Thank you for this question as well, Group 5!
Here are our responses:
1. What are the normal expected findings for this test?
Normal expected findings for the Slit Lamp Test would include normal structure of the eyes. The cornea should be crystal clear and should have a lustrous surface, allowing a lucid view of the iris. Similarly, the retina would appear transparent, without any ridges, corrugations, or paler-looking areas.
2. What are the expected findings for this test for patients who have the diseases you have mentioned where this is an option for diagnostics?
Abnormal findings would reveal the specific manifestations for each of the discussed corneal diseases as the exam does not have a positive/negative result or a number, but more of a direct answer. The ophthalmologist would simply inform the patient if they see any deviations from the normal characteristics of the eyes. These are the following:
a. Corneal Dystrophies: variable shaped corneal opacities in a clear or cloudy cornea
b. Retinal detachment:
- Rhegmatogenous retinal detachment: gray or opaque areas which look corrugated and paler than the normal retina depict where the retina is detached.
- Non-rhegmatogenous and tractional retinal detachment: large bullous separation of the retina
- Exudative retinal detachment: appears as shifting opaque liquid beneath the retina
c. Retinal Occlusions:
- Retinal Vein Occlusion: cotton-wool spots, optic disc edema, retinal hemorrhages, retinal edema, and macular edema
- Retinal Artery Occlusion: cherry-red spot at the macula, pale retina, and signs of retinal damage and hemorrhage
d. Keratoconus
Signs of centeral and parecentral thinning can be seen, as well as presence of Fleischer ring (a yellow or brown ring encircling the cone), as well Vogt straie.
3. What are the nursing considerations for this diagnostic exam?
Prior to the exam, instruct the patient to withhold eye medications as it may affect the results of the exam. It is important to educate the patient about what to expect during the exam. For instance, since dilating drops will be used, it is best that the patient knows that their eyes will be more sensitive to light for a couple of hours. Hence, they should wear sunglasses to protect their eyes from sunlight and have someone accompany them on the way home since their vision may become blurry. It is also important to remind patients to refrain from driving until after the effects of the dilating drops have worn off, which lasts up to 4 hours.
REFERENCES
Slit-Lamp Biomicroscopy | Davis’s Lab & Diagnostic Tests. (n.d.). https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425084/all/Slit_Lamp_Biomicroscopy