Slit Lamp Microscope:

Purpose:
A slit lamp, with its high magnification, allows the eye care professional to examine the front of the eye.

The Slit-Lamp Microscope at our centre has the following specifications:
* Galilean Type Binocular microscope (SM-70 Model)
(Takagi Seiko Pvt. Ltd., Japan)
* Slit Projection -0.8x
* Slit width - 0-10mm, continuously variable.
* Aperture diaphragms -10,5,3,2,1,0.2 mm Dia.
* Total Magnification: 6.3x,10x,16x,25x,40x
* Real fields of View: 35mm, 23mm, 14mm, 8.7mm, 5.6mm
* Closed Circuit Camera - to capture the images on the computer.

A-Scan Biometry (Sonography)

Purpose:
Used for Intra-Ocular Lens (I.O.L) Power calculation prior to a Cataract Surgery.

We have - Model Axis II (B.V.I - Quantel, France.) A-Scan Biometer




Operating Microscope with Camera:

Day after day, ophthalmologists all over the world strive to improve existing surgical procedures and optimize the protection of the patient's eye. So, to get the best result & perfection we have the best quality of Microscope i.e. Carl-Zeiss - OPMI MDO Surgical Microscope with X-Y Coupling.

The OPMI MDO is the surgical microscope, which Carl Zeiss has specially developed for use in Ophthalmology. Its computer-designed, high-performance optics, multiple illumination system and exceptional operating convenience guarantee the surgeon optimum comfort for all procedures in ophthalmic surgery.

This instrument provides an amazingly clear, razor-sharp image with outstanding contrast, superb color fidelity and optimum accuracy down to the very last detail. Some of the features are:
* Enhanced resolution
* Higher Contrast
* Increased color fidelity due to optimum chromatic correction of the entire system.
* Optimum magnification conditions in every discipline of microsurgery thanks to an
exceptionally large zoom range.
* Exceptionally good working conditions due to the compact microscope design
* Outstanding image quality for every surgical procedure due to the innovative multiple
illumination system and the re-designed high-performance optics.
* Superb viewing convenience for the entire surgical team.
* Optimum documentation with Video System. All surgeries are recorded
on our computer & stored in the Library.


Phaco-Emulsification:

Phaco-Emulsification is the latest technique used worldwide for the removal of Cataract. Most cataract surgery today is done by Phaco, which is also called small incision cataract surgery or Sutureless surgery. This device emits ultrasound waves that soften and break up the cloudy center of the lens so it can be removed by suction.

At DIVYADRASHTI we have, OPTICKON 2000 (ITALY) make PULSAR minimal Stress type of Phaco-Emulsification system. The "OPTIKON PULSAR" is an advanced microprocessor based unit for anterior segment surgical procedures. Reliability, versatility, mobility and adaptability combined with sound engineering design, make this machine unique among similar devices currently available on the world market. It is designed to perform:
* Irrigation
* Irrigation/Aspiration
* Phaco-emulsification
* Anterior and Posterior Vitrectomy
* Bipolar Diathermy Coagulation Procedure.

The system features of visual and audible signals aid in set up, indicates operating mode and situations requiring attention, to ensure patient safety.

Some of the important technical specifications are:

* Manufacturer: OPTIKON 2000, Italy.
Model: PULSAR
Classification: Class I - Patient Care Equipment

Irrigation:
Fluid Delivery: Gravity fed. Eye pressure determined by the height of irrigation source.
Valving Element: Solenoid driven pinch valve
Hand piece Type: Irrigating Cystotome
Control: System Footswitch

Ultrasound:
Hand piece Type: Piezoelectric
Frequency: Approx. 40KHz
Stroke: 85 Micron or more
Irrigation/Aspiration: Coaxial to the hand piece.
Available Vacuum Range: From 5 to 500 mmHg
Available Flow rate range: 4 to 50 cc/min
Surgeon Mode: Allows linear control of the U/S power via system footswitch depression
M.M.P Mode: Surgeon can select rapidly from up to two independent sub programs for the
best choice of setting for U/S power, Vacuum, Flow rate and I.V pole height
during the different phases of Phaco surgery.
Auto Priming: The PULSAR features a built-in auto priming system that fills tubing, checking
correct installation of I/A lines and ultrasonic tip.

