which is why it got its name.
In the Soviet Union, the most common slit lamp model is ShchL-56. Using a lamp of this model, it is possible to examine both the anterior and posterior parts of the eye - vitreous And .
Biomicroscopy makes it possible to identify the smallest changes in the eye, detect small ones and determine the depth of location pathological process. Biomicroscopy is very important for the diagnosis of perforated wounds of the cornea and other eye diseases.
Biomicroscopy (synonymous with microscopy of the living eye) is a research method that allows you to examine in detail the conjunctiva, cornea, iris, anterior chamber of the eye, lens, vitreous body, as well as central departments fundus (biomicroophthalmoscopy); proposed by A. Gullstrand. The biomicroscopy method is based on the phenomenon of light contrast (Tyndall phenomenon).
Using biomicroscopy, it is possible to carry out an early diagnosis of most (for example, glaucoma and trachoma), determine a perforated wound of the eyeball, detect very small foreign bodies in the conjunctiva, cornea, anterior chamber of the eye and lens that are not detected by x-ray examination(glass, aluminum, coal, eyelash). Biomicroscopy is carried out using a slit lamp.
The device (Fig. 1) consists of an illuminator and a binocular stereoscopic microscope. The light source in the illuminator is a lamp (6 V, 25 W), powered from an AC electrical network of 127 or 220 V through a step-down transformer. In the path of the light beam there is
a slit mechanism that allows for a vertical and horizontal lighting slit. The body of the binocular microscope contains an optical device that provides various options magnification (5, 10, 18, 35, 60 times). The binocular microscope has a diverging lens with a power of about 60 D, which neutralizes the positive effect optical system eyes and allows you to see the fundus.
Rice. 1. Slit lamp ShchL-56: 1 - front installation; 2 - illuminator; 3 - binocular microscope; 4 - coordinate table; 5 - tool table.
Biomicroscopy is carried out in dark room, creating a sharp contrast between the darkened and lamp-lit areas of the eyeball. In the process of biomicroscopy, diffuse, direct focal light, indirect illumination (dark field), transmitted light, sliding beam, and research in reflective zones (mirror field method) are used. The main type of lighting is direct focal. When focusing light on the cornea, an optical section of it is obtained in the form of a slightly opalescent convex-concave prism (Fig. 2). The front and back surface, the actual substance of the cornea. If there is an inflammatory focus or cloudiness in the cornea, studying the optical section allows you to decide where the pathological focus is located and how deeply the corneal tissue is affected; in case of a foreign body in the cornea - whether it is located in the corneal tissue or partially penetrates into the eye cavity, which allows the doctor to correctly determine the method of intervention.
When light is focused on the lens, its optical section is cut out in the form of a biconvex transparent body. In the section, the surfaces of the lens are clearly visible, as well as grayish oval stripes, the so-called interface zones, caused by different densities of the lens substance (Fig. 3). Studying an optical section of the lens allows one to see and accurately localize the beginning opacities of its substance, which has great value For early diagnosis cataracts. Focusing light on the fundus allows you to examine the retina and disc in an optical section optic nerve(Fig. 4). This is important for the early diagnosis of optic neuritis, congestive nipple, and centrally located retinal tears.
Less diagnostic possibilities are available with biomicroscopy of translucent and opaque membranes of the eyeball, for example, the conjunctiva and iris. However, in this case, biomicroscopy is an important addition to other methods of examining a patient with eye disease.
Rice. 2. Optical section of the cornea: a, b, f, d - anterior surface of the cornea; 3, e - edge of the rear surface; b, d, d, f - thickness of the cornea.
Rice. 3. Optical section of the lens: 1 - central gap; 2 - central surfaces of the embryonic nucleus; 3 - peripheral surfaces of the embryonic nucleus; 4 - surfaces of the senile core; 5 - subcapsular zones of cleavage; 6 - anterior and posterior surfaces of the lens. Rice. 4. Optical section of the retina and optic nerve head.
