- Email: [email protected]
An Angled Scleral Depressor
NOTES, CASES, INSTRUMENTS A T T A C H M E N T FOR SLIT-LAMP CONTACT GLASS W I T H I N D E N T O R O F VARIABLE LENGTH G. EISNER,
M.D.
Bern, Switzerland
Biomicroscopy of the peripheral retina, the ora serrata, and the posterior ciliary body is possible with the combined use of a mirror contact glass with a scierai depressor (inden tor). 1 In 1967, I described an indentation attach ment consisting of a funnel slipped over a Goldmann three-mirror contact glass.2 In or der to examine at various distances from the limbus, funnels carrying indentors of differ ent length had to be exchanged. To avoid this switching, a funnel with an indentor of variable length has been de signed.* The indentor knob previously fixed directly to the funnel is now affixed to a flat spring running in a track (Figure). The in dentor spring may be pulled forward or backward, thus placing the indentor knob at a longer or shorter limbus distance. The in dentor remains in the position desired by friction, the latter being increased by the ro tation of the funnel during the examination. This simple arrangement avoids complicated mechanical devices. According to the depth of indentation required, indentor knobs of different sizes may be chosen. The funnels are made of heat resistant and shock-proof plastic. Three shapes of funnels are available: (1) for normal eyes, (2) for abnormally long (myopic) eyes, and (3) for narrow palpebral fissures. From the University Eye Hospital, Bern, Swit zerland. Reprint requests to G. Eisner, M.D., University Eye Hospital, Freiburgstrasse 8, CH-3008 Bern, Switzerland. * The funnels were made by M. Huber-Stöckly, Seftigenstrasse 71, CH-3123 Belp, Switzerland.
Figure (Eisner). Indentation funnels with in dentor of variable length. Left, a, indentor knob ; b, indentor spring ; and c, guide track for spring. Cen ter, The spring inserted into the track on the fun nel. Right, the indentation funnel is slipped over a contact glass. The indentor knob is pulled into a po sition near the border of the contact glass, ready for examination of the ora serrata region. SUMMARY
A funnel attachment with an indentor of variable length has been designed to be slipped over a Goldmann three-mirror contact glass. This facilitates examination at various distances from the limbus without having to change the funnel. REFERENCES
1. Eisner, G. : Biomicroscopy of the Peripheral Fundus. An Atlas and Textbook. Heidelberg, Springer-Verlag, 1973. 2. Eisner, G. : Attachment for Goldmann threemirror contact glass. Am. T. Ophthalmol. 64:467, 1967.
AN ANGLED SCLERAL DEPRESSOR HERBERT J.
GERSHEN,
M.D.
San Francisco, California
In the past 25 years, binocular indirect ophthalmoscopy with scierai depression has become an indispensable diagnostic tool. Reprint requests to Herbert J. Gershen, M.D., Suite 210, 4141 Geary Blvd., San Francisco, CA 94118.
845
846
AMERICAN JOURNAL OF OPHTHALMOLOGY
NOVEMBER, 1973
A MODIFIED E Y E BLADE FOR R E T I N A L DETACHMENT SURGERY HERBERT J.
GERSHEN,
M.D.
San Francisco, California
A No. 55 eye blade has been modified* for use in retinal detachment surgery by bending the blade at a right angle to its shaft ( Figure). The blade has both edges sharp as well as its tip. This facilitates the dissection of scierai tunnels to anchor encircling bands. For merly, this was easy to do anteriorly but quite difficult in posterior approaches. Figure (Gershen). Angled scierai depressor.
However, it is one that is mastered only af ter hours of practice and contortions. I have found difficulty in depressing and examining the ora serrata in the 12 and 6 o'clock positions, as the condensing lens gets in the way of the depressor and my fingers. This is especially true with the Nikon 20 diopter lens that has become so popular. An angled depressor* has been designed to over come this problem. The shaft is 5 mm longer than the stan dard thimble depressor. At 15 mm, there is a 45-degree curve to the left. The standard tip is at the end of the shaft (Figure). The tip can be applied to the globe at the 12 and 6 o'clock positions tangentially while the thimble is held off to the left, away from the lens. I use the thimble in my left hand. It can also be used in the right hand by merely ro tating the thimble 180 degrees around the finger.
Figure (Gershen). Right-angled No. SS eye blade.
The sciera is grooved with a No. 67 eye blade to the desired width, length, and depth. The modified blade is then passed from groove to groove, its sharp point and edges splitting the scierai lamellae. The sharp edges can also be used to lengthen the groove when necessary. SUMMARY
SUMMARY
A scierai depressor has been designed with a curve to allow easier examination of the ora serrata. * The angled scierai depressor was built by Storz Instrument Co., St. Louis, Missouri.
A standard eye blade has been modified for retinal detachment procedures. Reprint requests to Herbert J. Gershen, M.D., Suite 210, 4141 Geary Blvd., San Francisco, CA 94118. * The modified No. SS eye blade was obtained from Rudolf Beaver, Inc., Belmont, Massachusetts.
