Slit-lamp examination
            1. Check set up of machine.

            2. Observe the patient before examination. Obvious signs may be missed on 
                slit-lamp such as different corneal diameter or heterochromia.

            3. Position the patient comfortably.

            a
            4. Examine the anterior segments and then the posterior segments unless told 
                otherwise.

            5. Remember to examine the fornix (scars, adrenochrome etc) and superior 
                bulbar conjunctiva for abeculectomy.

            6. Special note:

            • Learn direct, diffuse illumination, scleral scatter, specular reflection
            • Look for iris transillumination
            • If asked, formal AC depth measure:
              • set slit beam mounting at 60 degrees to microscope
              • use horizontal slit beam
              • adjust slit beam to join corneal and iris reflections measure slit length and multiply by 1.4 for AC depth in mm.


            Clinical signs which may be easily missed:

              •  pigmented lesions of the bulbar conjunctiva
              •  deposits on cornea such as ferritin line or pigments on the endothelium
              •  iris transillumination
              •  small corneal scar
              •  peripheral iridotomy
              •  Montelo's tube
            Back to the index for final MRCOphth

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