Biomicroscopy of the eye: features of the study and indications for its conduct

Biomicroscopy (another name for the method - microscopy of the living eye) is a special way of research conjunctiva, horny, iris, anterior chamber of the eye, lens, vitreous body, as well as central divisions of the fundus.The technique was proposed by Gulstrand, based on the phenomenon of Tyndal (or light contrast). With the help of biomicroscopy, early diagnosis of most ophthalmic diseases is carried out, even very small foreign bodies are detected. The main instrument used to carry out the investigation is a slotted lamp.

What it is?

Biomicroscopy is a technique for studying the eye's structures in detail, using a slit lamp (special optical device).The main part of the lamp is the diaphragm, which looks like a narrow slit.

Interesting to know. In the USSR, for the microscopy, the lamp model SHL-56 was used.

Biomicroscopy allows you to determine the slightest pathological changes in the eye, to detect small foreign bodies, to calculate the depth of the pathology.

Depending on the method of illumination, four types of research are distinguished:

• In direct focused light- in this case, the light beam is focused on a certain area of ​​the eyeball, which allows us to accurately estimate the degree of transparency of optical media.
• In reflected light- The study is carried out with the help of rays reflected from the iris and allows you to detect swelling, foreign bodies.
• In indirect focused light- the focusing of the light beam is next to the part of the eye being studied, the contrast between the strongly and poorly illuminated areas clearly demonstrates all the pathological changes.
• With diaphanoscopic indirect transmission- in this case, on the boundaries of optical media, mirror regions are formed, allowing to consider the localization of the changes.

Biomicroscopy in direct focused light

The main types of biomicroscopy are reflected, indirect focused, direct focused light, indirect diaphanoscopic translucence.

Indications

Biomicroscopy of the anterior part of the eye is the main way to diagnose most ophthalmic pathologies, namely:

• inflammation of the conjunctiva (including allergic, viral conjunctivitis);

Manifestation of viral conjunctivitis

• pathological processes in the cornea (erosion, dystrophy);
• cysts of the eyelids or conjunctiva, tumors;
• injuries;
• swelling of the eyelids;
• anomalies in the structure of the iris;
• inflammation of the iris (iridocyclitis, uveitis);
• keratitis;
• episcleritis, sclerites;
• dystrophic changes in the sclera or cornea;
• cataract and glaucoma;

Cataract

• hypertensive disease (allows to assess the state of the vessels of the conjunctiva);
• hit of foreign bodies in any structures of the eye;
• endocrine diseases.

Also biomicroscopy is performed before the operation before the eyes and within the framework of postoperative examinations.

Contraindications

The list of contraindications to conducting microscopy is minimal - it includes mental illnesses, alcoholic and narcotic intoxication.

Biomicroscopy is contraindicated in:

• narcotic or alcoholic intoxication;
• Psychological diseases (especially those associated with aggressive behavior).

Procedure

The doctor puts the patient in front of him and directs the narrow light beam of the slit lamp to his eye.Then, through the microscope, the doctor observes if there are pathological changes in the eye.

Biomicroscopy before operation

Increased sensitivity to light can make examination difficult - in this case, the doctor uses drops with an anesthetic.

Biomicroscopy of the fundus in childhood is most often performed in a state of deep physiological sleep.Position - horizontal.

Evaluation of results

As a result of focusing the light beam on the lens, its optical section is visible - it looks like a transparent biconvex body.In this case, the lens surfaces and oval bands of gray color (the zone of separation) are clearly visible in the cut. The study of the optical section allows the doctor to determine the presence of turbidity and localize them.

Optical lens section

Focusing of the light beam on the fundus is carried out by examining in the optical section of the reticular membrane and the optic nerve disk.It allows you to conduct early diagnosis of neuritis, stagnant nipples, rupture of the mesh shell.

With biomicroscopy, the light beam usually focuses on the lens or the eye bottom.

With biomicroscopy of semi- and opaque shells of the apple of the eye, diagnostic capabilities will not be as wide, but the technique is still universally applied by modern ophthalmologists.In this case, it becomes a complement to other types of research.

Video

conclusions

Biomicroscopy is an effective and inexpensive way to study all parts of the eye for the diagnosis of various pathologies, as well as the presence of foreign bodies (including the smallest).Its main essence is that when the light beam is focused on the lens, its optical section is formed in the form of a biconvex transparent body.Investigation of the slice allows to determine the available opacities. To analyze the condition of the disc and the optic nerve shell, light is focused on the fundus. The list of contraindications is minimal - it includes the state of alcoholic, narcotic intoxication, mental disorders.