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Ophthalmic instruments play a central part in diagnosis,
observation, and treatment of any eye disease. From a basic ophthalmoscope to
highly sophisticated imaging devices utilized in modern eye surgery, the
devices are as varied as they are specialized. As ophthalmology goes further
and further, new and better instruments are being marketed in the market with
emphasis on accuracy, reduced risk, and better patient outcome.
In this detailed guide, we will define different kinds of
ophthalmic instruments, their use, and current trends in the field.
Ophthalmic instruments are highly sophisticated machines
manipulated by eye care professionals for diagnosis, evaluation, and treatment
of eye ailments. Ophthalmic instruments are grouped into three categories,
i.e., diagnostic, surgical, and therapeutic instruments.
These three possess their own respective instruments and are
limited to only a specific ophthalmic procedure.
Diagnostic equipment assists eye health care providers to
establish the overall state of the eyes and diagnose forthcoming disease.
Ophthalmoscope is used for examining the retina and optic
nerve. There are two types available:
•Direct ophthalmoscope – Gives a magnified near
vision of the retina.
•Indirect ophthalmoscope – Gives a broad field view
of the retina and is used in retinal detachment.
Slit lamp is illuminated microscope to facilitate accurate
vision of posterior and anterior portions of the eye. It is utilized in
examination testing:
• Cornea
• Iris
• Lens
• Retina
Tonometer is utilized in assessment of intraocular pressure
(IOP) in finding glaucoma. Samples are:
• Applanation tonometry – subjects eye to pressure
against a flat probe.
• Non-contact tonometry – applies force of an air
puff's blow in determining the pressure within eyes without the touch of an
eye.
Retinoscope is used in refractive error measurement of a
patient by passing light into the eye and locating the reflection off the
retina.
A keratometer is used to measure corneal curvature and is
used most commonly in contact lens calculation and diagnosis of such disorders
as keratoconus.
OCT is an advanced imaging technology examination that
produces cross-sectional views of the retina and allows for early detection of
eye diseases such as diabetic retinopathy, macular degeneration, and glaucoma.
Perimeter examines the patient's field of vision, thus rendering glaucoma, optic nerve, and brain visual defects diagnosable.
Surgical ophthalmic instruments are used to carry out
surgery from cataract extraction to corneal transplantations.
Microkeratome is used in LASIK surgery to create a thin flap
in the cornea to re-contour the corneal surface.
The machine utilizes ultrasonic power to emulsify cataracts
before aspirating them out through a small incision.
Vitrectomy instruments such as forceps and vitreous cutters
are utilized during retinal surgery to extract the vitreous humor as well as
repair retinal detachment.
There are certain forceps and scissors employed in more
delicate eye operations. Some of them are:
• Iris forceps – For operating on the iris.
• Vannas scissors – In an effort to make micro
incisions.
A speculum is utilized in keeping eyelids open during
surgery to ensure eyesight is not impaired.
Cautery instruments help coagulate blood vessels in an
effort to reduce blood during surgery.
Trephine is used when one is being operated on for corneal transplant surgery in readiness for a round corneal button so that it can be transplanted.
They help treat eye conditions using a variety of
non-surgical and surgical methods.
Laser equipment is used in eyesight correction, treatment of
retinal disease, and treatment of glaucoma. They are:
• Excimer laser – Used in LASIK to reshape the
cornea.
• Nd: YAG laser – Used in posterior capsular opacification
after cataract surgery.
• Argon laser – Used in retinal photocoagulation of
diabetic retinopathy.
Used for freezing and treating retinal tumors and tears.
Used for cutting tissue or managing bleeding during surgery
using electrical current.
Intravitreal implants are novel drug delivery devices
utilized for controlled-release drug delivery in the treatment of chronic eye
disease.
New equipment with greater accuracy has been introduced
through technological advances, enhancing accuracy and patient safety.
2.1 Artificial Intelligence in Ophthalmology
AI-based diagnostic equipment can scan OCT and fundus to identify diseases like diabetic retinopathy and macular degeneration.
2.2 Robot Eye Surgery
Robot instruments like the Preceyes Surgical System provide
improved precision in complex eye surgery.
2.3 Eye Care Using 3D Imaging
Advanced imaging technology like 3D optical coherence
tomography (3D-OCT) provides intraocular anatomy with high-visual acuity
imaging.
2.4 Intelligent Contact Lenses
Intelligent contact lenses that incorporate intraocular
pressure sensors for glaucoma patients are under development.
2.5 Biocompatible Surgical Instruments
Titanium and shape-memory alloys are corrosion-resistant,
strong materials, with fewer complications, and longer life in ophthalmic surgery.
Daily handling and sterilization prevent infection and
extend the useful life of instruments.
3.1 Disinfecting and Sanitizing
• Following every use, disinfecting instruments prevents
particulate accumulation.
• Delicate instruments are best suited for enzyme cleaners.
3.2 Methods of Sterilization
•Autoclaving – Metal instruments are sterilized through the
use of steam.
•Gas sterilization – Most appropriate for heat-sensitive
devices.
•Ultrasonic cleaning – High-frequency ultrasonic sound waves
help in the removal of debris.
3.3 Storage and Handling
•Devices must be preserved under aseptic conditions to avoid
contamination.
•Precision with regular calibrations is indispensable.
The way forward for ophthalmic devices is automation, AI,
and personalized therapy.
4.1 Computerized AI-based Diagnostics
Computer-aided artificial intelligence-based applications
will handle the diagnosis and prognosis of eye diseases with enhanced accuracy.
4.2 Eye Devices Based on Nanotechnology
Nano-coating of the lens and nano-drug delivery systems will
enhance the effectiveness of treatment.
4.3 AR-Surgery
AR-surgery will allow surgeons to project virtual images on
top of live video during surgery for precise surgery.
4.4 Portable and Wearable Devices
Portable and wearable devices will allow remote diagnosis
and teleophthalmology.
Eye-care technology is responsible for diagnosing and treating most eye illnesses. Over time and the passage of time, technology has been advancing in accuracy and efficiency, all in the interest of the patients. In any small eye examinations or intricate procedures, the work that eye-care technology is responsible for doing with today's practice cannot be substituted.
Written by: Beauty Teck
08:30 – 13:30 | 14:00 – 17:00