INSTRUMENTS
STRIPS
FLUORESCENT STRIP
• 2 % Fluorescein Sodium Dye
• Examined under Cobalt-Blue Filter of Slit Lamp
• USES:
(1) LACRIMAL TESTING
1. DRY EYE:
-Tear film Break-up Time (TBUT)
2. WATERING EYE:
-Fluorescein Dye Disappearance Test (FDDT),
-JONE’S DYE TEST
(2) DETECTION OF CORNEAL EPITHELIAL DEFECTS
(3) DETECTION OF PENETRATION OF CORNEA : SEIDEL’S TEST
(4) GOLDMANN APPLANATION TONOMETRY
SCHIRMER’S STRIP
• 5 × 35 mm strip of Whatman-41 filter paper
• Schirmer test: It measures tear secretions
Schirmer 1 : WITH anaesthetic : measures BASELINE secretion
Schirmer 2 : WITHOUT anaesthetic : measures BASELINE & REFLEX secretion
• Strip is folded at 5 mm from one end and kept in the lower fornix at the
junction of lateral one-third and medial two-thirds.
• The patient is asked to look up and not to blink or close the eyes.
• After 5 minutes, wetting of the filter paper strip from the bent end is
measured.
• Normal : more than 15 mm.
• Mild to Moderate keratoconjunctivitis sicca (KCS) : 5–10 mm
• Severe KCS : less than 5 mm
REFRACTION
LENSES
• SPHERICAL LENS : POWER IN BOTH AXES
• CYLINDRICAL LENS : POWER IN ONE AXIS
• CONCAVE LENS : WITH MOVEMENT OF
LENS, MOVEMENT OF OBJECT IS IN SAME
DIRECTION, MINIFIED
• CONVEX LENS : WITH MOVEMENT OF
LENS, MOVEMENT OF OBJECT IS IN
OPPOSITE DIRECTION, MAGNIFIED
PIN HOLE
• Black Opaque Disc with central pinhole of 1 mm diameter
• PRINCIPLE:
Pinhole cuts off all peripheral rays and allows only the central
undeviated rays of light to pass through along the principal axis of
eye and thereby, helps perceive a clear image.
• USES:
1. If patient’s vision IMPROVES with PH: Uncorrected Refractive Error
2. If patient’s vision DOESN’T IMPROVE with PH:
- Central Lenticular Opacity occupying pupillary area
- Macular Pathology
PLANE MIRROR RETINOSCOPE
• RETINOSCOPY : also called Skiascopy / Shadow Test
• Definition :
OBJECTIVE method of finding out the refractive error by the
method of NEUTRALIZATION
• Principle :
When light is reflected from a mirror into the eye, the direction
in which the light will travel across pupil will depend upon the
refractive state of the eye
RED & GREEN LENSES/ FILTERS
• RED IN RE, GREEN IN LE
• USES:
[Link] FOR COLOUR DISSOCIATION
[Link] FIND SUPPRESSION OF EYES
[Link] FIND DIPLOPIA
[Link] WORTH 4 DOT TEST & FRIEND TEST
[Link] MEASURE FUSION, SQUINT
CATARACT SURGERY INSTRUMENTS
IRIS REPOSITOR
• Delicate, flat, malleable, straight or bent blade
with blunt edges and tip, attached to a handle.
• Uses:
(i) To reposit the iris in the anterior chamber in
any intraocular surgery.
(ii) To break synechiae at the pupillary margin.
SIMCOE’S TWO-WAY IRRIGATION AND
ASPIRATION CANNULA
• Uses:
(i) For irrigation and aspiration of the
lens matter in ECCE
(ii) Aspiration of hyphaema.
WIRE VECTIS
• It is a wire loop attached to a metallic handle.
• Uses:
1) To remove the nucleus in ECCE
2) To remove subluxated lens and anteriorly dislocated lens
in ICCE
LENS EXPRESSOR
• USES:
(i) To express the nucleus in ECCE
(ii) It can also be used as muscle hook if the latter is not available
(iii) Also used along with wire vectis to extract the dislocated lens
(iv) In the era of ICCE, its used during the delivery of lens
SINSKEY HOOK (OR) IOL DIALER
• It is a fine but stout instrument with a bent tip.
