A complete Guide to Essential Equipment for setting up an Ophthalmic center
India is the second most populated country in the world and home to 30% of the world’s population of blind people. The count is a staggering over 10 million people. (Ref. medicalmagazine.in)
Cataract is a major reason for blindness and contributes to 60% of cases while glaucoma causes blindness 13% of the time. Indian ophthalmologists conduct 5 million surgeries in a given year. As per the ophthalmology experts, 80% of these blinding cases can be avoided if detected in time. An effective screening done in the early stages can prevent irreversible consequences for the patients. Thus, it is imperative to have advanced diagnostic equipment in the domain of ophthalmology.
Setting up an ophthalmic center
The segment for ophthalmic equipment is complex and has a range that includes handheld equipment to the ones that have to be mounted on a tabletop. The manufacturers are introducing equipment with newer and enhanced technology regularly. The Indian market for ophthalmic equipment is huge as ophthalmologists are seen practicing in cities across India. The list of ophthalmic equipment that are crucial for setting up an ophthalmic center are as below
An auto lensometer, lensometer, or auto lens meter is a device used in optometry. The auto-lensometer calculates the following in an automated manner
- The prescription of the eyeglass lenses
- The sphere, cylinder, axis, and prism
- Mark lenses before cutting and correctly mount lenses in the frame
Auto lensometers are fast and accurate as compared to manual lensometers.
Auto refractometers are used to measure the refractive status of any patient. They objectively determine the refractive error and are of different types. They are gaining preference due to the speed, acceptable accuracy, and repeatability offered by them.
Also known as a refraction chair unit or ophthalmic refraction unit is a must-have for an eye clinic. This caters to ophthalmic as well as optometric needs to determine the power of the lenses and eyeglasses. A good refraction unit would have a backrest with a full elevation system. This provides full vertical support to the patient while screening. The chair would also have movable arms and foot support that can be adjusted for the comfort of the patient.
Digital visual acuity charts
It is imperative for the ophthalmologist and optometrist to measure the clarity of vision. Visual acuity charts have been in use since time immemorial. Visual acuity refers to the clarity of vision. It helps the examiner to determine the ability of the examinee to precisely identify the smallest of details as an observer. Technology today has made visual acuity charts available as digital software for more convenient and effective eye examinations. The digital software includes standard charts like binocular balance, aniseikonia, stereopsis and binocular fusion charts. Contract sensitivity adjustment, color blindness, and educational images are standard on most charts. The frequently used charts can be programed as per convenience and, with the integrated remote control can be pulled up during examination at the push of a button. These offers precise calibration for exam distances from 8′ to 20′ and can be used in smaller rooms using a mirror system. The charts fit into a wide range of LCD screens, including support for 17″, 19″, 20″, 23″ and 24″ LCD monitors, offering operators and patients better display options in size and design.
Slit lamps are used by ophthalmologists to determine the health of the eye. It is a biomicroscope with a light source that shines a thin layer of light in the eye. With the help of a site lamp ophthalmologists can study the inside of the eye during the examination of the patient and proceed with the diagnosis.
Synaptophore is an instrument used by ophthalmologists for diagnostic as well as therapeutic purposes. It helps in determining the disbalance in the eye muscle and treating them by orthoptic methods. It is used in cases of squints and to detect suppression and Abnormal retinal correspondence.
Motorized tables are an essential part of any ophthalmologist's chambers. Good tables come with a feather touch switch for up and down movement and are used for mounting slit lamps, keratometer, auto refractometer, synoptophore, lensometer. Good quality tables are smooth and soundless with low or no maintenance.
A- Scan is an acronym that stands for amplitude scan. This is performed to determine the length of the eye. The ophthalmologist/ Optometrists use this to determine the intraocular power of the lens.
These are autorefractometers with built in keratometer. They are used for determining the power of prescription glasses and also used to measure the shape of the cornea. They come handy for fitting the contact lenses.
Ophthalmologist use keratometer for the diagnosis of astigmatism. The keratometer helps them to measure the curvature of the anterior surface of the cornea. One cannot have a diagnosis center for eye without having the keratometer handy.
For an effective diagnosis of the eye, the ophthalmologist has to determine health of the retina, optic disc, and vitreous humor. This requires him to see inside the fundus of the eye. The ophthalmoscope also known as the funduscope helps him take a good peek inside the eye for any visible anomalies.
A phoropter or refractor is commonly used by ophthalmologists during routine eye examination. It contains different lenses used for refraction of the eye during sight testing. This helps the ophthalmologist in measuring an individual's refractive error and determine the prescription for his eye. It is also useful to measure the patients' phorias and ductions, which are the key characteristics of binocularity.
A Handheld karatometer serves the same purpose as a Keratometer and is small, light and easy to carry as it is a handheld device. The latest handhelds are designed for one hand operation and give precise and accurate results
Cornea is a crucial part of the eye. Pachymeter is a device that is used to determine the thickness of the cornea. The process of determining the thickness is called cornea pachymetry and it is a crucial step before the refractive surgery is performed. This makes Pachymeter a must have instrument for ophthalmologists.
