Opthal instruments

by
Dr. Nigam Rashmi Dhar
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Cystitome or capsulotome
Disposable 26 gauge or 30
gauge hypodermic needle.
USE:
-For doing anterior capsulotomy
-capsulorrhexis during ECCE
Chalazion
clamp
2 limbs like a
forceps,which can be
clampled with the help of
screw.
Tip of one limb is flattened
in the form of round disc
while the tip of other arm
has a small circular ring .
Usually,the flat disc is
applied on the skin & ring
on the conjuctivlal side of
the chalazion.

USE:-
To fix the chalazion &
achieve hemostasis during the
incision & curettage operation.
Spring action
(Barraquer’s type)
Needle holder
USE:-
For passing sutures in
the conjuctiva, cornea,
sclera & extra occular
muscle.
Lacrimal sac
disscetor & curette
Here, one end of which
is a blunt tipped
dissector & the other end
is curetted.
USE:-
In lacrimal surgery.
Wire speculum
Castrovijeo
calliper
Use:-
To take measurement
during squint, ptosis,
retinal detachement &
pars plana vitrectomy
surgery.
To measure the
corneal diameter &
visible horizontal iris
diameter.
Enucleation spoon
Spoon-shapped
instrument .
USE:-
 To engage the optic
nerve during
enucleation.
Bone punch
Use:-
To enlarge the bony
opening during DCR
operation by punching
the bone from margins
of the opening.
Carelessness during
the step can cause
accidental damage to
the nasal mucosa & the
nasal septum.
Towel clamp
 Punctum
dilator(Nettersip’s)
Use:-
To dilate the the punctum &
canaliculus during syringing,
probbing , dacryocystography ,
DCT & DCR procedures.

by
Dr. Nigam Rashmi Dhar
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Lid clamp or entropion clamp
 Advantage over
lid spatula:-
It’s a self-retaining
instrument & doesn’t need
any assist to hold.

Disadvantage:-
1. Less operative field
2. Pressure necrosis can
occur if fitted tightely.

 USE:-
 In lid
[Link]
& ectropion correction.
 It protects the
eyeball,supports the lid
tissues & provide
hemostasis during
 MOSQUITO CLAMP or
Small sized artery forceps
Mosquito artery
forceps:-it’s a small
artery forceps .
Most commonly used
in opthalmology
 Superior rectus holding forceps

USE:-
Hold the superior
rectus muscle while
passing a bridle suture
as cataract surgery,
glaucoma surgery,
corneal surgery, etc.
 Artery(Hemostatic forceps)
It’s a blunt-tipped stout forceps
having a scissors-like
configuration.
USE:-
I. To catch the bleeding
vessels during operations
of the lid & lacrimal sac.
II. To hold the skin & muscle
stay sutures.
III. To hold small ‘pea-nut’
gauze pellets for blunt
dissection in lacrimal sac
surgery & other
extraoccular surgery.
IV. To hold gauze piece while
packing the socket after
enucleation or exenteration
operation.
 Desmarre’s lid retractor
USE:-
To retract the lids during
examination of the eyeball in
cases of blephrospasm in
childreen,in cases with marked
swelling & ecchymosis, removal
of corneosclerosis sutures,
removal of corneal foreign body
& for double everion of upper lid
to examine the superior fornix.

Advantage:-
Allows continuous adjustment
of the lids & width of the palpebral
aperature.
Tooth forceps
Muscle forceps with
side lock

by
Dr. Nigam Rashmi Dhar
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Corneal
scissors
 Corneal scissors
Use:-
i. These are used to enlarge
corneal or corneoscleral
incision for conventional intra
capsular & extra capsular
cataract extraction techniques
of cataract surgery.
ii. To enlarge corneal incision in
keratoplasty operation.
iii. To cut the scleral and
trabecular tissue in
trabeculectomy.
iv. Used for cutting & undermining
conjuctiva in various operation
Arruga’s,steven,silcock
’s & kelt needle holder
USE:-
Very commonly used
in lid surgery & also for
passing superior rectus
suture.
 Plain forceps
USE:-
1. To hold the conjuctiva
during any surgical
procedure.
2. To tie sutures.
3. To hold scleral flap in
trabeculectomy.
4. To hold skin during
eyelid surgery.
5. To hold nasal mucosal
flaps & lacrimal sac
flaps in DCR operation.
Muscle(strabismus)
hook
USE:-
1. Used to engage the
extraocclar muscles
during surgery for
squint,enucleation &
retinal detachment.
2. In the absence of
lens expressor, it may
be used in its place.
Iris forceps
USE:-
To hold the cornea &
Scleral edge for suturing
during cataract,
glaucoma, repair of
corneal &/or scleral
tears & keratoplasty
operation.
 Sinskey hook or IOL dialer
USE:-
To dial the PMMA non-
foldable IOL for proper
positioning in the capsular
bag or cilliary sulcus.
To manipulate the
nucleus in
phacoemulsification
surgery.
Nucleus manipulation
may be in the form of
nucleus rotation in the
capsular bag, cracking of
the nucleus & feeding of
the nuclear fragments into
the phaco tip.
Use:-
chopper
 to split or chop the
nucleus into smaller
pieces and also for
nuclear manipulation
in
phacoemulsification
surgery.
 Lens spatula

