My digital video slit lamp

As practitioners, we have come to rely on this technology for detection, monitoring and education of posterior pole conditions. But are patients being disadvantaged if we don’t give their anterior eye complaints the same attention?

I started using a digital video slit lamp in 2020, and am still finding new ways to utilise its full range of capabilities. The system can capture still images and record video clips, which are easily reviewed and manipulated within its software. With some practice, it has become quick and simple to integrate into my usual slit lamp routine. I’m predominantly using the digital slit lamp to document and monitor anterior eye conditions and for troubleshooting contact lens issues, but it can also take really good retinal images through a Volk lens.

I started using a digital video slit lamp in 2020, and am still finding new ways to utilise its full range of capabilities

Patient engagement and progress

For me, the biggest advantage of using a digital slit lamp has been patient engagement. Nothing beats showing a patient an image of their own eye to explain their condition and why we are recommending a treatment, or perhaps why their contact lens isn't performing as expected. The images and videos are impressive, and are typically more familiar to a patient than a retinal photograph. Having a recognisable, personal image to reference makes explaining what is normal or potentially abnormal easier for them to understand. The more we can help them understand, the more likely they are to be receptive to our advice and to act on our recommendations.

Having a digital slit lamp also gives me the ability to record an accurate baseline and to monitor progress pictures at subsequent visits. This can be particularly useful with conditions like blepharitis. Here the patient gets to see first-hand the difference any management plan is making, which has been great at keeping patients motivated to continue with their treatment. It can also highlight to them a lack of improvement with poor compliance, or when a different management strategy may be needed.

In a similar way, taking a few moments to record a video of a toric soft contact lens swinging off axis can very simply demonstrate to a patient why they’re experiencing intermittent blur. Having this available allows them to appreciate why we may recommend a new fit or upgrade and why this could alleviate their symptoms.

The patient gets to see first-hand the difference any management plan is making, which has been great at keeping patients motivated to continue with their treatment

Referrals, handovers and education

They say a picture is worth a thousand words, and this is certainly the case with digital slit lamp images. The captures are clear and detailed and are stored for comparison at future visits. This level of documentation feels much more accurate and watertight than written notes and drawings. This can be particularly useful if the patient is seen by another practitioner for follow up appointments.

Within the software, areas of interest on the images can be magnified, measured and analysed, meaning small, subtle changes are more easily identified and acted upon. We have more confidence in monitoring these patients and when necessary can provide better quality, more timely referrals. The images taken also create a great educational resource. Not only for patients, but also for in-house training.

For a patient who otherwise only sees a very bright light during a slit lamp exam, it opens up a whole new understanding of their eye health

In truth, a digital slit lamp doesn’t show me anything through the eyepiece that an ordinary slit lamp couldn’t. However, for a patient who otherwise only sees a very bright light during a slit lamp exam, it opens up a whole new understanding of their eye health and creates a real ‘wow’ moment in a consultation.

Discussing the images with patients has helped to better educate and inform them of their conditions, keep them on track with treatments, and retain them for ongoing care and product purchases. I’ve come to rely on the digital slit lamp in the same way as retinal imaging and OCT, and my patients have come to expect it as part of a comprehensive, advanced examination.