Mar 6, 2016
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Hello, I'm new to this forum... I was looking to buy a pair of gonio lenses, one 3-mirror lens and either a 4-mirror or a 6-mirror lens. I just have a few questions I hope someone can help me with:

First of all, for the 3-mirror lens, should I get flange, no flange, nmr or what? And also what are people's views about the ocular max360 rotating lens?

And secondly what would you recommend for another lens, 4 mirror with flange or not or 6 mirror, Volk or OI?

I'm new to gonioscopy and really need some tips on which combination of lenses is better and more versatile, thanks in advance.
 
Mar 6, 2016
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Well I was thinking of getting a 3 mirror for a more versatile view of angle, peripheral retina and posterior pole, and a 4 or 6 mirror for a quick and complete look at the whole angle
 
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DrZeke

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Most clinics in an Ophtho residency have 3 mirror that you can borrow. It's a fun lens but if you can scleral depress you don't really need it. Why spend the money?

Using the 3 mirror to couple to the cornea/sclera with goniosol results in suction and false opening of the angle. This is why glaucoma specialists usually view the angle with a 4 mirror lens that you can perform indentation gonioscopy with... I would just get a 4 mirror. Flange makes the lens easier to hold if you don't have a handle...


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Shamsports

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I think it is a good idea to try a few gonio lenses before buying. I bought a Volk G-4 with a handle when residency started, and then I found out I hated the handle. Thankfully the handle is removable at least.

My favorite gonioprism now is the cheap disposable Sensor Medical Technology 4-mirror ($10). It is technically not supposed to be reused, but I just clean it with an alcohol wipe or soap and water between patients, and it has been working just fine.
 

cpufreak3

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I think it is a good idea to try a few gonio lenses before buying. I bought a Volk G-4 with a handle when residency started, and then I found out I hated the handle. Thankfully the handle is removable at least.

My favorite gonioprism now is the cheap disposable Sensor Medical Technology 4-mirror ($10). It is technically not supposed to be reused, but I just clean it with an alcohol wipe or soap and water between patients, and it has been working just fine.

Where'd you buy it from?
 

Shamsports

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You can buy a 10-pack for like $100 on the Sensor Medical Technology website: http://store.sensormedtech.com/. I keep one in a small ring box. It has been working awesome for me as a first year resident.

I think the Volk G-4 is a pretty good gonio lens, and the majority of the residents in my program own it. Hilariously, though, I like the $10 SMT lens better. I've never used the Ocular Instruments gonio lenses, but am guessing that they are pretty good, especially as Dr. Alward, the creator of gonioscopy.org, uses one (http://www.gonioscopy.org/index.php?option=com_k2&view=item&layout=item&id=49&Itemid=607)!

rcabrerab90, you can ask your local sales rep (e.g., Lombart, Volk, or OI sales rep) if he or she would be willing to bring you or send you some different gonioprisms to try prior to purchasing. Hard to say if the handle or flange is right for you without trying 'em out.
 

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A few things I wish I knew before ordering the gonio lens:
1. Handle vs no hande: I hate the handle and prefer the round ring to hold on to. Some people swear by the handle, but it is detachable.
2. Flange vs no flange: This is a round glass ring that presses against the patient's eye. Pros: Increased stability, more clear view. Cons: You need goniosol for your exam and you can't do dynamic gonioscopy because the pressure will be applied too far peripherally and the angle won't behave normally. To me the cons outweighed the pros to have the flange.
3. Number of mirrors: I find 4 to be the best, I'm not sure what advantage 6 provides. I have a really hard time locating the corneal wedge on the 6 mirror lens.
 
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Bluesclera

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I read somewhere that your own height plays into if you like the handle or not ( taller people let's say >6ft tend to prefer not having a handle vs I'm 5'8 and love the handle...)


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DrZeke

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I read somewhere that your own height plays into if you like the handle or not ( taller people let's say >6ft tend to prefer not having a handle vs I'm 5'8 and love the handle...)


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I've heard that too but I know some tall people who use handle and some short people who don't...


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