Hey everyone,

I'd welcome some advice on whether to buy surgical loupes now, and if so, what specifications/names should I look for.
I just started ophtho residency a few weeks ago. After finally feeling good about internship, I've returned to knowing nothing. It's pretty depressing.

Anyway, along with buying a ton of incredibly expensive and heavy books, as well as even more expensive lenses, my attending recommended I get loupes so I can "learn how to operate correctly from the beginning."

I'm not entirely averse, as it seems I may have to get them eventually anyhow. It might be good to learn to use them and see the anatomy clearly from the get go. But I wanted opinions from the peanut gallery and any recommendations for brand names, magnification, style, etc. Thanks in advance and good luck to all you new interns, and residents.

Hey everyone,

I'd welcome some advice on whether to buy surgical loupes now, and if so, what specifications/names should I look for.
I just started ophtho residency a few weeks ago. After finally feeling good about internship, I've returned to knowing nothing. It's pretty depressing.

Anyway, along with buying a ton of incredibly expensive and heavy books, as well as even more expensive lenses, my attending recommended I get loupes so I can "learn how to operate correctly from the beginning."

I'm not entirely averse, as it seems I may have to get them eventually anyhow. It might be good to learn to use them and see the anatomy clearly from the get go. But I wanted opinions from the peanut gallery and any recommendations for brand names, magnification, style, etc. Thanks in advance and good luck to all you new interns, and residents.

Loupes can get expensive in a hurry, particularly if you buy from the well-known manufacturers. At the same time, you may be over-spending to buy a high-end set at the beginning of residency without knowing what your post-residency needs for loupes will be.

I bought a set of Keeler spectacle loupes with 2.5x Galilean telescopes at the beginning of my residency. They were perfectly adequate for that period of my training. Later, during fellowship, I was provided with Designs for Vision roof prism loupes at a higher mag, which I still use (along with a couple other pairs I have bought since.) I sold the Keeler set on eBay after residency and got decent resale. There is a good market for them there. I can recommend you do the same.

Galilean optics are adequate and simple and compact. They are not as bright as roof-prism optics nor are they as expensive. If you rely on good loupe magnification for most of your surgery, a pair of roof prism loupes is the way to go, IMO.

Brands to look for are Designs for Vision, Zeiss, Heine and Keeler. There are other good but less well-known makers. All of those I named make both Galilean and roof-prism telescope loupes in a range of magnifications. I recommend you try a few on if you can first, maybe at a trade show. Occasionally a salesman will visit a residency program to show and demo his lines. Most manufacturers also offer a full-refund trial use period, which is something you should insist on before committing to buy.

Part of it will depend on your residency. Where I trained, if you didn't have loupes, you got to watch in peds and plastics, rather than actually operating. I also think it's nice to have them for dealing with lid lacerations in the ER.

I agree with orbitsurgMD that going high-end if you don't know what you'll be doing long term is probably not worth it. All but one resident that I can think of where I trained got the Heine 2.3x loupes. They adjust pretty easily, they're lightweight, reasonably sturdy, and they're relatively cheap (around $300 at the time, which wasn't that long ago).

I had strongly considered getting a Designs for Vision pair (it was an option for a Christmas gift from my parents one year), but I decided that they would be wasted on me for what I wanted to do.

but I decided that they would be wasted on me for what I wanted to do.

So who in your opinion should get them? Those going into peds and oculoplastics only?

I've been wondering too if I should get loupes. Very few residents in my program get them, maybe because we train with attendings who don't really use them. Our peds and oculoplastics attendings do not use loupes for their cases.

I bought a pair from design for vision (custom) which I now rarely use, but they were great for doing peds and plastics cases.

It maybe worthwhile for all the residents or residents in the same class to pitch in and purchase a pair of non-custom loupes since only one resident will be using them most of the time (this sill minimize cost and maximize your experience on your rotations).

I guess it depends on how much you think you'll use them. If you're at a program where none of the attendings use loupes (sounds odd), then you can probably get away without the expense. If your program requires them, but you don't think you'll use them after residency, you can probably get by with a "cheap" set. If you are destined for oculoplastic or peds and feel you will use loupes in practice, you may want to pony up for a nice set. Alternatively, you could still go with a "cheap" set, then upgrade once you are in practice and can more easily afford them.

I was in the middle category. Needed them, but knew I was going to do retina. I went with the Heine C series 2.3x on the frame mount. They were in the mid-300 range when I got them, but they're apparently about 100 more now. Still a good price for loupes. The mag is sufficient with good field of view. They come in a sunglasses-sized case, which makes for good portability. If you wear spectacles, there is a headband-mounted version available. I've actually held on to them, as they come in handy for odd jobs around the house!

I'd advise against the fitted loupes, unless you're sure you will use them in practice. They're expensive and can't be easily resold like the adjustable ones can.

some recs from an old thread:

http://forums.studentdoctor.net/showthread.php?t=222539

So who in your opinion should get them? Those going into peds and oculoplastics only?


I think that a lot of people in peds and plastics will eventually get them anyway. I just felt that they I wouldn't get the full value out of them, and that I could put the difference to better uses.

hi there,

can't find out if anyone has tried the HEINE HR® Binocular Loupes (see http://www.heine.com/eng_US/PRODUCTS/PRODUCT-OVERVIEW/Binocular-Loupes/HEINE-HR-R-Binocular-Loupes). there's lots of discussion amongst the dental peeps, but what about for eye docs?

just wondering, b/c i just bought the designs for vision (nike), which fit terribly for my face and hurt my nose. i think i might just return them altogether and go for the non-customized (and cheaper!) version. anyone have any experience with the Heine loupes?

thanks!

hi there,

can't find out if anyone has tried the HEINE HR® Binocular Loupes (see http://www.heine.com/eng_US/PRODUCTS/PRODUCT-OVERVIEW/Binocular-Loupes/HEINE-HR-R-Binocular-Loupes). there's lots of discussion amongst the dental peeps, but what about for eye docs?

just wondering, b/c i just bought the designs for vision (nike), which fit terribly for my face and hurt my nose. i think i might just return them altogether and go for the non-customized (and cheaper!) version. anyone have any experience with the Heine loupes?

thanks!

I have a set of Heine roof prism loupes mounted to a headband with an LED spotlight system. It runs off one of their mPack LiIon batteries, the same type as they use for their indirect ophthalmoscopes. The loupes are very good.

The pair in the photo you have linked to are a Galilean design, which will be simpler, lighter and less expensive than a roof prism telescope. I believe they are removable from the frame and can be replaced by a roof prism binocular loupe telescope later on if you decide you need something brighter or with higher magnification. For residency training, they should be fine for you.

Frame loupes that fit poorly and are uncomfortable are a misery that usually does not improve. If you can return the loupes you bought, I suggest you do so and find something else to use.

I've got the traditional Designs for Vision loupes with the lowest mag they sell and the optics are fantastic and they are very comfortable. I'm glad I don't have to adjust the telescopes everytime I put them on since they are mounted in the lenses. 99% of attendings use these loupes at the places I've been. Resident price: ~$850.

It is a good idea to buy a decent pair of loupes. You will probably use them for the rest of your career, even if you are not going into peds or plastics (you never know when a lid lac is going to come when you're on call). Designs for vision's 2.5x are probably the "standard" pair and run about $850. They have great optics and can take a beating. Also, you can clean them with alcohol wipes (other brands have certain coatings on the lenses that are ruined with alcohol). I use these and like them alot. Optical instruments makes great loupes at comparable prices and have a wider and deeper field of view. I would go with either one of these and I would buy them as soon as you can afford it.