10 Steps to a Better Slit Lamp Examination

10 Steps to a Better Slit Lamp Examination
Brush up on this essential part of every eye examination.
By Etty Bitton, OD, MSc, FAAO

Are you getting the most out of your slit lamp exam (SLE)? Like most, your slit lamp skills have no doubt improved with time. To maximize the use of your slit lamp, try adding the following 10 reminders to your routine.

1. Clean Up Your View

Whether or not you cover your slit lamp at the end of the day, dust and oils from your eyelashes will soil the oculars. Make sure you dust the mirror of the illumination column as well as the patient side of the oculars. You can use a small brush, which usually comes as part of the slit lamp accessories, to dust off the mirror. Adding a routine cleaning will keep your image sharp. 



 2. Adjust Your Oculars

This step may be more pertinent if you practice in a group or hospital
 setting whereby several individuals share the equipment. Verifying the
 interpupillary distance of the oculars prior to evaluation will maximize
 three dimensional (3D) viewing of the ocular tissues. In addition, you should
also adjust the objectives to your prescription by turning the knurled ring
 of the eyepiece. Daily handling can displace the interpupillary distance of the
 oculars, hence a small adjustment could make a big difference with respect to
 viewing comfort and rendering subtle
3D details more evident.

3. Follow the Anatomy A comprehensive SLE should follow a logical
sequence. It's best to begin with low magnification and observe the
 external structures first, such as lids, lashes, inner and outer canthi
 and tear meniscus. You can also evaluate the overall appearance of
the bulbar conjunctiva, cornea, iris and pupilBegin by sweeping the lid margin from the outer canthus towards the inner canthus. Of particular interest for contact lens (CL) wearers is a detailed examination of the lid margin, paying particular attention to the lids, lashes and tear film. Examine the lashes for signs of blepharitis, madarosis (loss of lashes) and trichiasis (misdirected lashes). Observing the tear meniscus should reveal a uniform structure with little debris and an inferior meniscus that's slightly larger than its superior counterpart. Note lid margin scars or deformities, especially if they obstruct the flow of the tears towards the punctum. Meibomian gland expression should require little force and reveal clear liquid secretions. Meibomian gland dysfunction is often underdiagnosed, leading to an unstable tear film and unexplained CL dropout. Make lid eversion a routine part of every anterior segment examination, even more so in CL wearers. Check the lids for signs of papillary response or hyperemia. Some silicone hydrogel lenses that have higher modulus have resulted in a papillary response in some patients. Switching to a lens with lower modulus may have beneficial effects. 

TABLE 1
llumination Techniques
ILLUMINATION	ILLUMINATION ANGLE (DEGREES)	MAGNIFICATION*	TISSUES
Diffuse	30-45	Low	External overall view, lid, lashes, CL fit
Direct:
• Broad beam	30-45	Low-med	Conjunctiva, cornea
• Parallelepiped	30-45	Med	Cornea, meniscus, iris, lens
• Optical Section	30-60	Med	Angle estimation, corneal layers, lenticular layers
• Conical Beam	30-45	Med	Anterior chamber (cells)
Indirect	45-60	Med	Cornea
Retroillumination	0	Low-med	Transillumination of the iris, lenticular opacities direct
Specular Reflection	90 from microscope	Med-high	Tear Layer, endothelium
Sclerotic scatter	60	Low	Corneal scars, central edema
Tangential	70-80	Med	Iris (freckles, suspicious nevi)
* Low: 6X to 10X, Med: 10X to 16X, High: 25X to 40X

A detailed examination of the corneal structures (epithelium, stroma and endothelium) is next, varying magnification and illumination as needed. Examine the iris, pupil and crystalline lens last because the direct illumination is more bothersome for the patient. A systematic SLE will improve efficiency, uncover reasons for CL intolerance, reduce chair time and limit omissions of tissue anomalies.

4. Know Your Illuminations

Can you differentiate between specular reflection and sclerotic scatter? Most practitioners vaguely remember learning about illuminations, but the specifics have developed cobwebs over time. Most of us perform SLE under a somewhat automated mode. We constantly switch from one type of illumination to another without realizing it.

