List of instruments used in ophthalmology

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This is a list of instruments used in ophthalmology. [1]

Contents

Instrument list

A complete list of ophthalmic instruments can be found below:

InstrumentUses
Toric Marker to mark 0 to 180 degree reference mark for Toric IOL implant
Pre-chopper to chop lens into pieces before implantation new lens and reduce phaco time
Spectacles (glasses)to correct refractive errors of the eye; not invasive
Contact lenses to correct refractive errors of the eye; a little invasive
Phoropter used in refraction testing
Tonometers used to determine the intraoccular pressure (IOP) - useful in glaucoma; video link for various types of tonometers.
Speculum:to keep the eyes open during any operation
Universal eye speculum -do-; heavy instrument and can not keep eyelashes out of the operating field
•Guarded eye speculum (left and right)-do-; heavy instrument but can keep eyelashes out of the operating field with its "guard" and hence left or right ones are required
•Wire Speculumto keep the eyes open during any operation; light wire instrument
Needle holders:holding the needle in position while applying sutures
•Silcock's needle holder-do-; has a catch and is used for heavier gauge needles; used mainly for skin, muscle and corneal incisions
•Arruga's needle holder-do-; has a catch (lock) and is used for heavier gauge needles (thicker than 6–0); used mainly for skin, muscle and corneal incisions
•Barraquer's needle holder-do-; small instrument with a spring action with or without a catch used for finer gauge needles (5-0 or finer); used mainly for intraoccular incisions
Forceps:to hold anything
•Artery forceps (haemostat)medium-sized, with a serrated tip and a catch; used to hold bleeding vessels and compress them in order to make them stop bleeding and also to hold or crush structures.
•Fixation forcepshas a few teeth at the tip; for holding structures and restricting their movement or to hold small swabs
•Plain dissecting forcepsblunt untoothed with a serrated tip; for holding structures and restricting their movement or to hold small swabs
•Iris forcepsfine tipped (straight or otherwise) with small teeth; to hold the iris tissue during procedures
•Elschnig's intracapsular forcepsfine untoothed forceps for holding tissue, swabs, sutures, etc.; removing things like clots, capsule fragments, lens, etc.; used in cataract surgery
•Arruga's intracapsular forcepsfine untoothed forceps holding tissue, swabs, sutures, etc.; removing things like clots, capsule fragments, lens, etc.; used in cataract surgery
•Colibri forcepsfine toothed forceps for holding flaps of cornea or sclera and rarely the iris
•Saint Martin's forcepsholding flaps of cornea or sclera and rarely the iris
•Superior rectus holding forcepsspecially curved (to fit into the orbit of the eye) forceps for catching hold of the muscle bellies of the intraorbital muscles and sutures
•Suture tier forcepsfine limbed untoothed forceps to hold fine sutures or hairs
•Capsulotomy forcepsto tear the anterior capsule of the lens during cataract surgery
•Disc holding forcepsused in glaucoma surgery (obsolete)
•Capsulorhexis forcepsfine sharp-tipped untoothed forceps for doing a continuous curvilinear incision and removal of the anterior capsule of the lens ("continuous curvilinear capsulorhexis - ccc")
•MacPherson's forcepsfine sharp-tipped untoothed forceps with an angulation for holding parts of the lens, the intraocular lens, 10-0 (very fine) sutures, etc.
•Chalazion forceps (clamp)self-retaining with discoid ends; used to hold and prevent a chalazion from bleeding during its surgery
Diamond knife used to perform microincisions on the cornea in the Radial keratotomy and Mini Asymmetric Radial Keratotomy (M.A.R.K.)
•Epilation forceps (Cilia forceps)stout flat-ended blunt forceps with a thickened end to remove eyelashes
•Entropion forcepsself-retaining with big discoid ends used to hold and prevent an entropion from bleeding during its surgery
Chalazion scoopto remove the granulation tissue from a chalazion during surgery
Entropion clampright and left varieties exist; large clamp with two limbs; self-retaining with big discoid ends used to hold and prevent an entropion from bleeding during its surgery
Nettleship's punctum dilatorto dilate the lacrimal punctum of the lacrimal apparatus of the eye for syringing or operations
Cystotomea 26 gauge needle bent twice used for incising the anterior capsule of the lens in lens extraction
Wire vectisa loop of wire attached to a stack used to extract cataract affected lenses
Irrigating vectisa small hollow instrument with a used to introduce fluid into the anterior chamber to raise its pressure to aid cataract extraction [2]
Canula used to carry fluid
•Irrigation-aspiration two-way canulaeffectively two small canulae fitted together, one to introduce fluid and the other to extract the cortical materials, blood, etc. in eye operations
•Lacrimal canulasmall curved canula the size of a syringe needle used to introduce fluids or drugs into the nasolacrimal passage to test its patency or during surgery (dacrocystography, dacrocystectomy, dacryocystorhinostomy(DCR), etc.
Lang's lacrimal dissector with scoopfor blunt dissections and cleaning during operations like dacryocystorhinostomy
Rougine dissection of lacrimal sac
Retractor to pull and hold overlying tissue out of the operating field
•Muller's self retaining adjustable haemostatic retractor-do-; self retaining haemostatic
•Cat's paw retractor-do-