I/A:
Irrigation: Gravity fed
Aspiration Pump Type: Peristaltic
Available Vacuum Range: 5 to 500 mmHg.
Available Aspiration flow rate: 4 to 50 cc/min.
Surgeon mode: Linear aspiration (Vacuum and/or Flow rate) from zero to preset parameter
linearly controlled via system footswitch.
Safety device: Vacuum sensor, monitors the vacuum in the aspiration line. Sets off occlusion
alarm in the event of ASP line blockage.
Hand piece type: Coaxial I/A
Control: System Footswitch

Vitrectomy:
Hand piece type: Disposable, pneumatically powered guillotine cutter.
Cutting Mode: Reciprocation motion.
Default cut rate: User programmable.
Available cutting rate: From 60 to 700 cuts per minute.
Available aspiration flow rate: 4 to 50 cc/min
Surgeon mode: Linear aspiration (Vacuum and/or Flow rate) from zero to preset parameter linearly controlled via system footswitch
Control: System footswitch

Diathermy (Cautery)
This instrument offers a high frequency diathermy for selective burn placement.

Some of the important specifications are:

Type: Bipolar generator. Generator stops when RF power is not needed.
Operating Frequency: 2 Mz
Nominal Power: 10W (250 ohm Load)
No load Max. Voltage: 100 V
Available Bipolar power: 5 to 100%
Hand piece Type: Bipolar micro forceps, slim stat pencil eraser, intraocular diathermy pencils.
Control: System footswitch

U/V Air Filter :

Purpose:
To sterilize the air in the Operation Theatre with the help of UV Germicidal light.

Working Principle:
UV Germicidal lamps have property to kill bacteria, virus & other primitive organisms.
In this unit, the air is drawn from the top & then subjected to strong radiation of UV-C light. As the air is very close to UV Germicidal Tubes, the bacteria and virus etc. are inactivated and sterile air is again circulated in the room.

Capacity:
With one unit, upto area of (25' W x 30' L x 15' H = 11,250 CU. Feet) & with the distance of 16feet, the air will be sterilized in ONE HOUR.


Ophthalmoscope:

Purpose:
It is an instrument with angled mirror, various lenses, and a light source. It is used to examine the Retina and Vitreous . In the retina, the head of the optic nerve, and the retinal vein and artery can be examined. Ophthalmoscopy requires dilating the pupils with drops to give the doctor the best view inside the eye.
There are two types of ophthalmoscopes: Direct and Indirect.


The direct is a hand-held instrument with a battery powered light source. It also has a series of lenses that can be dialed in to focus the doctor's view of the retina. The direct ophthalmoscope is useful for examining the central retina.

The indirect ophthalmoscope can be used to examine the entire retina. This instrument is worn on the doctor's head. While looking through the instrument's magnifying glasses, a special lens is placed in front of the patient's eye, allowing the doctor to see upto the periphery of the retina clearly.


Gonioscopy

Gonioscope - is an instrument used to inspect the anterior chamber of the eye. It consists of a magnifier and a lens equipped with mirrors, which is placed on the patient's cornea.
Purpose: To know the details of the Angle of the eye, thereby guiding the doctor to classify the type of glaucoma.

Perimetry (Visual Field Analysis)

We have recently installed the "Haag-streit" Octopus 301 model fully automatic visual field , with five custom tests programmes, Peritrend & Flicker software.

We have dedicated trained technicians to conduct the test. A higly user-friendly very fast test with high levels of interpretation.

Fundus Fluorescein Angiography (FFA)
Angioscopy / Angiography is a test used to photograph structures in the back of the eye and finding damage to the blood vessels, which nourish the Retina. There are two types of angioscopy:


(1) Fluorescein
and (2) Indocyanine green (ICG).

Fluorescein Angioscopy (FFA) is used primarily to study blood circulation in and just beneath the surface of the retina, while ICG angioscopy is better for photographing the deeper choroidal vessels. The purpose of either type of angioscopy is to determine whether there are irregularities in the circulatory system of the retina. Several serious eye disorders, such as Diabetic retinopathy, affect retinal circulation and are usually studied with the fluorescein procedure. Other problems, such as age-related macular degeneration, are caused by leakage from the deeper choroidal blood vessels. In these cases, the ICG procedure can provide additional information, which may not be available through a fluorescein angioscopy. In both angioscopy procedures, a small amount of colored dye is injected into a vein in the arm where it travels through the circulatory system and into the vessels in the eye. The dye makes these vessels visible to a special camera that is used to take photographs used by the doctor to diagnose various disorders of the eye.


