A comprehensive approach to biomicroscopic vitreous examination.

We recommend a biomicroscopic vitreous examination that combines an anterior vitreous examination done without using a neutralizing lens and a posterior vitreous examination using the high-power (low-magnification) double aspheric positive preset lens. When detailed observation of the posterior and peripheral vitreous are required, we also recommend the additional use of a low-power (high-magnification) double aspheric preset lens and the Goldmann three-mirror lens. Details of the anterior vitreous can be examined best without using a neutralizing lens and those of the posteror vitreous, by using the low-power double aspheric preset lens. The high-power double aspheric preset lens provides a wider field of view and more accessibility when the patient has small pupils and cataracts than the low-power double aspheric preset lens. The peripheral vitreous is best observed using a Goldmann three-mirror lens. We believe the method we describe can serve as a guide for a comprehensive clinical biomicroscopic vitreous examination.