Biomicroscopy of the eye is a method of non-contact examination of the structures and media of the eye, it allows you to painlessly identify eye diseases and pathologies. In the diagnostic process, a special ophthalmological microscope (slit lamp) is used, which is combined with a lighting device. The slit lamp allows you to examine at multiple magnification all the components of the structure of the anterior segment of the eye: eyelids, conjunctiva, lens, etc.
Ophthalmologists prescribe examination to their patients using biomicroscopy if they suspect the development of various pathologies organ of vision. Diagnostics allows us to identify eye diseases even in the initial stages.
Diseases that can be detected using a slit lamp:
Biomicroscopy can also detect a foreign body in the cornea. The procedure is shown before and after eye surgery to monitor the result. Diagnostics has virtually no contraindications; it is not performed only for those patients who behave inappropriately, are in a state of alcohol intoxication or under the influence of drugs.
Biomicroscopy of the lens does not require any preliminary preparation from the patient. In case of examination through a slit lamp of the vitreous body or lens, tropicamide is instilled 15 minutes before diagnosis: for adults 1%, and for children under 6 years of age with a 0.5% solution.
If the indications for examination are injuries or inflammatory diseases cornea, then the eye is stained with a solution of fluorescein or rose bengal. The substance is instilled into the conjunctival cavity, and then washed with eye drops - this manipulation allows you to wash off excess paint from undamaged areas, as well as color the affected areas of the epithelium. Lidocaine is instilled into the eyes if biomicroscopy is performed before surgery to remove a foreign body.
In the room where it will be produced diagnostic procedure, it must be dark. The microscope is placed on a special table with a head stand. The patient should sit at the table, placing his chin on the stand, his forehead should be pressed against the crossbar. The ophthalmologist sits on the other side of the alkaline lamp. The doctor will set the position most convenient for a detailed examination, adjust the width of the light beam, as well as its brightness, and begin the examination through a microscope.
During diagnosis, the doctor may use various types lighting, this makes it possible to detect even the slightest pathological changes in the tissues of the eye. It is possible to narrow the light beam to a thin slit or, conversely, expand it to a full circle that will illuminate the entire surface of the eye.
Important! The patient must sit still during the examination, cannot move his head, and blinking is not prohibited, but it is better to do this infrequently so as not to confuse the ophthalmologist.
Biomicroscopy takes a maximum of 10-12 minutes, it has no complications or severe side effects. In some patients it is possible allergic reaction for solutions used during the preparatory period.
To perform biomicroscopy of the eye lens, please contact medical centers President-Med
Biomicroscopy of the anterior segment of the eye is indicated for many pathologies. In fact, it is included in the standard ophthalmological examination, along with checking and examining the fundus.
Injuries on the eyelids
Swelling or inflammation of the eyelids
Trauma to the eye area
Anomaly in the structure of the iris
Inflammation of the iris (and)
Dystrophic changes in the cornea and sclera
Hypertension (to assess the condition of the conjunctival vessels)
Endocrine diseases (especially diabetes mellitus)
Foreign bodies in any structure of the eye
Preparing for eye surgery
Postoperative examination
Evaluation of treatment results
Biomicroscopy of the eye is contraindicated in the following conditions:
Drug or alcohol intoxication
Mental illnesses accompanied by aggressive or inappropriate behavior
Before the procedure, if it is necessary to examine deep structures (,), drops are instilled into the eyes. In case of examination of the cornea (its damage, inflammation or unknown pathology), a special dye is dripped into the eyes. After this any eye drops, washing off the dye from unaffected areas (changes on the cornea remain stained short time, allowing her to be examined). If it is necessary to remove a foreign body, then drops with an anesthetic are instilled before the examination (usually used).
The patient sits on a chair in front of the slit lamp, places the chin and forehead on special supports. The doctor takes a position opposite, on the other side of the lamp. The required illumination and the width of the light beam are set, after which the beam is directed into the eye being examined and the necessary structures are examined.