Amsler's Grid Chart

If you are over the age of 45 or if your family has a history of retinal problems such as macular degeneration, you should have your eyes checked periodically.
Your ophthalmologist will examine your eyes with an ophthalmoscope to see if damage is present in the macula. Should macular degeneration be apparent, further tests will be done. These include the Amsler's Chart.


Amsler's Chart

 

Proper use of the grid will enable you to detect very subtle changes in your vision which can occur when there is just a small amount of fluid under your retina. To perform the test properly, wear the glasses that you normally wear for reading. If you wear bifocals, use the bottom portion or reading portion of the glass. Attach the Amsler's Chart to a wall at eye level and stand 12"-14" (comfortable reading distance) away from it. Cover one eye. With the other eye, look at the center dot.
The first day you observe the grid, mark with a pencil any areas of distortion, any gray or blurry areas, or any blank spots. This will be your baseline pattern.
Each and every morning thereafter, look at the center dot of the Amsler's Chart. If you notice new areas of distortion, wavy lines instead of straight lines, or enlargement of the blank spots, especially towards the center, you should call your ophthalmologist and arrange for an appointment as soon as possible.


Blurry Areas and Black Spots

Wavy or Crooked Lines



Your evaluation will probably include a retinal examination and eye photography to determine whether your new symptoms are due to fluid under the retina, and whether laser treatments may help.


Keratometer
A keratometer is used to precisely measure the curvature of your cornea.
This is used for the IOL power calculation, & also to evaluate the base-curve of a Contact lens.

Specifications:
* Ascon Medical Instrument Pvt. Ltd. (Model: ASK 890)
* Type: Sutcliff Type
* System Type: External Reading
* Corneal Radius of Curvature : 6.4-9.4mm (0.5 steps)
* Corneal Refraction Power : 36D - 52D (0.25 steps)
* Axis of Corneal Assignment : 0-180 Degree (5 Degree Step)

Retinoscope:

Purpose:
Used to determine the refractive error of the eye & for precise detection of the cylindrical axis. Using a mirror, light is reflected into the eye to determine whether your patient is shortsighted or long-sighted. Retinoscopy is taught by two methods, spot or streak. By sweeping the beam of light back and forth across the pupil, you achieve a reflex that will either move with your sweeping movements (hypermetropic eye) or against (myopic eye). These movements are commonly referred to as "with" or "against" movements respectively. The next step is to achieve neutralization (no movement at all) by inserting trial lenses between the observer and patient and sweeping the Retinoscope back and forth until no motion is detected. This lens is then the accurate prescription for your patient.


Specifications:

Heine Optotechnik, Germany.


Lensometer:


Purpose:

An instrument used to measure the power of an individual's current prescription eyeglasses.

             

          Manual                               AUTOLENSOMETER

A lensmeter or lensometer, also known as a focimeter[1], is an ophthalmic instrument. It is mainly used by optometrists and opticians to verify the correct prescription in a pair of eyeglasses, to properly orient and mark uncut lenses, and to confirm the correct mounting of lenses in spectacle frames. Lensometers can also verify the power of contact lenses, if a special lens support is used.
The parameters appraised by a lensmeter are the values specified by an ophthalmologist or optometrist on the patient's prescription: sphere, cylinder, axis, add, and in some cases, prism. The lensmeter is also used to check the accuracy of progressive lenses, and is often capable of marking the lens center and various other measurements critical to proper performance of the lens. It may also be used prior to an eye examination to obtain the last prescription the patient was given, in order to expedite the subsequent examination. At “DIVYADRASHTI”, we have both Auto & Manual Lensometers.


