Ophthalmic System

Husam Yahya Naser

2022- 2023
 Slit Lamp
Purpose
1. Examination of the anterior segment of the eye.
2. The examination of the posterior region of the eye and
the chamber angle, the fundus and good part of the
retina.
3. Measure intraocular pressure, the curvature of the
cornea, the thickness of the cornea, the distance between
the cornea and the lens, the anterior chamber volume,
the opacity, etc.
4. Some slit lamps can have camera attachment for
photographic recording.
Slit Lamp
 TONOMETER
Tonometry is a diagnostic test that measures the pressure inside eye, which is
called intraocular pressure (IOP). This measurement can help your doctor
determine whether or not you may be at risk of glaucoma.

Purpose
- Measures the pressure inside eye.

Types
1. Applanation tonometer: it measure the force that is required to flatten the
cornea in mmHg.
2. Non-contact tonometer: it obtain IOP without touching the eye and do not
require anesthesia. The readings are taken after a soft puff of air is directed
at the patient’s eye and the resulting corneal deformity is measured and
converted to pressure.
3. The Schiotz tonometer # Used in operating rooms.
 TONOMETER
Components

1. Footplate that is placed on the cornea.

2. Central movable plunger that is fitted into a barrel.
3. Needle Attached to the plunger.
4. Scale for measurement.
 TONOMETER
Testing technique

1. Rest the tonometer on the anesthetized cornea.

2. The center plunger causes a slight depression in the cornea.
3. The position of the plunger indicates the internal pressure on the eye.
4. The force on a plunger can be varied by adding various weights (5.5, 7.5,
10.0 and 15.0 g).
5. The reading on the scale is converted to mmHg by using a conversion card
 Direct Ophthalmoscope
Electrical components:

1. Dry cells or a rechargeable battery kept in the

instrument handle.
2. Bulb.
3. Switch.
4. Variable resistor controls the current through the bulb
for changing its brightness.
5. Step down transformer if it uses main supply.
 Direct ophthalmoscope
Optical components:

A: Illumination system

Principle of work
1. Light rays from the lamp are slightly converged by Lens 1.
2. Lens 2 then focuses the rays so that an image of the lamp filament is
produced on the 45° mirror.
3. The aperture between Lens 1 and Lens 2 allows different shapes or colors of
illumination by horizontally oriented thumb-wheel.
4. Light rays from the mirror diverge, forming bundle of rays that enter the
subject’s eye.
5. Some of the rays are stopped by the iris, but others pass through the pupil
and then to the retina.
 Direct Ophthalmoscope
B: Viewing system

Principle of work
1. Light from the illuminated area is reflected in all
directions, but only some of the reflected rays pass to the
outside.
2. Some of the parallel (parallel to the observer eye) rays
intersect the mirror and are lost to view.
3. While others pass through the viewing aperture (hole).
4. Small diameter compensating lenses are placed just
behind the viewing aperture. They allow the observer to
bring into focus the image from the subject’s retina.
 Indirect Ophthalmoscope
Advantages over direct ophthalmoscope:
(1) Stereoscopic view
(2) Greater field of view
(3) Increased illumination
(4) Reduced distortion
(5) The doctor is at a distance from the patient.

Disadvantage compared to direct ophthalmoscope:

1. Inverted image.
2. Much lesser magnification.
 Indirect Ophthalmoscope
Components

A. Illumination system
B. Electrical system
C. Vision box
1. Two eye pieces moved laterally and medially
2. Hand held lens gives real inverted image
3. Two 90° to each other mirrors divide the beam into two beams
4. Two 45° mirrors or total reflecting prism
 Indirect Ophthalmoscope
D. The head band
1- The illumination box and the vision box attached to it
2- worn by the doctor
3- The lamp cable attached to it
4- contain screws to adjust the illumination box and the vision box
Thank you