Limitations of Slit-Lamp Examination
Some visually significant cataracts may appear minimal on slit-lamp biomicroscopy. However, examination of the lens with the retinoscope may clarify the lenticular contribution to the patient’s vision changes. By examining the retinoscopic reflex, the clinician may detect posterior subcapsular opacities, refractile nuclear changes, or even diffuse cataracts. Similarly, examination using the direct ophthalmoscope through a + 10.00 D lens at a distance of 2 ft will enhance the portions of the cataractous lens that are producing optical aberrations. This technique is particularly useful for identifying oil droplet cataracts.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.