SLIT LAMP EXAMINATION TOOLS

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Topcon’s SL-D2/D4 Slit Lamp Imaging System combines the SL-D2 or D4 digital slit lamp with the IMAGEnet Lite software package.

Using advanced slit lamp attachments in your practice can result in a more comprehensive exam experience for patients.

The slit lamp exam is an integral part of any eyecare practitioner’s diagnosis, treatment, and management of ocular conditions and diseases. Several ancillary devices such as anterior segment cameras and fundus lenses, have become useful along with these instruments. Here’s a quick survey of what’s out there.

ANTERIOR SEGMENT CAMERAS
There are many reasons for incorporating anterior segment photography into your practice. One of the best is patient education. A picture is very memorable and patients will understand more by seeing a picture. Photographing their anterior segment will better help them comprehend contact lens care, risk factors, and complications. Anterior segment photos also assist immensely with documentation and follow-ups for comprehensive patient care. In addition, having this imaging capability lends to the appearance of a high-tech practice.

Topcon Medical Systems, Inc. has two slit lamp imaging systems that are good examples of what’s available in this category. The first, the SL-D7/D8Z High Resolution Slit Lamp Imaging System, features either an integrated DC-3 8 megapixel or Nikon 12 megapixel camera. This system interfaces seamlessly with IMAGEnet Lite software for image archiving and management. The illumination for the flash can be controlled with 10 levels of intensity and amber filters can also be used for control and clarity.

The SL-D2/D4 Slit Lamp Imaging System combines the Topcon SL-D2 or D4 digital slit lamp with the IMAGEnet Lite software package. Users can get 8-megapixel images with the DC-3 digital camera that can be saved to a common patient database.

For photography, Haag-Streit’s BX 900 features a built-in retracting mirror that directs 100% of the light to the camera.

Woodlyn, Inc.’s HD Digital Slit Lamp Camera is compatible with Woodlyn’s HR3, HR5, or SL9803x slit lamps. Features include a beam splitter, manual focus override, amber filter, progressives scan, a CCD IEE1394 Fire Wire Camera, and the Medmont DV2000 software. This advance image capture system allows for precise capture, storage, and manipulation of images.

The BX 900 slit lamp from Haag-Streit USA combines high-quality optics with the latest in imaging technology. For photography, the built-in retracting mirror directs 100% of the light to the camera. Included in this model are an integrated, remote trigger flash, adaptors for Canon and Nikon cameras, and an interface with EyeCap™ to download, store, and manage images. EyeCap is a great imagining resource for any practice.

FUNDUS LENSES
Volk Optical, Inc.’s 60D lens gives high magnification of the posterior pole, helpful for detailed optic disc and macular imaging. The 78D lens, used for general diagnosis and laser treatment provides a good balance of field-of-view and magnification. For small pupil examinations, try the 90D lens, which is also a beneficial general diagnostic lens.

In its second generation, the Super Series, Volk introduced four lenses to deliver wider field, higher magnification with special features. For example, the Super 66 lens is made from patented double aspheric glass for high magnification of the central retina, including macula and disk detail. The 1.0x

GUIDE TO GONIOSCOPY FINDINGS AND CONDITIONS
• Iris Processes: can be a normal finding, also found in Axenfeld-Reiger Syndrome
• Hyphema: commonly seen in trauma or angle neovascularization
• Pigment: normal finding, Pigment Dispersion Sydrome, exfoliation, ocular trauma
• Exfoliative Material: exfoliation syndrome
• Peripheral Anterior Synechaie: trauma, surgery, chronic inflammation, angle closure attacks
• Neovascularization: secondary to iris neovascularization, initial new blood vessel growth

magnification makes optic disc measurement simple with a field-of-view of 80/96° (static and dynamic).

Volk’s Super VitreoFundus lens is used for wide field, pan retinal examination and has small pupil capability. The lens has a 103/124° field-of-view and a 0.57x. It is considered a “Super 90D” and is versatile in contact and non-contact settings with a field-of-view of 95/116° and 76x magnification. The Super Pupil XL offers small pupil capability with a 4mm working distance, 0.45x magnification, and a field-of-view of 103/124°.

Offering similar magnification to the original 90D lens with the widest view is the Volk Digital Wide Field 90D lens. The Digital 1.0x is ideal for slit lamp photography, while the Digital High Mag provides topographical views of the optic nerve fiber layer, and stereopsis for detection of optic disc swelling, cupping, and macular serous fluid.

Ocular Instruments also has a wide selection of quality lenses. The Ocular MaxAC 20D has an aspheric design for maximum resolution, an image magnification of 2.02x and a static field-of-view of 50°. With an image mag of 2.15x and static field-of-view of 59°, the Ocular MaxAC 28D has features the same aspheric design. The Ocular MaxField HD is a valuable general-purpose screening lens complete with Laserlight HD anti-reflective (AR) treatment, and works well through small pupils. It has an image mag of 0.60x, static field-of-view of 110°, and dynamic field-of-view of 146°. The Ocular Maxfield 120D provides an extremely large field-of-view (static: 120° and dynamic: 173°) and sharp image. This lens has an 80° field-of-view through a 2mm pupil, making it a great addition to any practice.

GONIOSCOPY
Despite its long tradition in optometry, gonioscopy still remains one of the most underutilized

Volk’s Digital High Mag provides topographical views of the optic nerve fiber layer and stereopsis.

procedures. Volk’s G-4 lens is the standard lens for static and dynamic gonioscopy. The four mirrors provide precise, accurate views of 360° of the anterior chamber. An all-glass design gives much better clarity than standard acrylic lenses, and is available in large ring, small ring, or two-position handle with or without a flange for true customization and comfort. The G-4 High Mag lens combines the G-4 lens with the clearest, highest magnification to give detailed views.

The Four Mirror Mini Gonio by Ocular Instruments has four 62° mirrors, which allow for superb angle viewing with minimal lens rotation. This lens is versatile due to its small diameter and small diameter flange, making it especially useful on eyes with small palpebral fissures. The Gaasterland Four Mirror Lens, also by Ocular Instruments, has a Laser-light HD AR treatment for high image brightness and contrast. There is a large field requiring minimal lens rotation, static field-of-view of 90°, high refractive index glass, and a choice of a large or small holding ring.

Incorporating diagnostic tools such as anterior segment photography, third-generation handheld lenses, and gonioscopy will help increase the medical services you offer in your practice. This not only increases medical reimbursement and profits, but provides your patients with the highest level of care, increasing patient satisfaction and referrals.

Jennifer L. Stewart is in private practice at Norwalk Eyecare in Norwalk, CT.

WHERE TO FIND IT
Haag-Streit USA
800-787-5426 • haag-streit-usa.com

Ocular Instruments
800-888-6616 • ocularinc.com

Topcon Medical Systems, Inc.
800-223-1130 • topconmedical.com

Woodlyn, Inc.
800-331-7389 • woodlynintl.com

Volk Optical, Inc.
800-345-8655 • volk.com

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