Ophthalmology Instruments
Deeksha
UNIVERSAL EYE SPECULUM
• called so because it can be used for both eyes,
i.e. right as well as left.
• It has two limbs and a spring mechanism with
a screw to adjust the limbs.
• Its blades are open/closed (with guard- to
keep out eyelashes)
DESMARRE’S RETRACTOR
• Saddle shaped instrument folded on itself at one end.
• It is available in two sizes: small (paediatric) and large (adult).
• Use: retract the lids during examination of the eyeball in cases of
-blepharospasm in children
-marked swelling and ecchymosis
-removal of corneoscleral sutures
-burns, chemical injuries
-removal of corneal foreign body
For double eversion of upper lid to examine the superior fornix.
• Advantages. Allows continuous adjustment of the lids and width of
the palpebral aperture.
• Disadvantages. It is not self-retaining, so an assistant is needed to
hold it
BARD PARKER’S (BP) HANDLE
• named after Charles Russel Bard and Morgan
Parker
• available indifferent sizes.
• also known as BP handle,
• it is light and affords a firm grip.
• Blade of different sizes can be fitted onto a
groove at the tip of the handle for making the
desired incision.
SURGICAL BLADE
• Sizes 11,15 commonly used
ABSORBABLE SUTURES
• Types- synthetic- vicryl
- natural- chromic gut, fast gut, plain gut
• Types of nonabsorbable-
- synthetic- polypropylene, nylon,
- natural- silk
• Sizes
10-0: cornea
9-0: conjunctiva
8-0: sclera
7-0: conjunctiva, eyelid skin, muscle reattachment
6-0: eyelid skin, traction sutures, muscle surgery
5-0: brow, facial skin
OPTIC NERVE HEAD GUIDE/ Evisceration
spoon
• It is a spoon-shaped instrument with a central
cleavage.
• Use: To engage the optic nerve during
enucleation.
EVISCERATION SPOON/SPATULA
• It consists of a small but stout rectangular
blade with slightly convex surface and blunt
edges attached to a handle.
• Use: To separate out the uveal tissue from the
sclera during evisceration operation.
CHALAZION CURETTE/Scoop
• It has a small cup with sharp margins attached
to a narrow handle.
• Use: To scoop out contents of the chalazion
during incision and curettage, after application
of chalazion clamp and vertical incision( to
prevent damage to meibomian glands)
BONE PUNCH (Kerrison’s)
• It consists of a stout spring handle and two blades
attached at right angle.
• The upper blade has a small hole with a sharp cutting
edge.
• The lower blade has a cup-like depression.
• Use:
• It is used to enlarge the bony opening during DCR
operation by punching the bone from margins of the
opening. Carelessness during this step can cause
accidental damage to the nasal mucosa and the nasal
septum.
CRESCENT KNIFE
• It is blunt-lipped, bevel up knife
• having cut-splitting action at the tip and at both sides.
• Its blade is curved and either mounted on a plastic handle
(disposable) or can be fixed with metallic handle.
• Use: It is used
(i) To make tunnel incision in the sclera and cornea for
phacoemulsification, manual SICS, and sutureless trabeculectomy
(ii) To separate the conjunctiva and subconjunctival tissue from the
sclera and limbus when umbal-based flap is made for
trabeculectomy surgery.
(iii) It can also be used to separate partial thickness lamellae of
sclera during trabeculectomy.
(iv) To separate pterygium head or limbal dermoid from the
underlying corneal lamellae.
(v) To separate corneal lamellae in lamellar keratoplasty.
15° SIDE PORT ENTRY BLADE
• It is a fine straight knife with a sharp pointed
tip and cutting edge on one side.
• Use. It is used to make a small valvular clear
corneal incision (commonly called as side port
incision) in
-phacoemulsification and SICS
-other intraocular surgeries including pars
plana vitrectomy.
KERATOME
• A keratome has a thin diamond-shaped blade with a sharp
apex and two cutting edges.
• Straight as well as curved keratomes are available in various
sizes (2.8 mm, 3 mm, 3.5 mm, 5.5 mm)
• Presently disposable curved keratomes are more commonly
used. (plastic handle)
• Use: Keratomes are used to make valvular corneal incisions for
entry into the anterior chamber for
-all modern techniques of cataract extraction viz.
phacoemulsification, SICS and even conventional ECCE
-other intraocular surgeries, e.g. iridectomies and
paracentesis.
26 gauge cannula
• Standard brown colour for 26G
• 2 bends:
110 deg-120deg and
90 deg- near the tip
• For CCC
CYSTOTOME/ CAPSULOTOME
• It is a small needle knife with a bent tip which
is sharp on both the edges.
• Presently, disposable cystotome is prepared
by bending the disposable 26 gauge or 30
gauge hypodermic needle.
• Use: It is used for doing anterior capsulotomy
or capsulorhexis during ECCE
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 lOL 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 may be in the form of nucleus
rotation in the capsuJar bag, cracking of the nucleus
and feeding of the nuclear fragments into the phaco
tip.
WIRE VECTIS
• It is a wire loop attached to a metallic handle.
• Use: It is used to remove subluxated lens and
anteriorly dislocated lens in ICCE technique and the
nucleus in ECCE technique.
• Irrigating wire vectis: It is a modified vectis in which
the loop is made of a thick hollow wire.
• Use: to deliver nucleus in the manual small incision
cataract surgery (SICS) and in conventional ECCE by
hydro expression or visco expression technique.
CHOPPER
• The chopper is a fine instrument resembling
sinskey hook in shape.
• The inner edge of the bent tip is cutting and
may have different angles.
• Use: It is used to
-split or chop the nucleus into smaller pieces
-also for nuclear manipulation in
phacoemulsification surgery.
LENS EXPRESSOR/HOOK
• It is a flat metal handle with a rounded curve at one end.
• Tip of the curve is knobbed.
• The plane of the handle is at right angle to the curvature of the
hook.
• 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 out the dislocated
lens.
(iv) In the era of ICCE, it was used to apply pressure on the
limbus at the 6 O'clock position during the delivery of lens in
intracapsular cataract extraction with Smith's (tumbling) and
capsule forceps techniques.
IRIS REPOSITOR
• It consists of a 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.
TENOTOMY SCISSORS/ Strabismus scissors
• Plain straight or curved scissors with blunt ends.
• Uses:
• (i) To cut the extraocular muscles during squint
surgery and enucleation operation; optic nerve
during enucleation
• (ii) To separate the delicate tissues (conjunctiva
and tenon’s mostly) without damaging the
surrounding area in oculoplastic operations and
squint surgery.
MADDOX ROD
• For ocular posture
• consists of many glass rods of red colour set
together in a metallic disc: which are stacked
cylindrical lenses
• converts the point light image into a line.