The adage “everything old is new again” has been proven through comebacks in cars (the Dodge Charger) dance (swing dancing), toys (Tamagotchis), acid wash denim and, as I discovered via a weekend of thorough spring cleaning in the practice with staff, ophthalmic equipment.

Here, I provide specific examples, so you can see the value in rediscovering equipment.

BINOCULAR VISION TESTING

Recovering the Worth Four Light Test, also known as the Worth 4 Dot test, and the Maddox rod test was a great reminder of their utility in performing extended sensorimotor testing on new patients suspected of binocular vision issues.

As a brief reminder, the former test aids in determining the degree of one’s binocular vision via the assessment of anomalous retinal correspondence, fusion and suppression. (Youtube videos demonstrating the test can be found at bit.ly/3v3Y9xC .)

The Maddox rod test, based on the principle of diplopic projection, helps us in identifying and measuring a horizontal, latent, manifest or vertical strabismus for near and distance. (See bit.ly/3yjHHeu .)

CORNEAL IRREGULARITY TESTING

Although the practice uses a device that provides both corneal topography and corneal pachymetry, we use this device exclusively for topography. As a result, when I found a hand-held ultrasound pachymeter at the bottom drawer of a filing cabinet, I decided to train the technicians on using it for indicated patients and submitting for CPT code 76514. This allows technicians to be able to use the device in a different room and not have to wait for the tomographer, maximizing office efficiency.

REFRACTIVE ERROR TESTING

Other pieces of equipment we found were two manual phoropters. One still works; the other does not. We decided to use the working phoropter in a nursing home to set up a satellite clinic where we could help the residents, and we added the other one to a small, kids play area in the office.

Additionally, we have started using the corneal mapping capabilities on our auto-refractor as a screening tool for all patients. This has led to more referrals for additional topography scans, when indicated. Also, the auto-refractor has been a helpful tool for patients who remove their contact lenses in the office before a refraction: If there is corneal irregularity detected due to extended or over wear, it’s a great educational supplement to explain why they should consider changing to other modalities or why repeat refractions are needed for glasses prescriptions. Using the different capabilities of the entrance testing has translated to increased efficiency and less confusion for technicians regarding multiple testing.

ANTERIOR SEGMENT TESTING

Instead of trading in old iPhones for credit toward a new one, we have turned ours into external anterior segment cameras via slit lamp adapters. (See “Examples of iPhone Adapter Companies,” below.) Staff and I have found that having an adapter and an older smartphone ready in each exam room makes it easy to acquire an external picture on the spot. From there, we send it to a Bluetooth-enabled printer or computer.

SPECIALTY LENS EQUIPMENT

Another piece of forgotten equipment that recently has served the practice well is a GP polishing station. After bringing it out from the recesses of the practice, staff is, once again, helping RGP lens wearers. Additionally, using the polishing station has helped us collaborate with other doctors in the area who may not have a polishing station. Specifically, we invite other practices to send their patients to us for a deep cleaning of their lenses, with a polishing of the edges, for a small fee. Patients and co-managing doctors appreciate having this service available, especially those patients who have trouble with at-home cleaning kits.

OPTOMETRY SCHOOL BAG ITEMS

Finding small equipment, such as handheld devices and trial lens kits, in old optometry school bags collecting dust in the practice’s basement has been particularly fortuitous during the COVID-19 pandemic. The reason: Because we were able to place this extra forgotten equipment in our exam rooms, the need to move equipment from one room to another has decreased, facilitating disinfection. Finding many slit lamp filters led to adding Velcro and attaching a separate filter to each slit lamp.

Examples of iPhone Adapter Companies

Digital Eye Center: Digitaleyecenter.com

 

Eye2Mobile: Eye2mobile.com

 

EyePhotoDoc: Eyephotodoc.com

 

Merco Frames: bit.ly/3twknri

 

TTI Medical: bit.ly/3x8q297

 

 Welch Allyn: bit.ly/3dtGXLx

 

  Zarff Enterprises: Zarfenterprises.com

 

VINTAGE EQUIPMENT

Finally, staff and I discovered some older monocles and a glasses-tinting station, which we decided to use to create a small, clear box coffee stand museum. I felt having this would be a great way for patients to learn about the history behind some of the equipment, while waiting to be seen. Whether the décor is spread throughout the office or in a small space, we have found that patients love looking at vintage equipment. For many patients, it’s a reminder of what they may have seen their grandparents wear, while for others, it’s a peek into prior fashion trends.

BRING IT BACK

Not only was it a fun weekend sifting through old equipment, but it was also an educational experience for some new technicians. For example, there was definitely a moment of appreciation from the staff when I explained how to use a handheld keratoscope to evaluate corneal irregularity. For this practice, decluttering brought about a welcomed side effect: discovering that the adage “everything old is new again” rings true in an optometric practice as well.

Whether it’s teaching the technicians how to utilize older or forgotten equipment or offering different services to patients, bringing out the equipment mentioned above has helped the practice. OM

DR. BHAGAT practices at the TLC Laser Eye Center, in Providence, RI, where she works alongside Dr. Ezra Galler, a corneal, cataract and refractive surgeon. She has been published in numerous journals, lectured and presented at major meetings and CE events and has volunteered on subcommittees for large optometric organizations.