NCLE Basic Exam Study Guide
Diffused Illumination - --Uses widest slit, longest aperture
-Light source positioned at an angle of 40º-50º
-Used to view overall areas, to observe the ocular adnexa, cornea, sclera,
lids, conjunctiva, lens surface, and CL fitting characteristics
-Direct Illumination - --Most important/useful illumination
-Light source positioned at an angle of 40º-50º to oculars
-Light beam and oculars are focused in coincidence on area being evaluated
-The difference in the illumination is not the angle used, but where the beam
is directed or focused and the width
-Varying width and aperture creates different illuminations
-Optic(al) Section - --Type of direct illumination that uses a narrow beam to
create a cross-section of the cornea
-Used to illuminate and observe individual layers of the cornea and tear film
-Used to evaluate corneal thickness, thinning, distortions, or depth of a
foreign body
-Shows corneal-lens relationship
-Parallelepiped - --Type of direct illumination
-Uses a 0.5-3.0 mm beam and a 40º-50º angle to create a 3-D cube
-Used to assess width, depth, and height of an object within the cornea
-Useful in observing scars, infiltrates, staining, and the corneal-lens
relationship
-Indirect Illumination - --Light source is moved out-of-click, the beam is 2-3
mm wide and is positioned next to the area being studied
-Illuminated area is translucent or opaque, allowing for observation adjacent
to illumination
-Used to observe foreign bodies, corneal nerves, and opacities
-Oscillation of light accentuates details
-Retroillumination - --Light source is out-of-click, moved to the side of the
area being observed
-Using a 1-3 mm beam, the light is reflected off the iris and used to back-
light the area studied
-Useful in examining corneal scars, debris, microcysts, scratches on the lens,
sub-epithelial changes, corneal vascularization, diffuse edema, and surface
deposits
-Sclerotic Scatter - --Uses a focused parellelepiped placed out-of-click
directed at the limbus
-Oculars are not used
, -The light is dispersed at the limbus, reflected through the cornea, creating a
circumcorneal halo
-Used to observe edema, stromal folds, lens deposits, bubbles under the
lens, lens defects, and scratches
-Corneal Topography - Axial Map - --Most widely understood map of the
cornea for many CL fitters
-Overall shape of the cornea
-Colors relate to steepness/flatness
-Sagittal reading measures the curvature of the cornea in diopters and is
called the axial power map
-Calculates curvature rather than power
-Corneal Topography - Tangential Map - --More sensitive map of the cornea
-Calculates corneal curvature based on the tangent to normal
-Found to be more beneficial in identifying corneal pathology
-Not used as frequently to fit CLs
-Corneal Topography - Refractive Power Map - --Show spherical aberrations
-More useful when assessing visual performance of post refractive patients
-Corneal Topography - Elevation Map - --Shows the difference in the
elevation of the cornea
-Measured in microns
-Corneal Topography - Irregularity Map - --Similar to elevation maps
-Uses best fit toric surface as a reference
-Eliminates any toricity from the eye and displays the elevation differences
-Corneal Topography - Photokeratoscopic Views - -Uses the placido rings
which are reflected onto the eye to subjectively determine the location and
regularity of the rings
-Corneal Topography - Numerical Views - --Arranges individual keratometric
findings to depict curvature readings of the eye
-Extremely useful when fitting specialty contacts
-Corneal topographic software calculates the "average keratometric" value
-Corneal Topography - Keratometry Views - --Represent the keratometric
readings along with the axes of the eye's presumed astigmatism
-Dioptric values define the findings from the center of the cornea to the
periphery
-This view helps the practitioner to quickly determine if corneal astigmatism
is symmetrical
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