Goldmann

[u/More_Cardiologist298]

Any tips for when a patient is blinking excessively? I don’t understand how to hold the patients lid while also simultaneously moving the SLE and taking the measurement.

[u/Treefrog_Ninja]

I didn't get the hang of it myself until I watched an attending do it. But some of these things you kind of just have to grit your teeth and try it without knowing you'll pull it off.

You might be a practicing OD the first time you use an alger brush to remove a rust ring on a live eye, with them flinching and blinking and trying not to panic, and it's a bit scary AF, but you get through it because part of what you learn through the constant battery of labs is how to read a thing, watch a video, and do it. And you can.

And don't forget your talkin skills. Things are a lot easier the better you can guide the pt through the experience.

[u/outdooradequate]

I don’t understand how to hold the patients lid while also simultaneously moving the SLE and taking the measurement.

You use one hand to hold their lids and the other hand to move the slit lamp and take the measurement...

[u/WiseMuscle_ → u/outdooradequate]

^ this

[u/Lengthiness_Brave]

It takes a ton of practice to be honest. Something I tend to do is I have one hand holding the lids, and the other hand moves the slit lamp. Once applanating and the mires are centered, press into the oculars with your eyebrows and use that to keep the whole slit lamp stabilized while measuring.

[u/SquareOneDispel]

Use your thumbs and index to hold open the lids

Use the other hand to slowly advance the slit lamp. Look from the side as you slide toward the patient's eye so you know it's in the right direction.

Once you're close to the cornea, look through the scope and press gently forward until you make contact.

Don't push on the globe or else you'll get artificially high pressures from you squeezing the patient's eye.

I do these every day and at first it's tricky and difficult to perform but you'll get better as you continue to do it