Welch-Allyn PanOptic

[in_translation]

I'm an entering first-year and trying to do some research on equipment. I was looking around at ophthalmoscopes and I was curious if anyone had opinions on the Welch-Allyn PanOptic? I would think most opt profs would recommend learning on the standard equipment, but the wider degree view of the PanOptic is enticing, albeit costly. Any opinions or advice would be appreciated!

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[rpames]

I have not met a 4th year of graduate that think the panoptic was worth the cost. None of us use it. DO NOT GET IT!!! It is $500 you can use on a ton of good reference books...or beer .

You may use it during 1st or 2nd year, but once you get in clinic you will most likely not grab for it. If you need to see a wide angle view of the posterior segment you will use a 90 diopter lens.

Again, don't spend the money.

 

[iiiimonica]

Counter point- We used it on our VOSH trip and in my module the clincians were fighting over it. Our head doc wants to buy one, she (a long time practicing OD) loved the views and it was much easier to see a full view. It also felt easier to get into the eye, but that might just be my sucky DO skillz

 

[4Eyes]

I haven't used mine much since I wanted to learn on the "regular," but I can tell you what my thought process was when I was trying to decide what to buy. When I was asking around to see what the then-3rd years thought, there were those that don't have it and don't miss it...and others who have it, love it, and use it all the time. Some felt it was easier with kids, and, in some low-income areas, they liked not having to get as close to people who...hadn't bathed in a while (sorry if that sounds bad...it's just what someone told me). Something else you might consider is the fact that it'll never be cheaper than while you're in school.

 

[r_salis]

Something else you might consider is the fact that it'll never be cheaper than while you're in school.

As an aside, this is true for all equipment -- if you think you might want something, it's probably worth buying it because you can always sell it later and get nearly all your money back out since the prices are so much better as a student.

 

[stevec]

I hear people use them for school screamings and SVOSH, but that's about it.

 

[in_translation]

I haven't used mine much since I wanted to learn on the "regular,"

So do you have a standard scope and then also the panoptic head?

 

[4Eyes]

So do you have a standard scope and then also the panoptic head?

Yes. I got the diagnostic set with two handles, the ret head, the regular o-scope head, the panoptic head, and miscellaneous accessories. I didn't think getting the panoptic was that much more $$, at least not in the grand scheme of things.

 

[yOyOYoo]

I won mine in a class raffle, I didn't think I would use it. But actually I find that it is a LOT easier to use than your regular Direct Ophthalmoscope. For me, it's much easier to get solid views of the fundus.

Then again, we're now learning how to use our 90D lenses + slit lamp, and supposedly, in our clinic, after people get that skill down, no one really goes for their DO anymore.

It's definately a nice tool to have for a quick look in the back of the eye.

 

[Phat Man]

The Pan-Optic is amazing, it gives you a bigger field of view and gives you the ability to not violate people's personal space. I do alot of screening/volunteer work and can't use a 90D when you are out of the office and this is a very useful tool, even in my private practive I tend to use it more than my 90D because i prefer it on small pupils.

 

[neurodoc]

The WA Panoptic is easy to use and provides a much better (larger field-higher magnification) view of the fundus, and works well thru small pupils. It is like those older monocular indirect scopes that WA used to make, but better ergonocially and optically. I especially like the continuous dioptric control, so much nicer than the discrete steps of the diopter wheel on standard direct scopes.

This is a lot easier to use than a binocular indirect. It lacks the stereo view of the BIO, but the image is not inverted. Sure, you can do more with a slit-lamp and accessory lenses and a BIO with hand lenses (my favorite is the Pan-Retinal), but this stuff is cumbersome, expensive, and requires a lot of skill to use. The Panoptic scope is easy to use in the clinic, the ER, and at the bedside. Well worth it in my opinion.

BTW, the new WA Macroview Otoscope is a great imprrovement over the conventional otoscope. Continuously variable focus and better view. Considering that good conventional sets cost around $500 and that you can get the Panoptic-Magnaview set for $800-900, the extra expense is worth it.

 

[jefguth]

just to clarifly, the panoptic does provide a better overall view of the fundus (a larger field of view) because it uses LESS magnification than a direct. The field of view is inverse to the mag... or somthing like that

 

[cpw]

just to clarifly, the panoptic does provide a better overall view of the fundus (a larger field of view) because it uses LESS magnification than a direct. The field of view is inverse to the mag... or somthing like that

Goooo OPTICS !!

