OM t of c.iii - Vision Research Coordinating Center - Washington ...

2/22/96 Chapter 7 Slit Lamp, Fundus, and Tonometry page 7-5
Lens
7.5.1 Direct Ophthalmoscopy or Biomicroscopy with Condensing or Hruby
(1) Ocular media: Focus progressively back through ocular media, noting the
location of any opacities as seen in retroillumination or slit lamp optic section.
(2) Optic nerve head: Grade the vertical cup-to-disk ratio.
(3) Macula: Inspect macular area and fovea.
7.5.2 Binocular Indirect Ophthalmoscopy
Use a 28 D or other appropriate condensing lens; recline patient if possible.
(1) Peripheral retina: Perform a 360° scan of the peripheral retina, out to the ora
serrata.
(2) Paramacula: Obtain an overall binocular view of posterior pole, including
disk, macula, and vascular arcades.
Media opacities or fundus abnormalities requiring attention should be referred
back to the referring practitioner. In the unlikely event of an ocular emergency, a
reasonable attempt should be made to contact referring doctor for disposition. If the
referring doctor cannot be reached then patient should be referred directly for
appropriate care.
7.6 Tonometry
The intraocular pressure is measured using a Goldmann applanation tonometer.
The tonometer is calibrated every month.
7.6.1 Technique
The right eye is always tested first.
The single measurement is made as follows:
(1) The examiner adjusts the force on the tonometer dial to an initial setting
corresponding to 10 mm Hg. The slit lamp magnification is set at 10X. The light source
is positioned at an angle of approximately 45°, and the aperture is maximally opened. A
cobalt blue filter is employed.