4-mirror gonio and Perkins advice

[eyedesire]

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Hey,

I was wondering if any students/practicing optometrists use a 4 mirror gonio and if there is a significant advantage over the 3-mirror gonio (besides being able to do corneal compressions with the 4 mirror!). Is it just a matter of preference? Or do you really get a better view.
Same goes with perkins tonometer. Is there a significant advantage to the Perkins over Goldman?

Thanks for the advice,

eyedesire

 

[armstrong77]

For convenience, 4 mirrors and 3 mirrors aren't even in the same sentence.

Performing an assessment using a 4 mirror is no more complicated than Goldman tonometry. In that respect, it has no equal.

That said - the 3 mirror allows u to assess breaks in the far periphery - so it won't be replaced by the 4 mirror.

 

[PBEA]

Hey,

I was wondering if any students/practicing optometrists use a 4 mirror gonio and if there is a significant advantage over the 3-mirror gonio (besides being able to do corneal compressions with the 4 mirror!). Is it just a matter of preference? Or do you really get a better view.
Same goes with perkins tonometer. Is there a significant advantage to the Perkins over Goldman?

Thanks for the advice,

eyedesire

3 mirror provides excellent view, and other mirrors can be handy for other things.
4 mirror gives adequate view, but its main benefit is its speed and smaller size.

I use 4 mirror

Perkins is generally reserved for cases where a slit lamp is not practical. If given the option, always choose slit lamp mount, as it is more reliable. BTW, they are both Goldmann, one is just handheld.

 

[jefguth]

Hey,

I was wondering if any students/practicing optometrists use a 4 mirror gonio and if there is a significant advantage over the 3-mirror gonio (besides being able to do corneal compressions with the 4 mirror!). Is it just a matter of preference? Or do you really get a better view.
Same goes with perkins tonometer. Is there a significant advantage to the Perkins over Goldman?

Thanks for the advice,

eyedesire

I have both, without a question I almost exclusively use the 4-mirror; its faster, easier for the examiner, and has the advantage of compression.

I reserver 3 mirror for cases where I'm just not getting an adequate view with the 4 mirror. That said I've only used it twice since second year optometry school.

As for the Perkins... that is one of the many things I've come to hate about optometry in Canada (Perkins, CSAO, other OD's...). For #$%&@ sakes I don't understand why Canadian OD's are so in love with that stupid thing. Unfortunately, you'll probably have to buy one since hardly any optometry clinics are equipped with a Goldman.

 

[optsuker]

I have both, but prefer the Sussman 4 mirror.
Easier to hold the lens and manipulate lids/lashes with the same hand.
Assessing peripheral retina is better with other instruments.

I use a Perkin's tonometer on every patient. Don't own a NCT and I like that it can be used on any patient. There are many patients who don't fit in slit lamp & the Perkins can be done in any room/chair.

 

[4Eyes]

(we were required to buy both....)

When either choice would be reasonable, patients also tend to prefer the smaller 4-mirror as well.

Not that it will matter in everyday practice, but for NBEO Part III - I was worried about nerves taking over and getting bubbles in my view. Since I had the choice, at that time I went with 4-mirror. Less room for error and faster. I don't think NBEO should necessarily influence your decision on whether or not to buy one though.

 

[Dwight Schrute]

although the 3-mirror is the standard and works great 99% of the time, every now and then you'll come across what we call cro-magnon patients where the 3-mirror simply cannot be consistently or comfortably placed over the angle because the eyes are too deep set or the eye socket is too small; you'll need the smaller 4 mirror for these patients--i think every practice should have both

 

[362.04]

Hey,

I was wondering if any students/practicing optometrists use a 4 mirror gonio and if there is a significant advantage over the 3-mirror gonio (besides being able to do corneal compressions with the 4 mirror!). Is it just a matter of preference? Or do you really get a better view.
Same goes with perkins tonometer. Is there a significant advantage to the Perkins over Goldman?

Thanks for the advice,

eyedesire

I think the nature and manner of the environment that you will practice will probably dictate more of what you will like or use in a gonioprism.

For some optometry graduates who will practice in the context of detect and refer, I would recommend a simple 4 mirror Zeiss type gonio. It is quick and usually creates little after effect on a cornea. It's safe. If you are anticipating in practicing in a more indepth mode then a 3 mirror Goldmann might be better.

I tend to use my 4 mirror a lot, especially when the schedule says 30-40 per day.