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Anterior and posterior ocular biomicroscopy

Biomicroscopy is the examination of the anterior segment of the eyeball under a slit lamp. Examination of the eye with a biomicroscope allows assessment of the anterior segment of the eye, that is, the conjunctiva, the anterior part of the sclera, the cornea, the anterior chamber of the eye, the iris, the lens and the anterior part of the vitreous body.

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If an additional lens (VOLKA) is used, it is also possible to observe the posterior vitreous body and fundus – that is, to precisely assess the posterior segment of the eye in a three-dimensional image. The test requires pupil dilation. On the other hand, when used in conjunction with a Goldmann triluminometer (a naked-eye, contact triluminometer lens), it is also possible to assess the angle of the isthmus and the far periphery of the retina. Before inserting the trilocular, the administration of anesthetic drops into the conjunctival sac is required.

However, without dilating the pupil, eye pressure can be examined with a Goldmann applanation tonometer (a contact method of examining eye pressure that requires anesthetic drops and fluorescein dye to be injected into the conjunctival sac), or gonioscopy (imaging of the isthmic angle) can be performed. Local anesthesia of the eyeball (administration of anesthetic drops into the conjunctival sac) is required for insertion of the gonioscope.

The slit lamp consists of a source of strong light, which can be directed at individual structures of the eyeball, and a biomicroscope, which allows the examiner to magnify the image (10, 16, 25 or 64 times), but also to see stereoscopically (spatially). The test is completely safe and can be repeated many times, since the eye is illuminated with normal visible light, which is not harmful to it. The patient sits at a slit lamp that sits on a table. The head must be immobilized, as minimal movements change the focus of the image.

Biomicroscopy is counted among routine ophthalmic examinations, but the test is also performed as part of the monitoring of therapy already implemented or, for example, as part of a package of tests as part of glaucoma diagnosis. Indications for biomicroscopy include:

pathological conditions of the iris
Evaluation of the implant position after the artificial lens implantation procedure
Imaging of the iris – shaping of the epithelium, verification of the result of laser iridotomy, iridoplasty

Modern slit lamps are equipped with the so-called. vision tracks, which allow simultaneous “live” viewing of the examined eye and recording of photo documentation of the examination.