A review of illuminations may be helpful in reminding us of those used less frequently but with inherent advantages. Table 1 offers a quick overview of different illuminations and which structures are best viewed under these illumination techniques. Some slit lamp models have the ability to tilt the illumination column (towards the patient) up to 20 degrees (in 5 degree increments). This oblique illumination is useful in reducing reflections during gonioscopy. In modern slit lamps, manufacturers have replaced most tungsten type bulbs, which have a redder light, with more efficient halogen illumination, which provides a bluer light. Fluorescein is also useful in performing the Seidel test, which identifies aqueous leaking.

5. Enhance Your View

Adding ophthalmic dyes to your SLE will improve your diagnostic evaluation. Sodium fluorescein highlights areas of corneal stress while lissamine green is best at highlighting conjunctival problems. Better tolerated than rose bengal, lissamine green is observed in white light and provides additional insight for patients presenting with dry eye symptomology or CL intolerance.

Document staining, noting the form, depth and extent. The shape of staining can be micropunctate (resembling small dots), macropunctate (larger dots) or coalescent staining (a patch). Its depth can be limited to the epithelium or it may enter the stromal layers. You can approximate the extent in percentage of the surface area affected by the staining. Improving your documentation of staining will facilitate your observation for any progression or regression at follow-up visits.

Table 2
Effect of Magnification on Field of View*
MAGNIFICATION	FIELD OF VIEW
6X	35.1mm
10X	22.5mm
16X	14.1mm
25X	8.8mm
40X	5.6mm
* Using a 12.5X eyepiece

6. Filters

We perform most of a SLE using white light. When using fluorescein, use a yellow (Wratten #12) barrier filter in conjunction with a cobalt (blue) filter to maximize viewing of the fluorescence. Positioning the yellow barrier filter in the path of the returning light and not in the path of the incident light will enhance the contrast significantly. Newer slit lamps have integrated the yellow barrier filter in the ocular housing, as its use is becoming more commonplace.

You can use the red-free (green) filter to differentiate vascular from pigmented lesions. Blood vessels and small hemorrhages will take on a dark appearance with the use of the red-free filter, whereas pigmented lesions will remain dark. Some slit lamps can also be equipped with a neutral density filter and/or a heat-absorbing filter to increase patient comfort.

7. Magnification

Most slit lamp models offer 10X, 16X and 25X magnification, although some models extend to 40X. Most use eyepieces of 10X or 12.5X. As magnification increases, it limits the depth of focus, hence small adjustments with the joystick of the slit lamp will keep the image in sharp focus. Furthermore, increased magnification reduces the field of view (Table 2), allowing for greater detail of structures. Depending on the model, magnification drums can have specified click stops or be continuous. The continuous option, also called zoom system, has the advantage of a smoother transition with no image loss.

If upgrading your biomicroscope is not in your immediate plans, then try extending the magnification by simply purchasing an additional set of oculars (for example, 20X). Returning the magnification to the lowest setting at the end of the examination will reduce prep time for the next patient.

8. Illumination Intensity

Novice users have a tendency to use the highest illumination intensity during the entire examination. The problem is that these habits are hard to break. The examination should begin under the lowest intensity to examine external tissues and to allow the patient to adapt to the illumination, which is even more important if the patient has undergone pupillary dilation. The slit width is often decreased to examine details of ocular tissues under higher magnification. Reserve higher intensity illumination for examining details and use it for a shorter amount of time to conserve energy. You can equally reduce the slit beam height to increase patient comfort during the use of higher illumination intensity.

9. Viewing Angle

During most of the SLE, the observation arm of the slit lamp is directly in front of the patient. You can move the illumination arm to obtain different illumination angles to assess different tissues. Large illumination angles allow you to determine the depth of corneal and lenticular lesions with greater accuracy because the distance between layers of these tissues is increased under these conditions.

To increase the distance between layers even further, make the illumination angle even larger. One way of achieving this is to displace the observation arm from its habitual central position to a more nasal one while extending the illumination column more temporal (Figure 2b). This will enhance your view of the individual layers of the cornea or lens and allow you to determine the depth of lesions with enhanced accuracy.