The procedure is absolutely painless. However, discomfort from the beam of light is also possible. Biomicroscopy of the eye takes about 10-15 minutes. During the procedure, it is recommended to blink as little as possible, which will speed up the examination process and increase its quality.
You can undergo an examination of the anterior segment of the eye in most public and private ophthalmology clinics.
Requires comprehensive inspection ocular structures using special devices. One of the examination methods that allows us to assess the condition and functions of the visual organs is called eye biomicroscopy.
This is an effective and affordable technique that has many advantages, and is widely used by ophthalmologists to identify and prevent pathological processes of various etiologies. Let's figure out what the essence of the technique is, why and how it is carried out.
Biomicroscopy – non-contact method research that allows you to determine changes in eye structures without pain and discomfort for the patient. Diagnosis is carried out using a slit lamp - a special device for studying ocular structures. It includes a 6-25 W light bulb, a microscope that allows you to magnify the image 5, 10, 35 or 60 times, a diaphragm and a lens.
To create vertical or horizontal lighting slits, a diaphragm is installed in front of the light beam. A lens attached to the top diffuses light and allows for a detailed examination of the eye's media. The procedure is performed in a dark room, which creates a contrast between the illuminated and darkened areas of the eye.
Biomicroscopy allows you to carry out the following diagnostic measures:
The beam emanating from the lamp has a slit-like shape. This makes it possible to examine the ocular environment and structures in a section, and accurately determine the localization of the pathological process.
IMPORTANT! In case of serious ophthalmological diseases, the results of biomicroscopy cannot always serve as the basis for making a diagnosis. To confirm the disease and determine its characteristics clinical course, additional ones are used.
The method is used to diagnose various ophthalmological diseases. Indications for the procedure include:
After reaching the age of forty, biomicroscopy is included in a mandatory comprehensive study. It allows you to identify age-related changes in the structures of the eyes and prevent complications. Preventive diagnostics It is recommended to undergo at least twice a year. If there is a predisposition to ophthalmological pathologies, it is performed once every 3 months.
Biomicroscopy can be performed in different ways, depending on the characteristics of the lighting used for the procedure.
Depending on the instruments used to carry out the procedure, biometrics can be conventional (light) or ultrasound. In the first case, it is performed using a slit lamp, and in the second, using ultrasound. Ultrasound diagnostics has advantages over the usual one - it allows for a more accurate assessment of ocular structures and recording the results on digital film.
REFERENCE! When diagnosing ophthalmological diseases, doctors most often use a combination of different procedure options. This allows you to most accurately determine the location and characteristics of the pathological process.
The advantages of biomicroscopy are high accuracy and absence of pain and side effects at the patient. The procedure is carried out by an ophthalmologist, who, after diagnosis, interprets the results and makes a diagnosis. Biomicroscopy is a common method for examining the organs of vision, which is used in many ophthalmological centers. The cost of the procedure depends on the region, the equipment used and the pricing policy of the medical institution.
Biomicroscopy does not require special preparation. The patient sits on a chair, places his chin on a special stand and presses his forehead to the holder, which ensures complete immobility.
The doctor directs a light beam into the patient’s eye, adjusts its angle and intensity if necessary, and then examines the eye structures. The examination takes 15-30 minutes, after which the patient can go home.
To reduce discomfort from bright light, drops with an anesthetic are instilled into the eye, and to facilitate diagnosis, a tropicamide solution is instilled. It causes a strong short-term dilation of the pupil, due to which the structures of the eye become clearly visible.
There are no contraindications for biomicroscopy, but it is not recommended in some cases. For example, people under the influence of alcohol, severe emotional arousal, or serious mental disorders. To carry out the procedure in childhood small patients are placed in a horizontal position to eliminate the possibility of accidental movements. Blinking during diagnosis is not prohibited, but it should be done as little as possible.
There are no side effects after light biomicroscopy, since contact of the devices with eye tissue is excluded. After the procedure, there may be slight discomfort, spots or spots before the eyes, which disappear after a few hours.