Auto Refractometer :

          

                    AUTOREFRACTOMETER

An Autorefractor or automated refractor is a computer-controlled machine used during an eye examination to provide an objective measurement of a person's refractive error and prescription for glasses or contact lenses. This is achieved by measuring how light is changed as it enters a person's eye.
The automated refraction technique is quick, simple and painless. After application of a cycloplegic agent to keep the ciliary muscle in relaxed position and avoid the erroneous diagnosis of a pseudomyopia, the patient takes a seat and places their chin on a rest. One eye at a time, they look into the machine at a picture inside. The picture moves in and out of focus as the machine takes readings to determine when the image is on the retina. Several readings are taken which the machine averages to form a prescription. No feedback is required from the patient during this process.
Within seconds an approximate measurement of a person's prescription can be made by the machine and printed out or shared electronically with an Automated Refraction System.
In some offices this is used to provide the starting point for the optometrist in subjective refraction tests. Here, lenses are switched in and out of a phoropter and the patient is asked "which looks better" while looking at a chart. This feedback refines the prescription to one which provides the patient with the best vision.
Automated refraction is particularly useful when dealing with non-communicative people such as young children or those with disabilities.

Tonometry (Schiotz & Applanation)

Purpose:
This instrument measures the Intra Ocular Pressure inside the eye, which is one of the very important tests to detect Glaucoma, a vision-degenerating disease. This pressure measurement is an important part of every eye examination, as increase in pressure may signal the beginning of Glaucoma, a sight-threatening disease. As per the normal guideline, pressure above 18 millimeters is considered to be elevated pressure.

The very common ways of Tonometry test is Noncontact tonometry (Air-Puff Test) & Contact Tonometry (Applanation & Schiotz Tonometer).

In case of first one, a gentle puff of air blows towards the patient's eye, when he looks through the machine. This will flattens the cornea slightly in order to give the pressure reading. The machine is gas pressurized and does not require direct contact with the eye.

While in later case, which is considered to be the most accurate, ophthalmologist use an instrument that looks like a pen in which the tip of the tonometer touches the eye and measures the pressure. An Applanation Tonometer measures the force required to flatten a small area of central cornea. A topical anesthetic and fluorescein dye are instilled before the measurement is taken. One type of Applanation tonometer attaches to a slit lamp, while another is hand-held. The Schiotz tonometer measures the amount the cornea indented by a fixed weight that artificially raises the pressure.

Color Vision Chart
A color vision test shows whether a patient can tell color differences. This is checked by Ishihara Color Vision Charts.

* Auto Refractometer (Picture and details of the machine attached separately


Flash Autoclave Sterilizer

Purpose:
Used in operation, to monitor sterilization cycle e.g. all the phases such as fill Heat, Sterilize, Vent, Dry & Completion are automatically preceded.
It's a high speed Autoclave machine which takes 5 to 7 minutes for a full sterilization cycle comapared to the conventional Autoclave machine.


Machine Highlights:

* Hanshin Medical Co. Ltd. (Model: HS-1321)
* Sterilization Temp. : 121-132 Degree Centigrade.
* Temp. Range: +10 to +40 Degree Centigrade.
* Reservoir: Capacity 51, 240w X 234h X 119d mm.

Ultrasonic Instrument Cleaner :

Purpose :
Used for effective cleaning of Instruments through a vibratory wave
of frequency.

Working Principle :
Ultrasonic is an effective cleaning method because it initiates cavitation. In this method, Gas filled, Vapour filled or empty cavities ranging in size from submicroscopic to very large may be produced in a liquid by varying methods such as Chemical, Thermal Or Mechanical actions and they may have a short or prolonged life. The production of these cavities and the effect that they induce on the medium or environment in which they are produced is known as Cavitation, minute bubbles are generated by Ultrasonics from gas nuclei. The Bubble expand until they are unstable, then they collapse at the onset of cavitation, the gas nuclei vary in size depending upon the surface tension of the liquid, temperature and the frequency of the applied Ultrasonic energy. The implosion generate minute vacuum areas which are responsible for the cleaning process. The forces of Cavitation are initiated at the instant of implosion and the binder or matrix which causes adherence of the dirt to the instruments surface is dislodged.

At DIVYADRASHTI we have, TARANG make ( D4 Surgicals) Ultarasonic cleaner, the specifications of which are :

Model : T J001
Tank Dimensions : 20 cm x 15 cm x 7 cm
Litre Capacity : 1.8 Ltrs
U/S Power : 50 Watts
U/S Frequency : 33 Khz
Input : 180 V- 270 V