Ophthalmology

Colour Atlas of Clinical Gonioscopy by Wallace L.M. Alward, Frederick C Blodi

By Wallace L.M. Alward, Frederick C Blodi

Gonioscopy is a method of exam of the iridocorneal perspective of the attention. it's a severe element of the exam of all sufferers, quite people with glaucoma. it's a a part of the attention exam that is tremendous tough for trainees to benefit. a few older practitioners have by no means develop into specialist in gonioscopic thoughts. This atlas provides all facets of the approach from the fundamental sciences in the course of the ideas, exam recommendations and interpretation of findings.

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The lens should be applied lightly, just until the air disappears from the corneal interface. The appearance of fo lds in Descemet's membrane is an indication that too much pressure is being applied (see 76). 56 55 ,r 55 Goldmann lens held with three fingers. The remaining two fingers are braced against the patient's face. The other hand is free to control the slit lamp. 56 Zeiss four-mirror lens held between thumb and index finger. The remaining three finge rs are used to brace against the patient's face.

The contour of the iris becomes more defined. Note that a solitary iris process is now appreciated. 60 Same angle as shown in 58 and 59. With narrow-beam focal illumination the iris process is seen clearly and the corneal wedge is well visualized. 30 Techn iques of Slit-Lamp Gonioscopy By using a thin slit of light, inclined from the angle of the oculars, two separate corneal reflections are perceived one on the inner aspect of the cornea and one on the outer. In addition to the inner and outer cornea, the narrow beam illuminates the interface between the cornea and the face of the opaque sclera (61).

70 Iris bombe makes a direct view of the angle difficult. ) view of the angle. 34 69 Same lateral angle as shown in 68 seen with the slit-lamp beam fully open. Obs. 71 If the patient's gaze is turned towards the examining mirror or the lens is shifted towards the angle being examined, it is possible to look over the iris and into the angle (a). 71 Techniques of Slit-Lamp Gonioscopy Indentation Gonioscopy ln 1966 Forbes described using the Zeiss fourmirror lens to distingui sh between angle closure due to synechiae and appos iti ona l closu re (Forbes, 1966).

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