10. Measuring Eyepiece

Practitioners have traditionally made a subjective evaluation of the height and width of lesions, nevi, staining, meniscus and neovascularization. A measuring eyepiece or graticule can replace a traditional eyepiece to considerably improve this measurement. The eyepiece has a linear and an angular scale, the latter being useful for evaluating toric lens rotation with improved accuracy. With the advent of ocular photography, many offices photograph lesions to properly document problems and to allow for future comparisons. If this capability isn't available in your office, then a measuring eyepiece may considerably enhance your documentation. You can subsequently store the eyepiece for safekeeping and future use.

Final Pearls

SLEs are dynamic. You should have one hand on the joystick and the other available to adjust the illumination arm, magnification, lighting intensity, slit width or even to hold an accessory instrument.

Locking your biomicroscope following examination will prevent unnecessary swinging and possible damage to the mechanics of the slit lamp during positioning towards or away from the patient. Using a dust cover over the slit lamp at the end of the day will help protect your investment.

Knowing the different options (filters; illumination width, height and intensity; magnification) your slit lamp has to offer, coupled with proper maintenance, will ensure a high image quality and help you perform a more efficient SLE. 

Interesting Article About Eye Health

Our eyes, like the rest of us, inevitably change with time. And almost everyone is going to need some help seeing the computer screen or the morning paper as middle age rolls around.
Other problems can be prevented, stalled or fixed if you get the proper medical attention and take care of your vision, experts say.
Too many people wait until they fail the vision test when they go to renew their driver’s licenses before seeking help, said a professor of clinical optometry.

“People are living longer, so they need to use their eyes longer. If we look at World War II (population) statistics and project those onto baby boomers, we’re going to see a doubling in the rates of legal blindness,” .
“The sad thing is, it’s preventable. Don’t wait until your vision is blurry. Come on in.”
After age 65, people need a dilated eye exam once a year.

   “There are changes that take place in the eyes and all of the tissues around the eyes that occur with aging,” said  an ophthalmologist. “Eyelids become more puffy, more droopy, and they may not make good contact with the eye. Eyes become drier with time.”

   On top of that, a muscle inside the eye that controls the focusing mechanism weakens over time (hence the reading glasses or bifocals), and the lens starts to turn cloudy, leading to cataracts.

   “If you live a normal-length life, you will develop cataracts,”. Most people have cataract surgery around age 71.

   Cataract surgery used to be much more complex, and patients were prone to infections and had to wear thick glasses after surgery. Now, most people do well with a quick operation in which their clouded lens is replaced with an artificial lens.

   Common cataract symptoms include trouble seeing at night or while driving in the rain, seeing halos around lights and needing more light to read.

   Annual eye exams are important for a number of reasons, particularly for screening for glaucoma, which does not have any symptoms. Those with glaucoma, cataracts or macular degeneration might need to be seen more frequently.

   Besides scheduling an annual exam with an optometrist or ophthalmologist, people can help protect their vision by wearing sunglasses that guard against ultraviolet rays, avoiding cigarettes and living a generally healthy life.

   “I tell patients: ‘Try to adhere to good general health practices. Control your blood sugar, control your blood pressure, control your cholesterol. Take a multivitamin usually. Do not smoke,’”.

   Protection from the sun helps prevent and slow the development of cataracts and macular degeneration, a disease of the center of the retina that can lead to blindness.

   Treatment for macular degeneration has come a long way. “There used to be very little we could do except diagnose it early.”

   Now, eye doctors understand that nutritional supplements, including antioxidants and lutein, can slow the progression of dry macular degeneration, in which the retina wastes away.

   In the rarer and more-severe form, which is called wet macular degeneration, new blood vessels form, impairing vision. Doctors can inject a cancer drug  to stop the growth of blood vessels.

   The procedure often has to be done repeatedly and is costly and burdensome, but “ the alternative is to go totally blind,”.

   Other potentially blinding diseases that increase with age are diabetic retinopathy (caused by a thickening of the arteries and high blood pressure) and glaucoma, a condition in which fluid pressure inside the eye increases because of slowed drainage from the eye.

   “Particularly with diabetes or glaucoma, the treatment goal is to keep it from getting worse, but you can’t get vision back once it’s gone,” .

