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2/22/96 Chapter 7 Slit Lamp, Fundus, and Tonometry page 7-1
Chapter 7
Slit Lamp Examination, Fundus Examination, and Tonometry
7.1 Slit Lamp Examination
All corneal slit lamp examinations are performed with the designated CLEK
Study slit lamp in each Participating Clinic. These slit lamps are kept covered when not
in use. The eyepieces should be checked for cleanliness prior to every examination and
cleaned as needed. The slit lamp chin rest and head rest are cleaned with an alcohol
swab prior to each examination. The patient is positioned to be comfortable in the chin
rest and at the proper height.
Results from the slit lamp examination at each visit are recorded on the CLEK
Examination Form as described in Chapter 17 of this Operations Manual.
7.2 Slit Lamp Examination Procedure
The following procedure should be performed on the right eye first and then on
the left eye.
(1) Set the slit lamp at 3/4 maximum illumination. Using 10X* magnification and
a diffuse, wide open illumination beam, scan the eyelids and lashes for signs of
inflammation.
(2) Scan the inferior palpebral and bulbar conjunctiva.
(3) Evert the upper eyelid and scan the superior tarsal conjunctiva at 7-10X*
magnification.
(4) Release the upper eyelid and scan the superior, nasal, and temporal bulbar
conjunctiva.
(5) At 16X* or greater magnification use a wide open, diffuse beam to observe the
entire cornea for signs of opacification.
(6) Observe the limbus at higher magnification using an approximately 3 mm
wide parallelepiped (16X*).
(7) Use an approximately 3 mm wide parallelepiped at 16X* or greater
magnification to scan the cornea. Set the biomicroscope lamp arm on the
patient's temporal side. Scan the inferior half of the cornea from the temporal
side to the nasal side. Swing the lamp arm to the nasal side and reverse the