 

[neurodoc]

just to clarifly, the panoptic does provide a better overall view of the fundus (a larger field of view) because it uses LESS magnification than a direct. The field of view is inverse to the mag... or somthing like that

Of course you are right; the panoptic gives LESS magnification and a wider FOV. Mea culpa, sorry...

But the wider FOV...it's great. I still use the direct for that magnified view when I need to do things like assess the c ratio. I've gottten good at using indirect with the slit-lamp and BIO set-ups. The panoptic gives a good view without the cumbersomeness of these other methods, not the elast of which is the benefit of a direct uninverted and upright real image.

 

[jefguth]

I would say choose the brand of handles you want first, just pick whichever one is most comfortable in your hand. If you happen to like WA then go ahead and get the whole set that includes the panoptic, its only a few hundred more and not a big deal if you find yourself never using it. I wouldn't choose WA though just because you have the option of getting the panoptic, I really really don't like the feel of WA instruments to begin with.

 

[PCO2010_OD]

Yes. I got the diagnostic set with two handles, the ret head, the regular o-scope head, the panoptic head, and miscellaneous accessories. I didn't think getting the panoptic was that much more $$, at least not in the grand scheme of things.

Do you remember how much that set cost you?

 

[4Eyes]

Do you remember how much that set cost you?

I've been trying to remember, but I can't for sure. I know I spent less than $1000 in equipment my first year, but I'm not sure about the diagnostic set itself. I want to say it was less than $700, but don't quote me on that. (I forgot to mention...that set included the desk charger.)

I think adding on the pan optic made a difference of mayyybe $200.

 

[NEATOMD]

I'm actually in MD school (considering ophtho), so maybe I'm not the best one to take advice on this from. But, in my opinion, I'd save the money on the panoptic and then invest in a BIO at a later point. Trust me, I thought my panoptic was the stuff till I got to use binocular indirect (you'll pee your pants when you see the difference). From what I've seen, most eye docs with a BIO's rarely use direct (for obvious reasons).

I got a panoptic and think its more useful for people planning to be GP's (and other non-eye specialty docs) because BIO's are too expensive for the relatively little amount of time they'd spend using it to its potential. Unfortunately for me, MD licensing still requires us to test on the ole' fashioned direct ophtholmoscope. What can I say, we like to make sure the MD's of the future are trained to use the latest and greatest tools for our patients' sake.

Just my $.02

 

[KaBlamO]

i find that the panoptic is easier to use on pediatrics since they never stay still or look steady for you.

 

[neurodoc]

Well, this is the difference between apples and oranges. The BIO (I have a 20 year old Frigitronics (sp?) and Nikon, Topcon, and Volk hand lenses) work very well, but they are cumbersome to use for routine neuro examinations. The BIO requires a lot of skill to use correctly, and even though I have the skill, they were so cumbersome that I was looking for something "better" than the direct and easier to use than the BIO. The Panoptic fits the bill.

BTW, the Panoptic comes with a rubber accordion-like fitting meant to contact the patient's brow to establish proper viewing distance and image stabilization. I've found that this rubber gadget is unnecessary and I can use the panoptic very well and indeed easier "freehand." I think WA included this gadget to make it "easier" for neophytes used to the DO to transition to the Panoptic. For someone who has experience with BIO techniques, this gadget is unnecessary.

I also like the plus-lens corneal adapter, which makes examination of the corneal surface and AC a breeze.

Bottom line: the Panoptic and direct head will allow you (if you know what you are doing) to see much more than you could with the DO alone, and see nearly as much as you can with the much more cumbersome BIO.

 

[4Eyes]

I'm actually in MD school (considering ophtho), so maybe I'm not the best one to take advice on this from. But, in my opinion, I'd save the money on the panoptic and then invest in a BIO at a later point.

You raise good points. Though BIO is a required purchase anyway, usually 2nd year.

I've found that this rubber gadget is unnecessary and I can use the panoptic very well and indeed easier "freehand."

I need to try this. I hate the rubber gadget. It just seems to get in the way, from what little I've used my pan optic.

 

[yOyOYoo]

Don't forget with a BIO you get better views only with dilation, while no dilation is necessary with the panoptic, and you still get a full view.

 

[Dr.Phenomena]

Does anyone know the cheapest place online to get individual pieces (Handles) in the 3.5v Welch Diagnostic Set, other than ebay.