   Good control of diabetes is the key to preventing diabetic retinopathy, or stalling the disease once it has already shown up, he said.

   Glaucoma can be found early only through pressure tests and by examining the optic nerve to see if there’s change over time. People with high blood pressure, heart disease or diabetes are at higher risk of developing the disease, as are African-Americans and Latinos.

   Glaucoma can be treated with drops, but if they don’t control the pressure, a doctor might recommend a laser procedure or surgery.

 A 66-year-old , was in for his annual eye exam a few years ago and learned that the pressure was up in both eyes. He went to an ophthalmologist and found out he had a precursor to glaucoma. Now, eyedrops are preserving his vision.

   “I don’t know of any family history, so it caught me by surprise,”.

   More primary-care physicians should do vision screening and talk about risks with patients. Even just reminding patients that they should go to an eye-care provider could help, he said.

   “They could very well be wearing glasses they got 15 years ago.”


 Age and eyes

   Age-related macular degeneration damages sharp, central vision. It’s the leading cause of vision loss in older adults.

   PARTS OF THE EYE

   Cornea: clear, outer layer of the focusing system at the front of the eye

   Iris: colored part of the eye that regulates amount of light that enters the eye

   Pupil: opening at the center of the iris, which adjusts to control the amount of light that enters.

   Lens: clear part behind the iris that helps to focus light and images on the retina

   TYPES OF DEGENERATION

   If you notice symptoms of age-related macular degeneration, contact an eye-care professional to schedule a dilated-eye exam.

   WET

   What it is: Abnormal blood vessels behind the retina grow under the macula and leak blood and fluid, which can displace and damage the macula.

   What you see: Straight lines appear wavy.

   Retina: light-sensitive tissue lining the back of the eye; converts light into electrical signals for the brain

   Optic nerve: millions of bundled nerve fibers that transmit signals from the retina to the brain

   Macula: sensitive area at the center of the retina that gives central vision

   Fovea: macula’s center that gives the sharpest vision

   DRY

   What it is: Cells in the macula break down gradually, causing blurred central vision in the affected eye. Yellow spots under the retina, known as drusen, are detected; it occurs in stages.

   What you see: As it progresses, a blurred spot might appear and grow in the center of vision; extra light might be needed to focus; faces can be difficult to recognize.

Sources: Columbus Dispatch Article 03/01/12
Sources: National Eye Institute; National Institutes of Health; American Academy of Opthalmology

What is a Slit Lamp...History of a Slit Lamp...iBEX LED Slit Lamps

What is a Slit Lamp

The slit lamp is an instrument consisting of a high-intensity light source that can be focused to shine a thin sheet of light into the eye. It is used in conjunction with a biomicroscope. The lamp facilitates an examination of the anterior segment, or frontal structures and posterior segment, of the human eye, which includes the eyelid, sclera, conjunctiva, iris, natural crystalline lens, and cornea. The slit-lamp examination provides a stereoscopic magnified view of the eye structures in detail, enabling anatomical diagnoses to be made for a variety of eye conditions. An additional hand-held lens is used to examine the retina.[1]

History of a Slit Lamp

To fully understand the development of the slit lamp one must consider that with this invention and its improvements, it had to be accompanied by the introduction of new examination techniques. Two conflicting trends emerged in the development of the slit lamp. One trend originated from clinical research and aimed at an increase in functions and the introduction and application of the increasingly complex and advanced technology of the time. The second trend originated from ophthalmologic practice and aimed at technical perfection and a restriction to useful methods and the applications of the instrument. The first man credited with developments in this field was Hermann Von Helmholtz (1850) when he invented the ophthalmoscope.

In ophthalmology and optometry, the term “slit lamp” is the most commonly referred to term however it would be more correct to call it the “slit lamp instrument”. Today’s instrument however is a combination of two separate developments in instruments. The two developments are the corneal microscope and that of the slit lamp itself. Though the slit lamp is a combination of these two developments, the first concept of the slit lamp dates back to 1911 credited to Alvar Gullstrand and his “large reflection-free ophthalmoscope.” The instrument was manufactured by the company Zeiss and consisted of a special illuminator that was connected by a small stand base through a vertical adjustable column. The base was able to move freely on a glass plate. The illuminator employed a Nernst glower which was later converted into a slit through a simple optical system. However, the instrument never received much attention and the term “slit lamp” did not appear and any literature again until 1914.

