Ophthalmology Instruments: Parts And Its Uses
1. Two Way Aspiration and Irrigation Cannula
MARKINGS:
- This is a two way cannula, one end of which is attached to a blunt needle via a silicone tube and this end is fitted with the irrigation or infusion system.
- Two way cannula is itself fitted with a 2ml or 5ml syringe for aspiration
- Therefore, it is called a two way aspiration and irrigation cannula.
USES:
- For simultaneous irrigation and aspiration of cortical materials in case of Extracapsular Cataract Extraction (ECCE) or Extracapsular Cataract Extraction (ECCE)with Posterior Chamber Intraocular Lens (PCIOL).
- To remove viscoelastic material after insertion of IOL
- Can also be used to remove blood in hyphema.
2. Chalazion Clamp
MARKINGS:
- It has a large visible screw, which is used for fixing the lid by the means of tightening
- It has serrations which is used to hold with a better grip.
- Ring side which is applied towards the conjunctiva as you can see in this picture.
- Then there is, Solid Plate which is applied on the skin surface of the lid.
- Encircling the chalazion the screw is tightened and the lid is everted, therefore exposing the chalazion for incision, as seen in the picture.
USES:
- To fix the chalazion for surgery and to achieve hemostasis
- For incision and curettage operation
- To give intralesional injection of steroids in chalazion after fixing it.
QUESTIONS:
- What type of incision is given during chalazion removal?
- Vertical incision
3. Chalazion Scoop
MARKINGS:
- It is a small scope which looks like a cup with sharp edges attached to a handle.
USES:
- To scoop out the granulation tissue after giving incision on chalazion, also complete scooping must be done to prevent recurrence.
4. Universal Eye Speculum
MARKINGS:
- It has a spring, two limbs and a screw to adjust the limbs.
- It is called the universal eye speculum because it can be used on either side of the right or left eye.
USES:
- It is used to separate both eyelids for good exposure of the eyeball, mainly during extraocular operations.
OPERATIONS:
- Pterygium excision
- Squint operation
- Evisceration and enucleation
- Debridement and cautery of corneal ulcer
- To give subconjunctival or sub-Tenon’s injection
- Removal of the corneal foreign body
- Removal of conjunctival cyst or mass
- During suture removal
QUESTIONS:
- What are the disadvantages of universal eye speculum?
- Ans: It has no guard and therefore eyelashes of upper lid may come in the field of operation
- Also, it is not used in intraocular operation as it can cause vitreous loss by direct pressure on the globe.
5. Guarded Eye Speculum
MARKINGS:
- It has a guard plate over here which keeps the eyelashes of the upper lid away from the field of operation, therefore two of these are required, one for the right eye and one for the left eye.
USES:
- It is used to separate both eyelids for good exposure of the eyeball, mainly during extraocular operations.
OPERATIONS:
- Pterygium excision
- Squint operation
- Evisceration and enucleation
- Debridement and cautery of corneal ulcer
- To give subconjunctival or sub-Tenon’s injection
- Removal of the corneal foreign body
- Removal of conjunctival cyst or mass
- During suture removal
QUESTIONS:
- What are the disadvantages of guarded eye speculum?
- Ans: Since it is heavier it provides more pressure on the globe
- Also, it reduces the operating field of vision.
6. Wire Speculum or Universal Wire Speculum
MARKINGS:
- It is a universal type and can be used in either eye
- Its lightweight, hence provides little pressure to the eyeball therefore, can be used in both intraocular operation and extraocular operation.
USES:
- It is used to separate both eyelids for good exposure of the eyeball, mainly during extraocular operations.
OPERATIONS:
- Pterygium excision
- Squint operation
- Evisceration and enucleation
- Debridement and cautery of corneal ulcer
- To give subconjunctival or sub-Tenon’s injection
- Removal of the corneal foreign body
- Removal of conjunctival cyst or mass
- During suture removal
7. Crescent Knife
MARKINGS:
- It has a blunt tip which beveled up, and is mounted on a plastic handle
USES:
- It is used to make sclerocorneal tunnel in manual SICS or phacoemulsification.
- It is used for lamellar dissection of the cornea in the lamellar keratoplasty.
- It is further used for suture less trabeculectomy
- It is also used to separate pterygium head from underlying corneal lamellae.
8. Angular Keratome
MARKINGS:
- It has thin diamond shaped blades with sharp apex and two cutting edges, since both sides have sharp edges.
USES:
- It is used to enter into the anterior chamber after making a sclerocorneal tunnel in manual SICS or phacoemulsification.
- Also used directly for making corneal sections in phacoemulsification.
9. BP Handle or Bard Parker Handle
MARKINGS:
- It has serrations which is used to hold with better grip.
USES:
- It is used for Abexterno corneoscleral section for cataract surgery.
- Skin incision as in Dacryocystorhinostomy (DCR), ptosis or other lid surgeries.
- To dissect the pterygium head from the cornea.
- To give incision in chalazion operations.
- For suture removal after cataract operation or keratoplasty.
10. MVR or V-lance Blades
MARKINGS:
- It has a fine straight triangular knife at the distal end having cutting edges on both sides.
USES:
- It is used to make a side port entry at the limbus.
- Also used in pars plana vitrectomy
11. Plain Forceps
MARKINGS:
- It has serrations at the tip of the forceps
USES:
As the name says its a simple and plain instrument with an ability to perform the following functions..
It is used..
- To hold conjunctiva during any surgical procedure
- To tie sutures
- To hold skin during eyelid surgery
- To hold nasal scleral flap in trabeculectomy
12. Superior Rectus Holding Forceps
MARKINGS:
- It is S shaped
- And has teeth at the tip
- It has serrations which is used to hold with better grip.
USES:
- It is used to hold conjunctiva to catch the superior rectus muscle belly for passing stay (briddle) sutures, as it helps to rotate the eyeball and fixed downwards in cataract, glaucoma and other surgery.
- It is also used to catch the inferior rectus muscle as in keratoplasty.
13. Artery Forceps
MARKINGS:
- It has a serrations at the tip
- It also has a catch
- It may be straight or curved
- Therefore, this is a medium sized fully serrated forceps with catch.
USES:
- To hold lid stitches and superior rectus stitch, and then to fix the suture ends with a head towel.
- To crush lateral canthus in lateral canthotomy
- To make irrigating cystitome from a 26 gauge needle
- To hold lacrimal sac prior to excision in Dacryocystectomy (DCT)
- For hemostasis during Dacryocystorhinostomy (DCR) or Dacryocystectomy (DCT)
14. Iris Forceps
MARKINGS:
- It has teeth at the tip
USES:
- It is used to catch the iris for the purpose of iridectomy during operation of cataract, glaucoma, optical iridectomy
- Excision for iris prolapse, tumors and foreign body
15. Wire Vectis
MARKINGS:
- It has a narrow limb
- Narrow limb is attached to the handle
- It has a wire loop at the tip, and appears as a hollow spoon
USES:
- To remove subluxated or dislocated lens
- To deliver nucleus in Extracapsular Cataract Extraction (ECCE) with irrigating vectis
16. IOL Holding Forceps
MARKINGS:
- It has a blades at the tip
- It is a spring action forceps with short blunt and curved blade with smooth edges.
USES:
- To hold optic of non-foldable PMMA IOL during implantation.
17. Sinskey Hook
MARKINGS:
- It is an angular fine hook attached to a long round solid handle.
USES:
- Used to dial the Polymethyl Methacrylate (PMMA) non-foldable IOL for proper positioning in the capsular bag.
- To manipulate the nucleus in phacoemulsification surgery