Kavya Sudhir

This week I was in the oculoplastics service as well as the glaucoma clinic. Both offered very different areas of Ophthalmology which was very interesting to see. In oculoplastics, a lot of procedures and decisions were made as the surgery progressed- excited to spend more time on this service to learn more about the needs of oculoplastics to lessen the burden on patients and allow the surgeons to focus on their procedure rather than figuring out what tubing may be the best for the patient. One bad design I noticed was the eye shield. While I see the need for them I feel as though they are designed poorly especially for the patients who are only under local anesthesia- I wonder if there was a smoother way to remove the eye shield from the eye other than sunction. This process felt like a lot of pressure was placed on the eye of the patient as well as sometimes just didn’t stick to the eye shield which wasted the time of the surgeon.

A: Levator lift procedure; checking to see the elevation was properly done proportionally to the person’s blink

E: 3 surgeons (2 residents and 1 attending) and 1 anesthesiologists

I: Patient was under local anesthesia, when necessary surgeon asked the patient to blink after removing the eye shields

O: surgical equipment, eye shield

U: Surgeon and patient- always controlled by the surgeon

One good design I saw was in the glaucoma clinic- a practice that uses a lot of medical devices on every patient. They have a handheld tonometer that is used in service for patients who have difficulty staying still and resting their head on the chin rest along with patients who are bedridden and/or in the inpatient unit unable to lift their head. This handheld device is lightweight and the optometrist stated it gave accurate measurements.

Spent a lot of time in contact lens and glaucoma clinic this week. Noticed similarities in patient’s inability to properly use the devices they need for proper eye care. For example, in contact lens clinic many patients have difficulty with inserting the scleral lens into the eye. In glaucoma clinic, many patients have difficulty with actually applying the eye drops into their eye to alleviate their intraocular pressure. It is evident that scleral lens insertion is very difficult as can be seen with approximately 20% of users who claim discomfort with scleral lens insertion [1].

In the contact lens clinic right now, they are using a styrafoam cup with a hole. A flashlight is inserted underneath and a plunger system is used to insert the scleral lens. This larger apparatus is used for patients who have a hard time with fine motor skills or has sever visual impairment so they can only see light. Currently, the “t5 mini inserter” exists which has a rod lik apparatus with a plunger system at the end and a light at the other end to guide the patients. It is currently patent pending and sold for around $400.

[1] Ruiz-Lozano RE, Gomez-Elizondo DE, Colorado-Zavala MF, Loya-Garcia D, Rodriguez-Garcia A. Update on indications, complications, and outcomes of scleral contact lenses. Med Hypothesis Discov Innov Ophthalmol. 2022 Feb 24;10(4):165-178. doi: 10.51329/mehdiophthal1435. PMID: 37641653; PMCID: PMC10460232.

Below is the needs statement that I worked to develop based on my observations throughout various clinics and OR settings at UI Health Ophthalmology.