While oculoplastic surgery services can be added to either an existing ophthalmology practice of any subspecialty or started as a single specialty practice, the equipment required in each case will differ. Here we will take a look at some examples of the latest equipment for either scenario and examine a few of the wide variety of options available.
One of the first things to consider is the overall layout of the office; as general eye exams will be necessary some of the lanes in an oculoplastic surgery office should be set up as a regular ophthalmology lane with all of the basics. This includes: a phoropter, slit lamp, and projector.
But unlike a general ophthalmology practice there is the need to set aside space to be set up as procedure rooms and/or injection rooms. Some providers also like to set up a separate room for photography, as this part of an oculoplastic practice is essential. This room can be combined with visual field machines for eyelid evaluations.
Ophthalmic Exam Chairs
Because a few of the rooms should have a basic ophthalmology set up, including chairs that have arms for the slit lamp and phoropter, finding chairs that works for your practice is essential. Here are a few options:
Veatch
S40ptik 2000 Tilt Recline Chair
Item # CSRM04-000
This chair offers a tilting Cradle Track System and silent Power Lift System. There is a rotation lock, height control locations, functional armrests, foot control, headrest and footrest.
S40ptik 2500 Combo Chair and Stand
Item # CSRM08-000
This unit has a 44.8” footprint and has a motorized recline system that extends from a seated to a supine position and every position in between. This unit comes with a rotation lock, foot rest, functional armrests, height control and articulating headrest. It comes with a fully counterbalanced slit lamp arm that accommodates all patients, even in wheelchairs. There is a chair up/down switch that is located on the front arm and is reversible for left hand set up. This combo unit comes with a halogen, low voltage (12V) overhead light that provides bright, direct light for general lighting or minor procedures. There is an upper refractor arm with a 12.5” vertical range and counter balance up to 20 lbs.
Haag-Streit USA, Inc.
980 Procedure Chair
This chair is a full power procedure articulating round-base examination chair/minor procedure table.
There is a programmable memory-positioning switch, an auto return button, dual controls for base and top functions by footswitch or membrane switches on both sides of the chair back. Finger switches and corded foot switches raise, lower and recline the chair. Rotation locks can be used from the sitting or standing position. The headrest is a single lock adjustable concave headreast.
FX 920 Exam Chair
This tilt chair has a square base and a memory positioning switch that allows you to pre-select the chair’s most used position. There is an auto return button to return to the upright position. There are finger switches or corded foot switch to raise, lower or recline the chair. Membrane switches and rotation locks control all operations of the chair from a sitting or standing position. There is a safety switch preventing small children from operating the chair. The armrests lock in place and have a release mechanism that allows patients to sit or leave from either side.
Some of the rooms should be set up as procedure rooms that are cater to injections and laser treatments, but that can also be used for minor procedures.
General Procedure Chair
Lemi 4
The Lemi 4 is a fully adjustable electric couch-bed chair that can be used for evaluations and procedures such as injections and laser treatments. The bed comes with 4 electric actuators for selection of the most suitable working height and position.
Midmark 107 Barrier Free Power Exam Table
Some prefer this type of ‘bed’ style chair for cosmetic procedures. This unit powers up and down with a footswitch and has a manual adjusting backrest.
Ophthalmic Photography
Photography is a key element to an oculoplastic surgery practice. Not just because before and after photos are essential in cosmetics, but also because pre-operative external photos of patients with functional dermatochalasis, brow ptosis or blepharoptosis are needed for submission to insurance. It is also nice to have high quality photos for publications. Some providers take photos with their smart phones, some paint one wall blue in each exam room to position the patient in front of, and some create separate photography rooms with a full set up. Here is a list of some equipment to consider for your ophthalmic photography needs:
Backdrop
Backdrops are important to standardize photos. They can be pulled down from the ceiling or set up on a stand. It is best to have a solid color backdrop; blue or black are the most commonly used for medical photos.
Portrait Umbrella
Portrait umbrellas can be purchased from most camera stores or even big box stores such as Walmart. As with backdrops they can either be ceiling mounted or on a floor stand and some come with a daylight balanced white continuous light bulb to remove shadows.
Cameras
There are a wide variety of cameras that are great for medical photography. Having a low cost body with a high quality lens (non-zoom) is recommended. It is best to keep the zoom lens at the same magnification at all times to get the same result in the before and after shots. Take photos from the same set distance and exposure. Basic settings using studio lights are white balance auto or florescent daylight, ISO 800, focus set to center spot, manual mode, shutter speed 1/125 sec, and lens opening (f-stop) 5.6.
Canon EOS Rebel T6 EF-S IS Digital Camera
This camera has 18 megapixels and includes a 18 – 55mm lens. There is a 3” LCD screen with image editing features and 920,000 dots and built in WiFi and NFC connectivity. It takes still images and video recordings. Filters include Toy Camera, Fisheye and Miniature Effect.
Additional Equipment
If functional eyelid patients will be seen, and the provider wishes to attempt insurance coverage, a visual field analyzer is necessary. Other basic instruments should be available in each exam room such as an irrigation cannula, punctal dilator and nasal speculum. A muscle light is often used as well as a near card, mirror, exophthalmometer and overhead light.
Consumables for an oculoplastic surgery practice should be the same as in any ophthalmology lane. However, if you are planning on having a large cosmetic component, additional consumables should be added: headbands, topical numbing cream, facial cleanser, and marking pencils.
There are a wide variety of options available for almost every piece of equipment required for an oculoplastic surgery practice. And while some of the equipment will be the same as found in any general ophthalmology practice there are some specialized requirements that should be considered. Be sure to consider the workflow and keep the patient, and insurance company, expectations in mind.