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LENS
NON – CONTACT
CONTACT
CONVEX INDIRECT
CONCAVE
LENS LENS
LENS MODIFIED GOLDMANN 3
KOEPPE’S MIRROR LENS
LENS
+60D +30D
+78D HRUBY +40D
+90D LENS +14/+
15D
ADVANTAGES
1. Larger field of retina visible
2. Lesser distortion of image of retina
3. Easier to examine , if patient ‘s eye movements are present and with high
spherical or astigmatic refractive errors
4. Easy visualization of retina anterior to equator , where most retinal holes and
degenerations exist
5. It gives a 3D stereoscopic view of the retina wth considerable depth of focus
6. Useful in Hazy media because of its bright light and optical property
DISADVANTAGES
1. Magnification in indirect ophthalmoscopy is 5 times
2. Impossible with very small pupils
3. Patient usually more uncomfortable with intense light and scleral indentation
4. Reflex sneezing on exposure to bright light
5. Requires extensive practice in technique
Volk's 60D,78D and 90D fundus lenses with slit lamp indirect
ophthalmoscopy as a standard diagnostic procedure for comprehensive
fundus evaluation.
Double aspheric lenses
Optics of indirect fundus biomicroscopy is similar to that of indirect
ophthalmoscopy.
Image formed is real, inverted, laterally reversed.
Technique
The patient’s pupil may be dilated and background lights dimmed
as for direct ophthalmoscopy.
The slit lamp viewing piece and the light column are kept at
an angle of 90 degrees.
The beam is focused onto the patient’s pupil and the +78 or +90 D
condensing lens aligned at around 5-10 mm from the patient’s cornea.
The slit lamp is then pulled backwards gradually towards the examiner
until the fundal glow is visualised
As with indirect ophthalmoscopy, the image from a non-contact Volk Lens slit
lamp biomicroscopic examination is inverted and laterally reversed.
The high dioptric power lens (30D) has the highest magnification :-
Least magnification of the retina, 60/30 = 2.
Stereopsis is half that of the normal, 2/4= 1/2
Field of view is generally the largest = (60 degrees, 30 x 2 ).
used to obtain a panoramic view when detail and stereopsis are
not as important , and used with small pupil.
+20 D lens
1. Dilate pupils
2. Instil topical anaesthetic drops
3. Insert coupling fluid into cup of contact lens but do not overfill
4. Ask patient to look up , insert inferior rim of the lens into lower fornix and
press it quickly against the cornea
5. Always tilt illumination column except when viewing 12 o’ clock position in
the fundus (ie, with the mirror at 6 o’clock)
6. When viewing different positions of peripheral retina, rotate axis of beam so
that it is always at right angles to the mirror
6. To visualize entire fundus, rotate lens for 360 degrees using the 59, 67
and 73 degrees tilted mirrors to give views of the peripheral retina, the
equatorial fundus and the area around the posterior pole, respectively
7.To obtain a more peripheral view of the retina, tilt the lens to the
opposite side and ask the patient to move the eyes to the same side.
Eg-to obtain a more peripheral view of 12 o’clock position (with mirror at
6 o’clock), tilt the lens down and ask the patient to look up
8. Examine the vitreous cavity with central lens, using a horizontal and a
vertical slit – beam and then examine posterior pole
Wide field (panfundoscopic) indirect contact lenses
As the index of refraction of a contact lens approaches that of the cornea, there is minimal refraction at the
interface of these two media, which eliminates the optical effect of the front corneal surface.
Thus light rays from the anterior chamber angle enter the contact lens and are then made to pass through
the new contact lens-air interface
GONIOLENSES(Direct)
1.Koeppe Goniolens
2.Huskins Barkans lens
3.Thorpe Goniolens
4.Swan Jacob ‘s lens
5.Richardson Shaffer’s Goniolens
6.Worth goniolens
7.Sieback goniolens
GONIOPRISMS
Requiring coupling agents
1.Goldmann single mirror gonioprism
Prototype diagnostic gonioprism
Mirror inclined at 62 degrees from plano front surface
Needs to be rotated 3 times to examine the whole angle
Mirror Height -12 mm
Central well diameter -12 mm
Posterior Radius of curvature -7.38 mm
Easy to use
Excellent view
Peripheral retina can be seen
Stabilizes the globe Can be used in Argon Laser trabeculoplasty
Disadvantages of Goldmann gonioprisms
Only 1 mirror for gonio-has to be rotated by 360 degrees
Cannot be used for indentation
In case of 3 mirror lens, broad area of contact with cornea may cause
artefactual closure of angle
ADVANTAGES DISADVANTAGES
• Easy to perform
Similar to Zeiss
Made of plastic instead of glass
Has a fixed handle
3.Sussman lens
Similar to Zeiss
but has no handle
4.Tokel Gonioprism
Thorpe Goniolens
Surgical and diagnostic lens for operating rooms
Swan jacob’s lens
• Surgical goniolens
• used in children
Worth goniolens
It anchors to the cornea by partial vaccum
Sieback goniolens
Tiny goniolens which floats on the cornea
2 types of laser lenses are available to assist in slitlamp delivery of
photocoagulation:
Plano-concave lenses
an erect image
high resolution of small retinal area.
mirrors angulated at 59 , 69 and 73 degrees