Ultrasound biomicroscopy can be carried out in two ways - contact and immersion. In the first case, the device comes into contact with the eyeball, and a drug with an anesthetic is first instilled into the patient’s eyes. With the immersion method, anesthesia is not used, since there is no contact with eye tissue.
REFERENCE! Before the biomicroscopy procedure, you need to relax as much as possible, since a tense state can interfere with normal diagnosis. If necessary, you can take sedative on plant based or do breathing exercises.
Details of how a slit lamp examination is performed during biomicroscopy:
Biomicroscopy is an effective and simple method for diagnosing the organs of vision. It allows you to quickly, painlessly and without side effects evaluate the ocular structures and their functionality. To prevent serious ophthalmological diseases, it is recommended to undergo the procedure at least twice a year, even with good vision.
Biomicroscopy is a method of examining the tissues and media of the eye for the presence of any diseases, which is often used by ophthalmologists when examining their patients. This examination is based on the use of a special device - a slit lamp (an optical apparatus that combines a binocular microscope, a lighting system, and a number of additional elements, allowing a more accurate examination of all ocular structures).
With the help of such a lamp, not only biomicroscopy of the anterior sections of the eye is performed, but also its internal compartments - the fundus of the eye, the vitreous body. Biomicroscopy of the eye is safe, painless and effective way diagnostics
Pay attention! "Before you start reading the article, find out how Albina Guryeva was able to overcome problems with her vision by using...
Used to examine not only the eye, but also other areas around it. This procedure is carried out in the following situations:
The procedure is not performed on the following patients:
The examination takes place in a darkened room.
Taking the method of lateral focal illumination as a basis and further developing, biomicroscopy of the eye began to differ in the method of illumination:
This type of lighting is the simplest, that is, the same side focal light, but stronger and more uniform.
This light makes it possible to examine the cornea, lens, and iris simultaneously in order to determine the affected area for further more detailed examination using other views.
The light is focused on the desired specific place in eyeball to identify places of turbidity, foci of inflammation, and also to detect a foreign body. Using this method, you can determine the nature of the disease (keratitis, cataracts).
To create a contrast in illumination to examine any changes in the structure of the eye, a beam of light is focused near the area in question. Scattered rays falling on it create a zone of darkened field, where the focus of the microscope is directed.
Using this method, unlike others, it is possible to examine the deep sections of the opaque sclera, contractions and ruptures of the sphincter of the pupil, to distinguish true tumors of the iris from cystic formations, detect atrophic areas in its tissues.
Combination light that combines direct and indirect focal lighting. Their quick change makes it possible to determine the light reaction of the pupil, to detect small particles of foreign bodies, especially metal and glass, which are not visible during radiography. This type is also used to diagnose damage in the membrane between the stroma and Descemet's ocular membrane.
Used to diagnose the transparent media of the eye that transmit light rays. Any part of the eye, depending on the area of study, becomes a screen from which beams of light are reflected and the area in question becomes visible from behind in reflected light. If, for example, the area being diagnosed is the iris, then the lens becomes the screen.
Lighting is directed from the side. Rays of light seem to glide over various surfaces of the eye. It is especially often used to diagnose changes in the relief of the iris and to detect irregularities on the surface of the lens.
The most complex type of illumination, used to study the areas separating the optical media of the eye. A beam of light specularly reflected from the anterior or posterior corneal surface allows examination of the cornea.
Produced by exposure to ultraviolet light. Before such a study, the patient drinks ten milliliters of two percent solution fluorescein.
For a more detailed study of all structures and layers of the eye, which is not provided by simple biomicroscopy, ultrasound is used. It allows:
It is carried out using a precision microscope connected to a computer. This device makes it possible to examine with microscopic maximum clarity all layers of the cornea, and especially its inner layer - the endothelium. Thus, already at early stages, it is possible to determine any pathological changes cornea. Therefore, the following groups of people need to regularly undergo such diagnostics:
The cost of biomicroscopy in Moscow clinics ranges from 500 to 1200 rubles.
