Imaging guide BX900 - 20 Pages

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Catalogue excerpts

Slit Lamp Imaging Guide PHOTO SLIT LAMP

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Preamble On August 3rd, 1911, Alvar Gullstrand introduced the first rudimentary model of the slit lamp illuminator. An occasion of tremendous significance to ophthalmology had just taken place. Gullstrand described a device with the potential to advance the understanding of the eye and its problems as profoundly as did the direct ophthalmoscope 50 years earlier. By 1916, Henker had developed a practical combination of Gullstrand's illuminator and Czapski's corneal microscope, marking the first major advance in methods of examining the external eye in more than a century. In 1936 Comberg established...

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ANTERIOR CHAMBER, CHAMBER ANGLE_14

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4 BX 900® PHOTO SLIT LAMP 1. Cable guide 3 1 2 2. Flash housing 4 5 3. Flash intensity changer for background illumination 6 4. Objective tube 7 5. Camera body 8 9 6. Eyepiece with double cross hair reticle 7. Mirror housing 11 8. Background illumination 9. Mirror and Diffusion filter 10 10. Cold light source 11. Shutter release bar 12. Photo control unit 12 The Haag-Streit Photo-Slit Lamp BX 900® is based on the Slit Lamp BQ 900®. It is therefore possible to use the same instrument both for ocular examination and documentation. A photo-slit lamp is a combination of a biomicroscope, and illumination...

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5 1. The cable guide contains the high voltage cable for the flash light. 2. The flash housing contains the flash tube. Firing the BX 900® trigger will simultaneously deliver a flash through the illumination system and, via a glass fibre cable, the fill background illumination, while synchronising with the camera shutter. 7. The background illumination is swivel-mounted on a horizontal level and is illuminated through two glass fibre cables. The flash fill light comes from the flash housing and the modelling light comes from the cold light source. The modelling light is used to show where any...

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Magnification Changer Ocular Magnification Range of Adjusting Oculars Inter-pupillary Distance right ocular SLIT LAMP ILLUMINATOR Slit Height Slit Width Slit Beam Diffuser Light Source Illumination Device Light Source Background Illumination blue, green (red free), N. D. 10% PHOTO ATTACHMENT Image Delivery Objective Tube Focal Length Light Source Flash Light Quick Return Mirror 100 % light for examination or dependent on magnification and aperture Values will be increased by 35% in transparent media of the eyes IMAGE AND MAGNIFICATION DATA Circles: visible field of the eyepiece

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7 PHYSICAL AND OPTICAL CONDITIONS The binocular examination of the eyes with the slit lamp takes place in a three-dimensional space with great depth of field. Normal slit lamp imaging is a two-dimensional documentation with a very small depth of field. The difference between stereo viewing and monocular imaging can sometimes prove troublesome. However, viewing monocularly can help. Note only the image through the right eyepiece is recorded. The photographer’s view through the eyepieces is not the same as the recorded image. Through the eyepieces a circular image is visible whereas the image captured...

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STANDARD SETTING The BX 900® has many different adjustments in order to give optimal illumination and exposure. It is advantageous to always start with a standard setting and to make adjustments after each image captured. An example for a standard setting is the diffuse illumination: 1. Main switch on, photo control unit POWER ON and 2. After waiting a few seconds, set the flash intensity on HIGH. 45° Angle between microscope and background illumination Slit beam vertical Slit beam fully open (slit width and height) Slit beam centred (screw tightened) 100% slit illumination (without filter) Slit...

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DIFFUSE ILLUMINATION WITH SLIT ILLUMINATION AND BACKGROUND ILLUMINATION The diffuse illumination with slit beam and background illumination gives a shadow- free illumination with natural colours and two light reflexes. This is most useful for low magnification overview images. Flash Intensity: Slit Beam: fully open DIFFUSE ILLUMINATION WITH BACKGROUND ILLUMINATION ONLY The diffuse illumination with only the background illumination increases the con- trast. The structures of the iris are more visible and there is only one light reflex. Flash Intensity: Slit Beam:

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DIFFUSE ILLUMINATION Diffuse illumination provides evenly balanced lighting. Flash Intensity: Slit Beam: fully open DIFFUSE ILLUMINATION Diffuse illumination provides evenly balanced lighting. Exposure control is more varied due to increased reflectivity. NARROW SLIT Flash Intensity: Slit Beam: fully open A centred, narrow slit beam projected at a 45° angle demonstrates surface topography and trans-illumination of the lesion. The background illumination gives the position Flash Intensity: Slit Beam:

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INDIRECT ILLUMINATION A moderately wide and decentred slit beam is projected just adjacent to the border of the lesion. The light penetrates conjunctiva and illuminates the clear fluid below. In the presence of blood or scar tissue, the light is absorbed. Flash Intensity: Slit Beam: DIFFUSE ILLUMINATION This illumination technique can only be used in the presence of dense corneal patholo- gies because diffuse light does not penetrate very well through the cornea. Dilating the pupil can enhance pathology by creating a darker background. WIDE SLIT BEAM - TANGENTIAL ILLUMINATION This technique can...

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MODERATE SLIT BEAM WITH SEPARATION OF ILLUMINATED EPITHELIUM AND ENDOTHELIUM The moderate beam produces two different layers of illumination, one on the epithelium and one on the endothelium. Note the corneal changes are closer to the posterior reflection and therefore they lie deep in the cornea. NARROW SLIT BEAM - OPTICAL SECTIONING A narrow focal slit beam is projected at a 45° to 60° angle. It cuts an optical section through the cornea like a knife. With this technique it is possible to locate the layer of the pathological changes. These examples demonstrate endothelial and surface DIRECT...

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INDIRECT RETROILLUMINATION FROM THE IRIS The moderate slit beam is now decentred even more and angled to project onto the iris adjacent to the area behind the area of interest. The background is dark and the edges of non-pigmented lesions are well defined by the diffuse light reflecting from SCLEROTIC SCATTER Flash Intensity: Slit Beam: The wide decentred slit beam is projected onto the limbus. The light striking the lim- bus is internally reflected through the corneal tissue like a fibre optic. Corneal changes or abnormalities can be visualised by reflecting the scattered light. Careful post...

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