Optometric Equipment Question - Gonio/Slit lamp lenses, stereo tests

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chb64

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I have to make equipment purchases soon and was hoping someone could give me some advice on these - I have never done gonio/slit lamp exams (I just finished first year) and have really no idea how to use these lol so any advice is appreciated!

my options are:
1) Volk 3 Mirror Gonio Fundus lens - flange or no flange? (apparently flange provides stability for the examiner but is difficult to remove off the patient's eyes?)

2) Volk 20 D lens, 90 D lens, 78D lens, and/or Superfield NC Lens

3) Stereo Test - Butterfly or Randot (is there any real difference between the two, except that butterfly is geared towards pediatric patients?)

Thanks!!

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I am pretty sure NBEO Part 3 only provides a Gonio lens with flange. We weren't given an option at my school, and it is not that hard to remove. Prepare yourself for boards and go with the flange.
 
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Thanks for the reply - should've specified I am a Canadian optometry student. Will check what is used for Canadian Boards but thanks for the heads up - didn't think of this.
 
I have to make equipment purchases soon and was hoping someone could give me some advice on these - I have never done gonio/slit lamp exams (I just finished first year) and have really no idea how to use these lol so any advice is appreciated!

my options are:
1) Volk 3 Mirror Gonio Fundus lens - flange or no flange? (apparently flange provides stability for the examiner but is difficult to remove off the patient's eyes?)

2) Volk 20 D lens, 90 D lens, 78D lens, and/or Superfield NC Lens

3) Stereo Test - Butterfly or Randot (is there any real difference between the two, except that butterfly is geared towards pediatric patients?)

Thanks!!

I would encourage you to buy as little equipment as possible. Once you finish school, chances are, wherever you accept work, you will be provided with such items. If you are not, you can buy things then, which is more sensible, as, one, you actually will have income, and, two, you'll have a much better idea of what to purchase.
 
If you do end up buying things, be cautious to purchase what you think is the best tool — don't buy based simply on what is available for Part III of the N.B.E.O. examination.
 
I have to make equipment purchases soon and was hoping someone could give me some advice on these - I have never done gonio/slit lamp exams (I just finished first year) and have really no idea how to use these lol so any advice is appreciated!

my options are:
1) Volk 3 Mirror Gonio Fundus lens - flange or no flange? (apparently flange provides stability for the examiner but is difficult to remove off the patient's eyes?)

2) Volk 20 D lens, 90 D lens, 78D lens, and/or Superfield NC Lens

3) Stereo Test - Butterfly or Randot (is there any real difference between the two, except that butterfly is geared towards pediatric patients?)

Thanks!!
1. I wouldn't get a flange. It's so much easier to pop the gonio on the eye rather than having to get goniosol involved. You don't gain enough from the flange to warrant the hassle.

2. You need 1 slit lamp lens and 1 BIO lens. 20/90 is great to start. You can get 78/66 if you want more mag (but these are harder for undilated pupil exams)

3. Do you really need to buy your own stereotest? Randot has 10 targets which measures down to 20 arcsecs, Butterfly has 9 targets which measures down to 40. Not much of a real-world implication but a subtle difference does exist between the two.
 
My school made us get a 3 mirror flange gonio lens because you'll likely learn how to do dilated peripheral retina with the mirrors as well as gonio. I also have a Volk G4 which I use for routine gonio because you don't need celluvisc but it's less stable because it's flangeless.

I bought the standard 20 and 90 for DIRT cheap off this site because it seemed like that's what everyone uses. I hate them both. They're both collecting dust most of the time in my drawer. The 90 gets more use than my 20 (unless you count when my attendings double check behind me). I use my 78 for my dilated fundus exams in SLE and my 28 for all my BIO. I get out to ora that way and the lens is smaller with a shorter working distance which is LOVELY for me as a 5'1" woman. I don't need excessive mag in BIO-If i see something-I look at it in SLE since BIO is first anyway. 90 I reserve for undilated exams and I'm thinking of getting rid of that for a digital wide field when I get some spare cash anyway. If anyone is selling-let me know.

All lenses are personal preference but I don't recommend jumping the gun and engraving anything in case you don't fall in love with it and want to sell them, it might make it A LOT harder.
 
My school made us get a 3 mirror flange gonio lens because you'll likely learn how to do dilated peripheral retina with the mirrors as well as gonio. I also have a Volk G4 which I use for routine gonio because you don't need celluvisc but it's less stable because it's flangeless.

I bought the standard 20 and 90 for DIRT cheap off this site because it seemed like that's what everyone uses. I hate them both. They're both collecting dust most of the time in my drawer. The 90 gets more use than my 20 (unless you count when my attendings double check behind me). I use my 78 for my dilated fundus exams in SLE and my 28 for all my BIO. I get out to ora that way and the lens is smaller with a shorter working distance which is LOVELY for me as a 5'1" woman. I don't need excessive mag in BIO-If i see something-I look at it in SLE since BIO is first anyway. 90 I reserve for undilated exams and I'm thinking of getting rid of that for a digital wide field when I get some spare cash anyway. If anyone is selling-let me know.

All lenses are personal preference but I don't recommend jumping the gun and engraving anything in case you don't fall in love with it and want to sell them, it might make it A LOT harder.

I don't think I've ever heard of someone who hated the 90 and 20. Others may prefer other lenses, but what makes you hate those lenses so much?

You don't want the increased mag using BIO but want it with the slit lamp? Did you purchase your 28D and 78D new or used?
 
You don't want the increased mag using BIO but want it with the slit lamp?

^Yes. Exactly what I said. I don't need the mag on BIO, I prefer the field. I get out farther in the periphery. And for me, the decreased working distance is phenomenally easier than leaning back awkwardly. I don't want to have back issues at 30. If I see something I need to look at in more detail, enter the 78. When the patients are dilated, it's a magical partnership. Optically it doesn't make sense that you get MORE mag and field than a 90, but the lens is physically larger, so you do end up getting more field kind of ass-backwards without moving your hand. I keep the slit lamp on a low mag to start and then kick up to look at nerve and macular detail.

The only time I use my 90 is when pts are undilated, and like I said, trying to get a DWF anyway. With low mag I feel like I don't see enough detail with a 90-and with higher I feel like the clarity sucks + I can't move into the periphery of the lens without distortion. This is just my opinion and experience, I know I'm disagreeing with almost every person in the field right now, but it's what I like and what works for me.
 
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