Use:-
To apply counter-
pressure @ 12 o’clock
position during
expression of nucleus in
ECCE.
In the era of ICCE, it
was used in a similar
way to extract
catactous lens in smith’s
technique.
 Bart parker Knife holder with blade

by
Dr. Nigam Rashmi Dhar
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Epilation forceps

USE:-
To epilate the cilia in
trichiasis & stye .
To remove cilia after
electrolysis & cryolysis &
to remove cilia loged in
the punctum.
Cat’s paw lacrimal wound
retractor
It’s a fork-like
instrument.

USE:-
To retract the skin
during lacrimal sac & lid
surgery.
Two way irrigation &
aspiration cannula

USE:-
i. For irrigation &
aspiration of the lens
material in ECCE.
ii. Aspiration of
hyphaema.
 Iris repositor
USE:-
To reposit the iris in
the anterior chamber in
any IOL surgery.
To break synechiae at
the pupillary margin.
 (Nettleship’s)punctum dilator
USE:-
To dilate the punctum
& canaliculus during
syringing, probing,
dacryocystography, DCT
& DCR procedure.
 Lacrimal probe(Bowmam’s)

USE:-
i. To probe
nasolacrimal duct in
congenital blockage.
ii. To identify the
lacrimal sac during
DCT & DCR
operations.
 Lid spatula
USE:-
 To protect the globe
& support the lid
during entropion,
ectropion, ptosis, &
other lid surgeries.
 Fine needle holder
USE:-
To hold the tip of the
needle.
 LENS
[Link] lens
[Link] lens
Pin hole lens
USE:-
For pin-hole test.
Stenopaeic slit
USE:-
For diagnosis of
astigmatism.
Keratomes
USE:-
To make valvular
corneal incision for
entry into the anterior
chamber for all
modern technique of
cataract extraction.-
phacoemulsification
 -ECCE
 -SICS
Other Intraoccular
surgeries,e.g.
 -iridectomies
 -paracentesis
Crescent knife
USE:-
To make tunnel
incision in the sclera &
cornea for
phacoemulsification,
manual SICS &
sutureless
trabeculectomy.
15* side port entry
blade

USE:-
To make a small
valvular clear corneal
incision in
phacoemulsification &
other intraocular
surgeries including pars
plana vitrectomy.
 IOL folding injector
USE:-
To inject the
intraoccular lens in
cataract surgeries
Kelman-Mc Pherson
forceps
USE:-
To hold the superior
haptic of IOL during its
placement.
To tear-off the anterior
capsular flap in ECCE.
Can be used for suture
tying.
Universal metallic
eye speculum

USE:-
Use for both eyes.
Mechanism:-
Has two limbs & a
spring mechanism with
a screw to adjust the
limbs.
Its blades are open.
Slit-lamp
Tonometry

by
Dr. Nigam Rashmi Dhar
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Nd-Yag laser
USE:-
In after cataract
complications.
In the treatment of
glaucoma.
Maddox rod
Schiotz
tonometer
USE:-
To measure the
intraoccular pressure.
Occular pharmacology
 Common agent used in
opthalmology
• [Link]-infective agents
• (a)Anti-bacterial agents
• (b)Antiviral agents
• (c)Antifungal drugs
• [Link] & cycloplegics agents
• [Link]-glaucoma drugs
• [Link]-inflammotry & immunosuppresive
agents
• (a)corticosteroids
• (b)NSAIDs
• (c)Immunosuppresive & antimiotic drugs
• [Link]-allergic & vasoconstrictor drugs
• [Link] agent & artificial tears
• [Link] & irrigating solutions
• [Link] substance
• [Link]-VEGFs agents
• [Link] used in opthalmology

by
Dr. Nigam Rashmi Dhar
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