• The tip engages the dialing holes of the IOL.
• Uses:
(i) It is used to dial the PMMA non-foldable IOL for proper positioning in the
capsular bag or ciliary sulcus.
(ii) It can also be used to manipulate the nucleus in phacoemulsification surgery.
Nucleus manipulation :
Nucleus rotation in the capsular bag
Cracking of the nucleus & feeding of the nuclear fragments to the phaco tip.
GENERAL
MUSCLE (STRABISMUS) HOOK
• Blunt guarding knob at the end to prevent muscle slippage.
• Uses:
It is used to engage the extraocular muscles during squint,
enucleation, and retinal detachment procedures.
CHALAZION CLAMP
• It consists of two limbs like a forceps, which can be clamped
with the help of a screw.
• The tip of one limb is flattened in the form of round disc while
the tip of the other arm has a small circular ring.
• Usually, the flat disc is applied on the skin side and ring on the
conjunctival side of the chalazion.
• Use:
To fix the chalazion and achieve haemostasis during the
incision and curettage operation.
CHALAZION SCOOP
• It has a small cup with sharp margins attached to a narrow handle.
• Use:
To scoop out contents of the chalazion during incision & curettage.
EVISCERATION CURETTE
• It consists of a rounded shallow cup with blunt margins
attached to a stout handle.
• Use:
To curette out the intraocular contents during evisceration.
ENUCLEATION SPOON
• It is a spoon-shaped instrument with a central cleavage.
• Use: To engage the optic nerve during enucleation.
NETTLESHIP’S PUNCTUM DILATOR
• Cylindrical corrugated metal handle with a conical pointed tip.
• Uses:
To dilate the punctum and canaliculus during
Syringing
Probing
Dacryocystography
DCT and DCR procedures.
BOWMAN’S LACRIMAL PROBE
A set of straight metal wires of varying thickness (size 0–8) with
blunt rounded ends and flattened central platform.
Uses:
(i) To probe nasolacrimal duct in congenital blockage.
(ii) To identify the lacrimal sac during DCT and DCR operations.
CASTROVIEJO CALLIPER
• Divider- like instrument
• One arm attached to a graduated scale (in mm)
• Other arm can be moved by a screw over the scale.
• Uses:
1. To take measurements during squint, ptosis, retinal
detachment and pars plana vitrectomy surgery.
2. To measure corneal diameter
DESMARRE’S LID RETRACTOR
USES:
1. RETRACT LIDS DURING EXAMINATION OF EYEBALL IN BLEPHAROSPASM AND IN CASES
WITH MARKED SWELLING
2. REMOVAL OF CORNEOSCLERAL SUTURES
3. REMOVAL OF CORNEAL FOREIGN BODY
4. DOUBLE EVERSION OF UPPER LID TO EXAMINE SUPERIOR FORNIX
Advantage : Allows continuous adjustment of the lids and width of the palpebral aperture.
Disadvantage: It is NOT SELF-RETAINING, so an assistant is needed to hold it.
UNIVERSAL GUARDED METALLIC EYE SPECULUM
• UNIVERSAL –BECAUSE IT CAN BE USED FOR BOTH EYES i.e. RE / LE
• 2 LIMBS AND A GUARD
• USES:
1. INTRAOCULAR SURGERIES LIKE CATARACT SURGERY/ GLAUCOMA SURGERY/
KERATOPLASTY
2. EXTRAOCULAR SURGERIES LIKE SQUINT SURGERY/ PTERYGIUM SURGERY
3. ENUCLEATION & EVISCERATION OPERATIONS
4. REMOVAL OF CONJUNCTIVAL AND CORNEAL FOREIGN BODIES
5. EXAMINATION OF EYE IN PATIENTS WITH BLEPHAROSPASM