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Fundoscopy, an inspection of the structures at the back of the patient’s eye for medical diagnoses, is a standard procedure in every doctor’s routine physical assessment.
Standard direct ophthalmoscopes have been reliable and efficient tools for the job, but often it is a challenge to look into an undilated or constricted pupil with such a gadget.
Luckily, with the invention of the PanOptic Ophthalmoscope, the examiner’s job has become easier, with easy entry into the eye of the patient, a larger field of view of the fundus, and digital capturing, storing, and sharing of images of the examination.
Guide to Parts
The PanOptic ophthalmoscope is very similar to traditional direct ophthalmoscopes but simpler and easier to use. Its parts include the standard components of any ophthalmoscope–the light source, viewing aperture, filter dial for different filters, and focusing dial for different lenses.
The PanOptic provides a strong source of illumination with Halogen HPX® technology. The filter dial of the PanOptic provides versatility through different light filters or sizes, each with their own purpose. In a well-lit room, the pupil is constricted, and in darkness, the pupil is dilated.
The differently-sized light sources are used depending on the level of pupil dilation, with the small light an ideal setting for constricted pupils in well-lit environments, and the large light best used when pharmacological eye dilators such as mydriatic eye drops are used.
For non-dilated pupils in dark environments, the medium-sized light is used. Meanwhile, for some patients, the half-light setting becomes useful with pupils that are partially obstructed by cataracts.
The slit beam setting is a thin line of light that is extremely helpful in spotting contour abnormalities of the cornea, lens, and retina. The grid setting has the primary purpose of allowing approximations of relative distances between lesions.
The different filter settings, meanwhile, include a red-free filter, which improves contrast and makes the view appear black and white. This setting presents as a green beam of light. In some ophthalmoscopes, there is also a blue light setting used to examine corneal abrasions and ulcers with the use of fluorescein pre-staining.
Meanwhile, the focusing dial for different lenses is used to select the strength of the lens by rotating clockwise for plus lenses and counterclockwise for minus lenses.
The purpose of the lens bank is to bring the different structures into focus during the examination, as well as to compensate for refractive errors in both the patient and observer.
How It’s Used
Similar to other traditional ophthalmoscope types, the first step to using the PanOptic is to prepare the proper exam room environment. The lights should be dimmed, and the patient should be seated comfortably at a height that is also comfortable for the examiner.
Depending on the need, the doctor can also decide to administer mydriatic eye drops for pupil dilation; although the PanOptic allows easy entry even to undilated pupils.
In preparation for the procedure, it is recommended that both patient and doctor remove their eyeglasses unless the patient is highly astigmatic, or the doctor is highly nearsighted.
Depending on the eye to be examined, the instrument must be held with the hand belonging to the same side as the examining eye–the patient’s left fundus must be examined with the left eye and the right fundus with the right eye.
Ask the patient to focus on a single point about a meter’s distance ahead. The next step in the fundoscopic procedure is to look for the patient’s red reflex, the reddish-orange reflection of light by the patient’s eye.
At the distance of arm’s length, the doctor uses the ophthalmoscope to illuminate the patient’s eye and look for the R/R through the viewing aperture.
Once this has been achieved, the lens is adjusted to +10 diopters, and standing from the patient’s side; the examiner moves towards the patient while following the R/R through the viewing aperture until he is 1-2 inches from the patient’s eye.
Next, the examiner adjusts the lens dial from +10 to 0 diopters to effectively shift the focus from the front to the back of the patient’s eye, toward the retina and other structures.
Comparison: PanOptic Ophthalmoscope Versus Traditional Direct Ophthalmoscope
The PanOptic is rightly considered a modern classic, an updated improvement of traditional direct ophthalmoscopes used by doctors and healthcare practitioners. Using PanOptic ophthalmoscope is taking a huge step towards increased efficiency and practicality in providing quality healthcare to patients.
In what ways are the PanOptic better than traditional direct ophthalmoscopes?
Regarding performance, the PanOptic offers a field of view of the eye that is five times larger than standard ophthalmoscopes, at 25 degrees versus the standard 5-degree view. Through this feature alone, the PanOptic’s edge over all other ophthalmoscope types is clearly emphasized.
With such a large field view, looking for specific structures becomes effortless and straightforward, and examiners wouldn’t have to move the device around as much just to get a complete view.
Additionally, the PanOptic also offers a 26% increase in image magnification, another great advantage over other ophthalmoscopes.
Compared to other ophthalmoscope models, users of this device would need less time to figure out how to use the instrument, ultimately allowing them to devote more time to figure out what they’re looking at.
This can be considered both an advantage and a disadvantage, as it shall always provide better visualization, but doctors who train with and get used to the more expensive PanOptic may face trouble when using the more widely distributed standard ophthalmoscopes in most hospitals.
Given this, though high-quality visualization is at a premium, and any responsible healthcare provider would be relied on to know how to use any device in any setting.
In terms of structural design, the PanOptic is equipped with a more highly dynamic focusing wheel, which allows examiners to adjust the strength of the lens in a smoother, continuous action.
This can be considered a great advantage, especially for precise, immediate adjustments in the middle of the fundoscopic procedure. In terms of comfort, the patient eyecup at the front of the device is the perfect addition to maintaining the proper distance between patient and examiner.
This addition also helps in allowing enough flexibility to move the device around while providing stability in visualization and screening out ambient light. The eyecup secures the position of the device as it is comfortably attached to the patient’s face.
Through this, the PanOptic requires lesser proximity between patient and examiner, giving them more comfort during the procedure. Aside from this, the PanOptic is also equipped with an ergonomically-designed grip for better control.
Carrying out fundoscopic procedures throughout the day could be a tiring activity for doctors, and ensuring ease of use and comfort can go a long way to improving healthcare procedures.
Finally, what makes the PanOptic a sophisticated piece of technology is how it makes the fundoscopic procedure digital.
With the PanOptic ophthalmoscope, doctors and healthcare practitioners have the option to capture digital images of the fundus of the eye through an additional gadget, the iExaminer, which allows for secure attachment of an iPhone to the viewing aperture of the device.
This can be especially useful for practitioners who are also professors, who shall use the tool for educational purposes in the medical setting. Digital sharing of fundoscopic photographs can also be a great advantage in explaining cases to each patient with the use of handy visual aid.