•Desmarre's lid retractor-do-; specially for noncooperative patients and to see the fornices (see human eye)
Bone punchto fracture pieces from a thin bone in facial surgery and during operations like dacryocystorhinostomy
Evisceration spoon or scoopremoving all the contents of the eyeball during evisceration (complete removal of all structures within the eye in diseases like endophthalmitis
Lid plateflat large instrument that has a groove and is placed between the lid and globe of the eye to provide a solid support for eyelid surgery
Hammer, chisel and bone gougebone cutting and shaping
Bowmen's discission needlemicrosurgery of the lens capsule [3]
Knives to cut structures
•Surgical scalpel with small bladesgeneral purpose instrument
•von Graefe's cataract knifecutting out of the anterior chamber from the inside through the limbus
•Tookes' knife (Sclero-corneal splitter)making sclerocorneal tunnels in "small incision cataract surgery (SICS)" and keratoplasty
•Crescent knife (Sclero-corneal splitter)making sclerocorneal tunnels in "small incision cataract surgery"
•Angular keratomemaking sclerocorneal tunnels in "small incision cataract surgery"; larger one used to increase the size of the incision
•Side-port blademaking sclerocorneal "side port" (a secondary tunnel) tunnels in "small incision cataract surgery"
•Beer's knifeincise the conjunctiva or the eyelid skin
•Keratotomesmall triangular blade with two sharp edges used to incise the limbus (sclerocorneal junction)
•Zeigler's knifevery tiny knife for intaoccular maneuvers specially when space is less
Scissors-
•Conjunctival sac scissorsflat small curved scissors to cut the conjunctive
•Corneal spring scissorsmedium spring-open used to cut the external side of the cornea, fine sutures; iris, etc.
•de' Wecker's iris scissorssmall slender spring-open scissors for intraoccular maneuvers (iris and deeper and more delicate structures); has two wings to operate it and one sharp and one blunt blade.
•Vannas' scissorssmall slender spring-open scissors for intraoccular maneuvers (iris and deeper and more delicate structures); has two wings to operate it and one sharp and one blunt blade.
•Enucleation scissorsthick scissors used to cut the optic nerve in enucleation operation
Bowman's lacrimal probeprobing the nasolacrimal duct
Lens expressorused to force out the lens in extracapsular or intracapsular cataract extraction
McNamar's spoonused to force out the lens in intracapsular cataract extraction
Iris repositortwo limbed instrument used to remove the iris during posterior chamber maneuvers
Sinsky's hook intraocular lens diallerangulated round hook with a handle used in insertion of an intraocular lens
Strabismus hookmuscle hook or squint hook; sharp tip or knobbed tip; used in squint surgery
Foreign body spud and needleSpud to remove superficial and needle for the deep foreign bodies in the eye
Elliot's trephine with handleused in corneal donation (eye donation) to cut out the cornea in a circular fashion
Castroveijo's calipersvarious measurements are taken
Castroveijo's corneal trephineused in corneal donation (eye donation) to cut out the cornea in a circular fashion
Pin-holetesting visual acuity
Red green goggles(red - right side & green - left side) used in Worth 4 dot test, diplopia testing
Prisms to measure the degree of squints; in other instruments; refractive correction; etc.
Placido's discto assess the condition of the corneal surface
Retinoscope objective determination of refractive error and for looking inside the eye
Loupeused to search for magnified examination of the anterior segment of the eye (uniocular or binocular)
Jackson's cross cylinderused to check the power and axis of a cylindrical lens
Maddox rodused to test for latent squint and retinal function
Refraction boxhas lenses of different powers for refraction testing
Slit lamp bio microscopeused for examining the anteriorly placed structures the eye; video link
Charts for vision -
•Distant vision to determine visual acuity of distant vision
••Snellen's distant vision chart -do-; for those who can read in English
••Regional language charts-do-; for those who can read in their local language
••E Chart -do-; for those who can not read
••Landolt's broken ring chart -do-; for those who can not read
••Toys pr picture chart-do-; for children
•Near vision -do-; to determine visual acuity of near vision
••Jager's chart-do-
••Printer's types of N series-do-
••Snellen's near chart (1/17th reduction of distant chart)-do-; standard chart of alphabets; video link
•Colour vision:to test colour vision
••Ishihara's chart to determine the type of colour blindness
Stenopaeic slit detection of axis of the cylindrical (astigmatism) power of the eye; glaucoma testing
Implants -
•Intraocular lens prosthetic lenses implanted after lens (anatomy) removal
•Artificial eyesas non-functional cosmetic implants into the eye socket
Blade breakerto break disposable blade after use to prevent reuse
Thermo-cautery to coagulate blood vessels and prevent haemorrhage
Cryoprobe to freeze and extract the lens
Yttrium aluminium garnet laser (YAG laser)to correct posterior capsular opacification (specially after removal of a cataract, if required), peripheral iridotomy, retinal surgery, laser-assisted sub-epithelial keratectomy (LASEK) [4] etc.
Electrolysis used for permanent hair removal
Electrocautery for electrosurgery
Phacoemulsification used for extraction of a cataract affected lens after emulsifying it using a high frequency (energy) ultrasound probe [5]