M.D.
Bern, Switzerland
Biomicroscopy of the peripheral retina, the ora serrata, and the posterior ciliary body is possible with the combined use of a mirror contact glass with a scierai depressor (inden tor). 1 In 1967, I described an indentation attach ment consisting of a funnel slipped over a Goldmann three-mirror contact glass.2 In or der to examine at various distances from the limbus, funnels carrying indentors of differ ent length had to be exchanged. To avoid this switching, a funnel with an indentor of variable length has been de signed.* The indentor knob previously fixed directly to the funnel is now affixed to a flat spring running in a track (Figure). The in dentor spring may be pulled forward or backward, thus placing the indentor knob at a longer or shorter limbus distance. The in dentor remains in the position desired by friction, the latter being increased by the ro tation of the funnel during the examination. This simple arrangement avoids complicated mechanical devices. According to the depth of indentation required, indentor knobs of different sizes may be chosen. The funnels are made of heat resistant and shock-proof plastic. Three shapes of funnels are available: (1) for normal eyes, (2) for abnormally long (myopic) eyes, and (3) for narrow palpebral fissures. From the University Eye Hospital, Bern, Swit zerland. Reprint requests to G. Eisner, M.D., University Eye Hospital, Freiburgstrasse 8, CH-3008 Bern, Switzerland. * The funnels were made by M. Huber-Stöckly, Seftigenstrasse 71, CH-3123 Belp, Switzerland.
Figure (Eisner). Indentation funnels with in dentor of variable length. Left, a, indentor knob ; b, indentor spring ; and c, guide track for spring. Cen ter, The spring inserted into the track on the fun nel. Right, the indentation funnel is slipped over a contact glass. The indentor knob is pulled into a po sition near the border of the contact glass, ready for examination of the ora serrata region. SUMMARY
A funnel attachment with an indentor of variable length has been designed to be slipped over a Goldmann three-mirror contact glass. This facilitates examination at various distances from the limbus without having to change the funnel. REFERENCES
1. Eisner, G. : Biomicroscopy of the Peripheral Fundus. An Atlas and Textbook. Heidelberg, Springer-Verlag, 1973. 2. Eisner, G. : Attachment for Goldmann threemirror contact glass. Am. T. Ophthalmol. 64:467, 1967.
AN ANGLED SCLERAL DEPRESSOR HERBERT J.
GERSHEN,
M.D.
San Francisco, California
In the past 25 years, binocular indirect ophthalmoscopy with scierai depression has become an indispensable diagnostic tool. Reprint requests to Herbert J. Gershen, M.D., Suite 210, 4141 Geary Blvd., San Francisco, CA 94118.
845
846
AMERICAN JOURNAL OF OPHTHALMOLOGY
NOVEMBER, 1973
A MODIFIED E Y E BLADE FOR R E T I N A L DETACHMENT SURGERY HERBERT J.
GERSHEN,
M.D.
San Francisco, California
A No. 55 eye blade has been modified* for use in retinal detachment surgery by bending the blade at a right angle to its shaft ( Figure). The blade has both edges sharp as well as its tip. This facilitates the dissection of scierai tunnels to anchor encircling bands. For merly, this was easy to do anteriorly but quite difficult in posterior approaches. Figure (Gershen). Angled scierai depressor.
However, it is one that is mastered only af ter hours of practice and contortions. I have found difficulty in depressing and examining the ora serrata in the 12 and 6 o'clock positions, as the condensing lens gets in the way of the depressor and my fingers. This is especially true with the Nikon 20 diopter lens that has become so popular. An angled depressor* has been designed to over come this problem. The shaft is 5 mm longer than the stan dard thimble depressor. At 15 mm, there is a 45-degree curve to the left. The standard tip is at the end of the shaft (Figure). The tip can be applied to the globe at the 12 and 6 o'clock positions tangentially while the thimble is held off to the left, away from the lens. I use the thimble in my left hand. It can also be used in the right hand by merely ro tating the thimble 180 degrees around the finger.
Figure (Gershen). Right-angled No. SS eye blade.
The sciera is grooved with a No. 67 eye blade to the desired width, length, and depth. The modified blade is then passed from groove to groove, its sharp point and edges splitting the scierai lamellae. The sharp edges can also be used to lengthen the groove when necessary. SUMMARY
SUMMARY
A scierai depressor has been designed with a curve to allow easier examination of the ora serrata. * The angled scierai depressor was built by Storz Instrument Co., St. Louis, Missouri.
A standard eye blade has been modified for retinal detachment procedures. Reprint requests to Herbert J. Gershen, M.D., Suite 210, 4141 Geary Blvd., San Francisco, CA 94118. * The modified No. SS eye blade was obtained from Rudolf Beaver, Inc., Belmont, Massachusetts.