hello there welcome to the clinic so today's ocular session is dedicated to looking for any
anterior eye pathology using a special piece of equipment so just allow me to focus the machinery
and then we're going to focus
on the lids and lashes to begin with looking for any common problems or defects
so we seem to be focused there
okay i don't want it too bright, i don't want to create any unnecessary photophobia
okay so let's focus
with a low magnification here
and i'm just going to observe the eye
from the side there swing the light across looking for any gross abnormalities
any lumps
change the filter there
okay so let's look through the slit lamp, i'm just going to
increase the magnification there.
i'm just going to look at the lids i'm looking for any xanthelasma
upper and lower
okay now we're looking for any milia
which can be found under the lower lid more commonly
okay i'm going to just
put the magnification up there a little bit more, i'm just focusing on the lashes
just ensuring there's no trichiasis
or any poliosis
the lashes are pointing in the correct direction there,
just going to look on the lid margin there where the tarsal glands are found
to ensure there's no blockages
and to the upper lid, just look up to the ceiling
on the nasal there
okay and i'm just going to look for any cysts on the upper margin
particularly moll or zeiss cysts
and down to the lower lid margin
and there's no signs of any cysts there
now i'm going to bring my attention
to the conjunctiva, the clear membrane that covers the sclera
just look to the left
and look to the right
okay so there may be signs of some stromal degeneration which is manifesting as a pinguecula
the nasal part of the conjunctiva there, no apparent hyperaemia on or around the pinguecula
okay look to your left side
just looking for any retention cysts
or to right
okay now just look up to the ceiling
no signs of any hyperaemia,
cysts on the inferior conjunctiva. look down to the floor, now lift that upper lid
and there's no evidence of pathology on the superior part ther,e
excellent just checking the limbal area
looking for any neovascularization
and look up again quickly and look down again
it looks fine let's move our way to the
cornea, the window of the eye, should be nice and transparent
no signs of arcus
no evidence of limbal girdle
or crocodile shagreen
all right so if we can switch to a different
filter here, i'm going to use the blue light and a maximum beam width and brightness
there we go a little bit brighter there a little bit softer than the white light
and we're going to pop some sodium fluorescein into the eye
okay you won't feel this, look up to the ceiling
nice, one drop in the lower part of the eye
and i'm just going to incorporate this special wratten filter
just there. okay now just continue to look in this direction,
i'm going to observe the corneal integrity there
looking for any areas where the dye may bind or pool on the corneal surface
it can show up as specs or linear abrasions
wonderful it's looking nice and clear
okay i'm just going to bring the light angle there and thin the beam there
and i'm go
performing a cross-sectional view of the cornea
looking towards the dial here
checking the layers of the cornea, you can see the epithelium
Bowman's layer, stromal, Descments' and the endothelial
nice clear endothelium
the stroma is nice and transparent
i'm just going to focus my attention on the corneal endothelium
looking for any signs of dystrophy
or a beaten metal appearing
looking for any kruckenberg spindle or general pigment dispersion
that looks fine. i'm going to focus my attention going forward a little bit more
onto the anterior iris surface. i'm going to do a general sweep looking for any freckles
any signs of pigment deposits
just look up
looking at the collarettes and the crypts
looking to the left
and looking to the right, also looking for any nodules
and now we're going to check for any iris trans illumination. okay we have to
bring this down a little bit
and i'm just going to increase the brightness
just look in this direction
on the iris there
that's fine
no evidence of any laser or surgical interventions there on the iris
the pupil is round, no evidence of peaked pupil
okay look down to the floor once again
all right okay i'm going to bring the attention back a little bit to the
conjunctiva and scleral surface
look up to the ceiling
just examining the blood vessels in a little bit more detail
look down to the floor please
the superior portion
look to your left
and to your right
looking good just bring the
intensity down a little, back to the white light now. i'm going to focus
on the anterior lens surface here just to finish off the assessment
looking for any deposits on the lens surface, any signs of pigment dispersion or pseudoexfoliation
okay let's bring the beam down, i'm going to
just perform a cross-sectional view of the crystalline lens
just ensuring there's no pathology there, such as cataract
okay so apart from the nasal pinguecula, which isn't causing any problems in the
nasal part of the right eye, i'd say everything's looking good there
okay
that concludes the examination. thank you for coming in today