Slit-lamp exam

The slit-lamp is a low-power microscope combined with a high-intensity light source that can be focused as a thin, slit-like beam.

You will sit in a chair with the instrument placed in front of you. You will be asked to rest your chin and forehead on a support to keep your head steady.

The health care provider will examine your eyes, especially the eyelids, cornea, conjunctiva, sclera, and iris. Often a yellow dye (fluorescein) is used to help examine the cornea and tear layer. The dye is added either by touching a small strip of paper to your eye or by adding it as an eyedrop. The dye rinses out of the eye with tears as you blink.

Next, drops may be placed in your eyes to widen (dilate) your pupils. The drops take about 15 to 20 minutes to work. The slit-lamp examination is then repeated using another small lens held close to the eye, so the back of the eye can be examined.

No special preparation is needed for this test.

Your eyes will be sensitive to light for a few hours after the exam if dilating drops are used.

This test is used to examine the:

• Conjunctiva (the thin membrane that covers the inner surface of the eyelid and the white part of the eyeball)
• Cornea (the clear outer lens on the front of the eye)
• Eyelids
• Iris (colored part of the eye between the cornea and lens)
• Lens
• Sclera (the white outer coating of the eye)

Structures in the eye are found to be normal.

The slit lamp exam may detect many diseases of the eye, including:

• Clouding of the lens of the eye (cataract)
• Injury to the cornea
• Dry eye syndrome
• Macular degeneration
• Separation of the retina from its supporting layers (retinal detachment)
• Blockage in a small artery or vein that carries blood to or from the retina (retinal vessel occlusion)
• Inherited degeneration of the retina (retinitis pigmentosa)
• Swelling and irritation of the uvea (uveitis), the middle layer of the eye

This list does not include all possible diseases of the eye.

If you receive drops to dilate your eyes for the ophthalmoscopy, your vision will be blurred.

• Wear sunglasses to protect your eyes from sunlight, which can damage your eyes.
• Have someone drive you home.
• The drops usually wear off in several hours.

In rare cases, the dilating eyedrops cause:

• An attack of narrow-angle glaucoma
• Dizziness
• Dryness of the mouth
• Flushing
• Nausea and vomiting

Biomicroscopy

Atebara NH, Miller D, Thall EH, Brodie SE. Ophthalmic instruments. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 2.5.

Chuck RS, Dunn SP, Flaxel CJ; American Academy of Ophthalmology Preferred Practice Pattern Committee, et al. Comprehensive adult medical eye evaluation preferred practice pattern. Ophthalmology. 2021;128(1):1-29. doi.org/10.1016/j.ophtha.2020.10.024. Published November 12, 2020.

Prokopich CL, Hrynchak P, Flanagan JG, Hynes AF, Chisholm C. Ocular health assessment. In: Elliott DB, ed. Clinical Procedures in Primary Eye Care. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 7.

Updated by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.