Optical Biometer are critical in determining the anatomical characteristics of the eye. With the help of these ophthalmologist perform the non-invasive process of biometry. A good biometer determines the length of the optical axis in a precise manner and calculates the IOL calculations for arriving on the correct power of the IOL before it is implanted.
A B Scan or a brightness scan is an essential diagnosis of various ocular and orbital diseases. It is a two-dimensional imaging system that utilizes high frequency sound waves between 8-10 MHZ. It is ultra-critical for the diagnosis and is in high use by ophthalmologists and eye surgeons
Optical coherence tomography is an imaging procedure to measure the thickness of Retina and optic nerve. It provides high resolution images of retina and anterior segment. Having an OCT setup for your retina clinic is a good choice.
Green laser/YAG lasers
Green laser/YAG are advance technology lasers that are needed for various surgical procedure in eye surgery. They are used for cutting, burning and vaporizing damaged tissues without harming the surroundings and the healthy tissues.
The fundus camera is used for taking high resolution images of the rear portion of the called fundus. The photographs are taken through the pupil. These pictures help in diagnosis of issues related vitreous, retina, choroid and optic nerve for diagnostic purposes. These photographs are also used for therapeutic assessment of recently performed retinal laser surgery and to aid in the interpretation of fluorescein angiography.
The specular microscope helps in the assessment of corneal layer specially endothelium specially for cellular shape, size, density and distribution. The magnification offered by specular microscope is very high as compared to the split lamp bio-microscopy.
There are many instruments that are used in Ophthalmology/optometric, still the list is instruments is incomplete without the mention of magnification lenses. These are available in various shapes and sizes and are critical for visualization of the remote areas of eyes. With the help of these lenses the ophthalmologist can go for therapeutic interventions that are otherwise impossible.
Micro Perimeter is used to conduct a type of visual field test and create retinal sensitivity map of the quantum of light perceived in specific parts of the retina. This is usually conducted for those people who are unable to fixate on an object or a light source. Unlike the traditional perimeters the Micro perimeter would include a system to image the retina and an eye tracker that compensates for the eye movement during visual field testing.
Tonometer or ocular tonometer is an instrument used by ophthalmologists to find out IOP or Intra ocular pressure of the liquid inside the eye. This is critical in cases of patients suffering from glaucoma.
NCT or non contact tonometry still remains a popular test for checking the Intra ocular pressure. As this does not require any optical anesthetics and fluorescein dye and no direct contact with the cornea, NCT remains a popular way to screen patients for Glaucoma. It is also known as air-puff test.
Aberrometers are used to measure the aberrations in the eye. It uses wavefront as it passes through the eye. The eye with no aberrations will have wavelength to be flat like a paper while the one having aberrations will be bent.
Microscope also referred as an operating surgical microscope is one of the key instruments in ophthalmic surgery. The operating field of an eye is very small and being binocular the microscope gives additional benefit of high-quality stereoscopy.
Phaco Machine also known as phaco emulsifiers are the machines used in modern cataract surgery. They are used to perform the phaco emulsification surgery that involves breaking the cataract into small pieces through a very small incision in the eye
Lasik Surgery machine
LASIK surgery is an effective treatment option for nearsightedness, farsightedness and astigmatism. LASIK (Laser-Assisted-In-Situ-Keratomileusis) treats refractive errors by folding back the top layer of the eye and re-shaping tissue underneath. Like other laser eye surgeries, LASIK treats vision impairments by reshaping the cornea to correct the way light is focused on the back of the eye.
Femto lasers are used for FLACS as it helps in replacing various stages in cataract surgery. It is also used for correcting mild astigmatism.
An Ophthalmologist cannot have a functional OT without an OT table. The modern OT tables are fluidly motorized operation table. The OT have vertical height adjustment that enables the ophthalmologist to perform operations in standing or sitting position.
IOL- Intra Ocular Lenses
An Intra ocular lens is the lens that is used to replace the affected natural lens in cataract surgery. It helps in bending the rays of light that enters the eye and helps in visualising things around. These lenses are implanted as a treatment for myopia and cataract.
Laser Indirect Ophthalmoscope is used to perform laser retinopexy. It looks like a miner’s helmet with laser attached to it. This helps the ophthalmologist to determine where to apply the laser.
Bipolar coagulation is a principal that forms the basis of instruments used in micro surgeries in ophthalmology. A popular instrument used on this principle is the coaxial electrode probe. This instrument produces a desired scleral marker in retinal surgery under controlled power settings.
Cryo Surgical Unit
Cryo surgical unit are used to perform cryo surgery procedures in ophthalmology. The ophthalmology surgeon uses the technology to freeze and destroy abnormal tissues.
Vitreoretinal Machine is used to perform the various types of vitreoretinal surgeries. Patients suffering from age-related macular degeneration, diabetic retinopathy, diabetic vitreous hemorrhage, macular hole, a detached retina, epiretinal membrane and CMV retinitis.
Ophthalmic centers are the need of the hour. With the advancement in technology and availability of equipment on-line, it is easy to procure equipment at the right price. Click on the link below to get best quality equipment for setting your center at the right price