It wasn’t until 1919 that several improvements were made to the Gullstrand slit lamp made by Vogt Henker. First, a mechanical connection was made between lamp and ophthalmoscopic lens. This illumination unit was mounted to the table column with a double articulated arm. The binocular microscope was supported on a small stand and could be moved freely across the tabletop. Later, a cross slide stage was used for this purpose. Vogt introduced Koehler illumination, and the reddish shining Nernst glower was replaced with the brighter and whiter incandescent lampSpecial mention should be paid to the experiments that followed Henker’s improvements in 1919. On his improvements the Nitra lamp was replaced with a carbon arc lamp with a liquid filter. At this time the great importance of color temperature and the luminance of the light source for slit lamp examinations were recognized and the basis created for examinations in red-free light.

In the year 1926, the slit lamp instrument was redesigned. The vertical arrangement of the slit projector (slit lamp) made it an easy to handle instrument. For the first time, the axis through the patient’s eye was fixed at a common swiveling axis. This was a fundamental principle that was adopted for every slit lamp instrument developed. A limitation still with the instrument was it lacked a coordinate cross-slide stage for instrument adjustment but only a laterally adjustable chin rest for the patient. The importance of focal illumination had not yet been fully recognized.

In 1927, stereo cameras were developed and added to the slit lamp to further its use and application. In 1930, a man named Rudolf Theil presented the further development of the slit lamp was encouraged by a company named Goldmann. Horizontal and vertical co-ordinate adjustments were performed with three control elements on the cross-slide stage. The common swivel axis for microscope and illumination system was connected to the cross-slide stage, which allowed it to be brought to any part of the eye to be examined. A further improvement was made in 1938. A control lever or joystick was used for the first time to allow for horizontal movement.

Following World War II the slit lamp was improved again. On this particular improvement the slit projector could be swiveled continuously across the front of the microscope. This was then improved again in 1950. In 1950, a company named Littmann redesigned the slit lamp again. The adopted the joystick control from the Goldmann instrument and the illumination path present in the Comberg instrument. Additionally Littmann added the stereo telescope system with a common objective magnification changer.[

In 1965, the Model 100/16 Slit Lamp was produced based on the slit lamp by Littmann. This was soon followed by the Model 125/16 Slit Lamp in 1972. The only difference between the two models was their operating distances of 100 mm to 125 mm. With the introduction of the photo slit lamp further advancements were possible. In 1976, the development of the Model 110 Slit Lamp and the 210/211 Photo Slit Lamps were an innovation by which each were constructed from standard modules allowing for a wide range of different configurations. At the same time, halogen lamps replaced the old illumination systems to make them brighter and essentially daylight quality. From 1994 onwards, new slit lamps were introduced which took advantage of new technologies. The last major development was in 1996 in which included the advantages of new slit lamp optic.[2]

How Slit Lamp excellence was created

 In 2005 iBEX LED Slit Lamps were introduced, designed and built by Appasamy & Associates in collaboration with Trevi Technology. With Appasamy’s 2500 employees and a 600+ research and development team leading the way, Appasamy and Trevi promote a creative environment where research, development, clinical testing and manufacturing work seamlessly. The work is carried out with one objective — to build performance products that enhance clinical eye exams.

With modern optical design typical of high end surgical microscopes, iBEX Slit Lamps deliver high definition observation with reduced reflections and the widest field of view. Ultimately, the user achieves improved diagnosis and less observation strain.

LED Illumination

The proprietary LED delivers the industry’s brightest and most uniform illumination. Wavelengths are full spectrum and synced to maximize anterior and posterior observation. Most importantly, heat to the patient’s eye has been reduced by nearly 80% less compared to traditional illumination, resulting in greater patient comfort during intense and prolonged observation.

EZ Shipping and Setup

We’ve made the process simple. iBEX Slit Lamps are 95% pre-assembled and shipped direct to your office by FedEx. Unpacking and installation takes 20 minutes or less.

