Tuesday, February 12, 2013

Welch Allyn Panoptic Ophthalmoscope Head

Welch Allyn Panoptic Ophthalmoscope Head

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Price: $539.90 $500.00   Updated Price for Welch Allyn Panoptic Ophthalmoscope Head now
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Product Feature

  • Head Only
  • Handle/power source Not Included

Product Description

Welch Allyn Panoptic Ophthalmoscope Head

Welch Allyn Panoptic Ophthalmoscope Head Review

I am a second year family medicine resident and for a long time I have been avoiding fundoscopic exams because I felt like it made the patient uncomfortable and I had tremendous difficulty seeing the entire retina using the standard Welch Allyn direct opthalmoscope. The best I could achieve was finding one of the retinal veins and then *maybe* seeing the edge of the disc-- and even then I wasn't sure what I was seeing. I am sure if I practiced enough with someone patient enough to let me practice on them, I would get better at identifying things.

Deciding it was time for me to do a proper exam on my patients, I ordered myself a panoptic opthalmoscope, and reviewed some videos on youtube. When I finally received it, I excitedly opened up the package and attached it to my Smart Lithium Handle and went to see the back of my wife's eyes. To my dismay, I couldn't see anything except glare. That night I went back online to see tips and instructions on using it properly.

I then went back the next day and tried again; I carefully cleaned the lenses with my lens cloth; instead of telling her to focus on a distant object, I just told her to look straight ahead. I also told her not to look into the light. I approached at a 15 degree angle and found the red reflex. Again, I couldn't see things. I did more research and noticed in one video that they recommended that if you lose the image you should back off and reapproach the fundus.

The next day I did just that, I was finally able to see the fundus. I was clearly able to see the cup/disc and veins. The arteries too, but not so obvious. And when your time is limited and you're concerned about your victim's comfort, the best you might achieve initially is "yep, I see the cup/disc." If you're as inexperienced with the fundus exam as I am, then expect to only be able to identify gross, gross pathology and nothing too subtle.

Even after seeing the disc, however, I had difficulty panning to see the vessels in all four corners. If I moved one way or the other, I easily lost the image; since the panoptic has such a narrow focus, any deviation from the entryway of the eye will cause problems. I still have not had success in getting to the macula. And the tips I've seen online where they tell you to make the patient look up, down, left, right, etc to see the rest of the eye require you to back off and find the fundus again each time. So basically, the moral of the story is: don't expect to become an expert in eye exams overnight. There is still a learning curve with this item. You definitely get a fuller view with it but you need to actually know what you're looking at.

The more you practice the faster you'll be and the more comfortable you will be in actually looking for pathology rather than searching for the cup. I hope that after quite some time the panoptic will give me enough experience with the fundus so that I might even be able to perform a good eye exam with a standard scope.

All in all I think it is worth the money.

In terms of the convenience, however, it is big and bulky. I carry it around in my white coat pocket in a little black bag, and it's fallen out of my pocket three times already in two days. Lint collects all over the rubber eye cup and the lens. I need to find a better way to transport it.

In a busy clinic day, it may seem hard to find time for the panoptic, especially since you might have to pull it out, assemble it, and clean it. But it is worth it to take the time with each of your patients if you can squeeze an extra minute or so with each patient for your benefit and theirs.

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