question on buying lenses

[smercury]

I'm starting my ophtho residency in a couple weeks, and I'll have to buy my own lenses.
I've got a lot of questions: What company is the best? How much money do I have to invest? What sizes should I get (66, 90, 20?) and do the standard sizes come in their own set, or do you customize your box set?

Any help would be appreciated!

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[Andrew_Doan]

I'm starting my ophtho residency in a couple weeks, and I'll have to buy my own lenses.
I've got a lot of questions: What company is the best? How much money do I have to invest? What sizes should I get (66, 90, 20?) and do the standard sizes come in their own set, or do you customize your box set?

Any help would be appreciated!

I purchased the VOLK 90D and 20D lenses. I also like the VOLK Superfield, but have found that I can see everything with the 90D and 20D lenses.

You'll customize your set as needed. Lenses will cost ~$200 each for the 90D or 20D. If you look on eBay, then you may get lucky and find a lens for less than $100. Good luck!

http://volk.com/

 

[Retinamark]

A Volk 60 D lens is fantastic for examining the macula. You'll be amazed how much more you can see. Subtle macular edema, tiny macular branch vein occlusions, CNVM etc. It's a bit harder to use than a 90 & it's not much use for things outside the arcades, but as a supplement to the 90, for examining macular lesions, it is an excellent investment.

Likewise, a 30D lens is great for examining kids, adults with small pupils (eg ICU patients where the neurosurgeons won't let you dilate the pupils) and retina patients with intra-ocular gas.

Pay the extra money & get Volk lenses - they'll last you a lifetime.

 

[GlaucomaMD]

I agree with others in recommending Volk. I feel their lenses are much superior to Nikon or Ocular Instrument.

If you can only afford 2 lenses - get 90D and 20D. You can do 99.99% of what you need with these two.

If you can afford 2 more lenses, I suggest 78D and 28(or 30)D.
You have to have a well-dilated pupil to use 60D which you can't get in a lot of patients (especially glaucoma patients!) whereas 78D allows better mag than 90D while only needing slightly larger pupil. 28 or 30D will let you see the periphery further as well as through a smaller pupil than with 20D.

Again, though 90D and 20D will let you do almost everything you need.

Of course, I can't finish this reply without exhorting the need for a good gonioprism 😀 . My favorite is the Posner gonioprism made by Ocular Instrument. I think it's easier to use than the Zeiss prism or the handheld gonioprisms (Sussman) made by Volk.

Best time to get lenses are at the Academy, I think. If not, I would try to find a local distributor as they have better prices than Volk direct.

http://www.lpoproducts.com/index.asp
http://www.lombartinstrument.com/products.htm

Good luck with the residency!

(Too bad your residency doesn't provide you with lenses. Both Baylor and Bascom Palmer provide their residents with free lenses...)

 

[smercury]

all your input helps a lot. time to do some more researching and shopping!

 

[Eyesore]

Check out the first link by GlaucomaMD, and click products and look up the lenses. It has good descriptions for you to make the comparisons including field of view and image magnifications. I wouldn't pay those prices though. You can certainly get them cheaper and companies like Lombart give discounts to residents. They will even throw in the case.

Good luck with your choices!

 

[GlaucomaMD]

Eyesore,

How do you like your Super 66? I'm getting mine next month...

I have noticed that Pan Retinal 2.2 gives slightly distorted image not seen with 20, 28, or 30D. What has been your experience?

 

[Retinamark]

If you're going to buy just one indirect lens, the 2.2 is a good compromise, with similar (but not quite as much) mag as the 20 & a field of view much better than a 20 (but not quite as good as a 30).

If you can afford 2 lenses, you're better off with a 20 & 30, because then you have the better mag of the 20 when you need it, & the better field of view of the 30.

I bought a 2.2 initially & it's a great lens & I was really happy with it. But then I found I really needed a 30 for post-op retinal surgery patients. So now I wish I had just bought a 20.

They are all good though, & you can be a great clinician no matter what lenses you have. Someone told me that Don Gass used to use a Hruby lens!

 

[Eyesore]

Eyesore,

How do you like your Super 66? I'm getting mine next month...

I have noticed that Pan Retinal 2.2 gives slightly distorted image not seen with 20, 28, or 30D. What has been your experience?

I love the Super66! It's all that I really use for dilated exams. Not only is the image larger, the stereo is excellent. This really allows you to discern the fine details. It gives you a view that you can't get by using a different lens and increasing the mag on the slit lamp. Also, I feel you can see decently far out in the periphery with this lens. Basically, I only use the SuperField on undilated patients.

As far as the 2.2, I don't notice the distorted image, but it's all that I've ever used. I haven't really used the 20, and I only use the 28 to see post op retina patients.

Let me know how you like your Super66 when you get it. I have a feeling that your 78 may take a back seat to this one.

 

[JJMD]

the 2.2 is better for getting anteriorly than the 20...the 66 gives better axial mag than the 78 but has more distortion laterally...i have owned all four, and would buy a 90, 2.2, and 78.