To learn about LED Powered Slit Lamps….Contact:

Trevi Technology, Inc.
info@ibexeye.com

Certifications

References:
1.  Wikapedia
2. Wikapedia

                                                             

                                                           

How the human eye works

 The human eye is the organ which gives us the sense of sight allowing us to see and interpret the shapes, colors, and dimensions of objects in the world by processing the light they reflect or emit.  The eye is able to detect bright light or dim light, but it cannot sense objects when light is absent.

Light enters the eye

Light waves from an object  enter the eye first through the cornea, which is the clear dome at the front of the eye.  The light then progresses through the pupil, the circular opening in the center of the colored iris.

Fluctuations in incoming light change the size of the eye’s pupil.  When the light entering the eye is bright enough, the pupil will constrict or get smaller, due to the pupillary light response.

Initially, the light waves are bent or converged first by the cornea, and then further by the crystalline lens (located immediately behind the iris and the pupil), to a nodal point (N) located immediately behind the back surface of the lens.  At that point, the image becomes reversed (turned backwards) and inverted (turned upside-down).

The light continues through the vitreous humor, the clear gel that makes up about 80% of the eye’s volume, and then, ideally, back to a clear focus on the retina, behind the vitreous.  The small central area of the retina is the macula, which provides the best vision of any location in the retina.  If the eye is considered to be a type of a complex camera, the retina is equivalent to the film inside of the camera, registering the tiny photons of light interacting with it.

Within the layers of the retina, light impulses are changed into electrical signals.  Then they are sent through the optic nerve, along the visual pathway, to the occipital cortex at the posterior (back) of the brain.  Here, the electrical signals are interpreted or seen by the brain as a visual image.

Actually, then, we do not see with our eyes but, rather, with our brains.  Our eyes merely are the beginnings of the visual process.

myopia, hyperopia, astigmatism

When  the incoming light from a far away object focuses before it gets to the back of the eye, that eye’s refractive error is called “myopia” (nearsightedness).  When incoming light from something far away has not focused by the time it reaches the back of the eye, that eye’s refractive error is “hyperopia” (farsightedness).

In “astigmatism,” one or more surfaces of the cornea or lens (the eye structures which focus incoming light) are not spherical (shaped like the side of a basketball) but, instead, are cylindrical or toric (shaped a bit like the side of a football).  As a result, there is no distinct point of focus inside the eye but, rather, a smeared or spread-out focus.  Astigmatism is the most common refractive error.

presbyopia

After age 40, and most noticeably after age 45, the human eye is affected by presbyopia.  This natural condition results in greater difficulty maintaining a clear focus at a near distance with an eye which sees clearly far away.

Presbyopia is caused by a lessening of flexibility of the crystalline lens, as well as to a weakening of the ciliary muscles which control lens focusing.  Both are attributable to the aging process.

An eye can see clearly at a far distance naturally, or it can be made to see clearly artificially, such as with the aid of eyeglasses or contact lenses, or else following a photorefractive procedure such as LASIK (laser-assisted in situ keratomileusis).  Presbyopia eventually will affect the near focusing of every human eye.

eye growth

The average newborn’s eyeball is about 18 millimeters in diameter, from front to back (axial length).  In an infant, the eye grows slightly to a length of approximately 19½ millimeters.

The eye continues to grow, gradually, to a length of about 24-25 millimeters, or about 1 inch, in adulthood.  A ping-pong ball is about 1½ inch in diameter, which makes the average adult eyeball about 2/3 the size of a ping-pong ball.

The eyeball is set in a protective cone-shaped cavity in the skull called the “orbit” or “socket.”  This bony orbit also enlarges as the eye grows.

extraocular muscles

The orbit is surrounded by layers of soft, fatty tissue.  These layers protect the eye and enable it to turn easily.

Traversing the fatty tissue are three pairs of extraocular muscles, which regulate the motion of each eye: the medial & lateral rectus muscles, the superior & inferior rectus muscles, and the superior & inferior oblique muscles.

eye structures

Several structures compose the human eye.  Among the most important anatomical components are the cornea, conjunctiva, iris, crystalline lens, vitreous humor, retina, macula, optic nerve, and extraocular muscles.

