The slit-lamp biomicroscope are very useful which provides a stereoscopic sight of the retina that is very beneficial in evaluating the elevation of exciting features. The auxiliary lenses offer greater magnification with high resolution. Most of the practitioners experienced with the Hruby lens recommend that it surpasses a plus 90D or plus +78 indirect test in finding delicate deviations. Even though many aspects of this kind of method stop it from becoming part of the regular test, there is no other method to gain an equivalent sense of depth. The Hruby lens (minus 55D) generates an upright virtual image which is not laterally reversed.
Patient co-operation is one of the most important things and could be improved by the attention to comfort in advance. The doctor focuses the oculars in order to accommodate any refractive error and they set the pupillary distance, keep the magnification to the lowest setting and remove all the filters. Generally the magnification is set about 6x. After this, the doctor will adjust the illumination of the slit-lamp in order to intermediate slit height and 2 mm in width and then they place straight ahead position between the oculars at zero degree. The slit-lamp generally adjusted according to the individual practitioner. The doctor will adjust the height of the patients with the chin rest therefore the fixation tool is in the middle of the patient's field facing the contra-lateral eye. Once the slit-lamp is moved into a position therefore the slit is imaged in the pupil of the patient’s eye, the Hruby lens is brought in front of the eye as near as possible without contacting the lashes or cornea.
Direct ophthalmoscopy using negative auxiliary lenses and a slit-lamp could provide greater magnification than the monocular hand held direct ophthalmoscope.
Next page: Modified indirect ophthalmoscopy
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