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An artificial iris is an intraocular implant that is used as both a cosmetic and to treat those with aniridia or other eye trauma. People with this condition experience photophobia, or increased sensitivity to light. The artificial iris, made from silicone, acts as a replacement iris. The artificial iris is implanted in the eye using different surgery techniques depending on the patient's eye trauma. Most of the major artificial iris manufacturers are European and the treatment is used sparingly in the United States because of limited FDA approval, in part due to possibility of vision loss and other risks.

Manual small incision cataract surgery (MSICS) is an evolution of extracapsular cataract extraction (ECCE); the lens is removed from the eye through a self-sealing scleral tunnel wound. A well-constructed scleral tunnel is held closed by internal pressure, is watertight, and does not require suturing. The wound is relatively smaller than that in ECCE but is still markedly larger than a phacoemulsification wound. Comparative trials of MSICS against phaco in dense cataracts have found no difference in outcomes but MSICS had shorter operating times and significantly lower costs. MSICS has become the method of choice in the developing world because it provides high-quality outcomes with less surgically induced astigmatism than ECCE, no suture-related problems, quick rehabilitation, and fewer post-operative visits. MSICS is easy and fast to learn for the surgeon, cost effective, simple, and applicable to almost all types of cataract.

References

  1. ↑ Ophthalmology Oral & Practical 3rd edition, by Dr. Danesh ISBN   81-86793-66-6
  2. ↑ Irrigating vectis – Patent 4479802
  3. ↑ Billson FA, Thurgood R, Perriam DJ (December 1975). "Discission needle". Br J Ophthalmol. 59 (12): 741. doi:10.1136/bjo.59.12.741. PMC   1017447 . PMID   1218187.
  4. ↑ US FDA/CDRH: LASIK – Learning About LASIK Archived 2004-11-20 at the Wayback Machine
  5. ↑ Untitled Document
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