IBEX LED SLIT LAMPS #1 SELLING SLIT LAMP

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Don’t let the low price fool you! After years of researching, developing and clinical testing, this slit lamp is built to perform!
Check out the latest reviews –
“When I first looked through the iBEX Slit lamp, I noticed the brighter, truer color of the LED light source immediately. This has made a big difference for me, especially on my anterior segment photography. It really is apparent when I look back at the more yellow colors of the pictures on my previous slit lamp. The next thing I noticed was the superior optics and easy binocularity, even in the higher magnifications.” Dr. Michael Raies		“The iBEX 2 Step Led Slit Lamp offered a view of the cornea I was not prepared for. The light source, and optical quality combination allowed me to see each layer of the cornea, better than any of my other slit lamps in the office. I kept finding myself moving patients to the lane with the Ibex, when i needed a more accurate view of the anterior segment”. Dr. Patrick Dollenmayer
Contact us today at info@trevitechnology.com to get your exam room the slit lamp it needs. Visit our web site to learn more why you should be examining your patients using the iBEX LED Slit Lamps at: www.trevitechnology.com

iBEX LED Slit Lamps

iBEX LED Slit Lamps

With modern optical design typical of high end surgical microscopes,
iBEX LED Slit Lamps deliver high definition observation with reduced reflections and the widest field of view.
Ultimately, the user achieves improved diagnosis and less observation strain.

LED Illumination

The proprietary LED for iBEX Slit Lamps deliver the industry’s brightest and most uniform
illumination. Wavelengths are full spectrum and synced to maximize anterior and posterior observation.
Most importantly, heat to the patient’s eye has been reduced by nearly 80% less compared to traditional illumination, resulting in greater patient comfort during intense and prolonged observation.

EZ Shipping and Setup

We’ve made the process simple. Ibex slit lamps are 95% pre-assembled and shipped direct to your office by FedEx.Unpacking and installation takes 20 minutes or less.




www.iBEXeye.com

We provide Optometrist and Ophthalmologist with an efficient and pleasant alternative to traditional purchasing and distribution of their new eye exam slit lamps.
 Our website is fast, informative and straightforward so that you can access product detail 24/7 –
even purchase products online.

reviews of advantages of a using a iBEX LED Slit Lamp

Check out these awesome reviews we are getting about the advantages of a using an iBEX LED Slit Lamp.....

Better for Slit Lamp Imaging
Oct 07, 2011 

    When I first looked through the iBEX Slit lamp, I noticed the brighter,
truer color of the LED light source immediately. This has made a big difference
 for me, especially on my anterior segment photography. It really is apparent
when I look back at the more yellow colors of the pictures on my previous slit lamp.
    Then next thing I noticed was the superior optics. Great quality and easy
binocularity …even in the higher magnifications.

    The other advantage of the iBEX slit lamp doesn’t happen in the exam room.
It happens when I’m on the phone. The customer service at Trevi Technology is second
 to none. These guys CARE about what they are doing. Sure, they make a great product, but
they also want to make a difference for the practitioner and the patient as well. Just read
their mission statement and you’ll see what I mean. Genuine guys you can trust. – Dr. Michael Raies, Portsmouth, OH


NEW Slit Lamp Outstanding!

Jun 18, 2011 

    Amazing quality slit lamp and a pleasure to work with this company


Beautiful

Jun 14, 2011 

    Beautiful Slit Lamp. Great Price & Great Packaging. Thanks!!




iBEX 2-Step Slit Lamp by iBEXeye.com

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2-Step LED Slit Lamp

View of the Cornea Excellent

Sep 26, 2011 

    The iBEX 2 Step Led Slit Lamp offered a view of the cornea I was not prepared for.
The light source, and optical quality combination allowed me to see each layer of the cornea,
 better than any of my other slit lamps in the office. I kept finding myself moving patients to
 the lane with the Ibex, when i needed a more accurate view of the anterior segment. A keeper in
our office for sure, I recommend the iBEX Led Slit Lamp without reservation. – Dr. Patrick Dollenmayer, Columbus Ohio