Ophthalmic instruments play an important role in the delivery of eye care. The role ranges from diagnosis to surgery and is used by several cadres, from technicians to ophthalmologists. While these play an important role, they can only function effectively when they are in the proper condition. While these equipment are critical to eye care workers, they lack the knowledge to maintain the equipment an ensure that they are in proper working order. Despite the fact that these are usually very expensive equipment, little is done to maintain them. This issue of Site News looks at the ways the ophthalmic community can maintain and repair these equipment. It presents simple and cost-effective ways in which this can be done on a regular basis, at even small hospitals.
This Site news explores Instruments and Ophthalmology, Maintenance and Repair, Training and Learning. This issue also covers Purchasing Equipment, Procedures and Manuals, and Standard List.
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The instruments and equipment used in modern eye care have become very sophisticated and expensive. Keeping them in good working condition can become a nightmare, especially if hospitals are located in places where there is little service support from manufacturers or suppliers. These items can fail to work unexpectedly and the resultant downtime can compromise outcomes and patient safety.
An important fact about instruments and equipment is that, when manufactured by well-established firms and supplied by reliable dealers, they seldom fail, provided they are maintained as described in the user manual.
- INSTRUMENTS FOR CATARACT SURGERY: RESULTS FROM OUR SURVEY
For any operation, including cataract surgery, the appropriate instruments must be available and in good working order. If instruments are not available, or are blunt, or do not function properly, it may be necessary to delay or postpone surgery. Using such instruments in an operation can result in a poor outcome, or even pose a risk to surgeons and their assistants.
- INSTRUMENT CARE: EVERYONES RESPONSIBILITY
Some eye units have technicians who are responsible for taking care of instruments. It is certainly important to have a specific person assigned to do tasks such as monthly checking and maintenance, even on a part-time basis.
- DEBRIS ON PROCESSED OPHTHALMIC INSTRUMENTS: A CAUSE FOR CONCERN
To assess the quality of processedophthalmic instruments and look for the presence of foreign material on the surface of these instruments.
- EQUIPMENT MAINTENANCE AND REPAIR
The repair and maintenance of ophthalmic equipment, including surgical instruments and diagnostic devices, can be compared to the maintenance of a motor vehicle, something many of us understand well.
- THE MAINTENANCE AND REPAIR OF OPHTHALMIC SURGICAL INSTRUMENTS: TRAINING AT THE EYE CLINIC
Ophthalmic microsurgical instruments are delicate and require special care. In developing countries, where instruments are usually difficult to replace, maintenance and repair are even more important. The Jan Worst Research Group started a project in 1994 - after several requests for assistance in the repair of ophthalmic microsurgical instruments - to train staff at eye clinics to maintain and repair these instruments.
- CARE OF INSTRUMENTS AND EQUIPMENT: A SUCCESS STORY
When a person is hungry and you give him a fish, his hunger is satisfied for that occasion. If you teach him how to catch a fish, it can take care of his hunger for the rest of his life.” This is a teaching principle that is often repeated, and one that is also very useful in the maintenance of medical equipment.
- CARE OF OPHTHALMIC SURGICAL INSTRUMENTS
This article gives an overview of the principles of surgical instrument care. Both subjects are covered more comprehensively in OPHTHALMIC OPERATING THEATRE PRACTICE: A Manual for Secondary and Tertiary Levels in Developing Countries.
- GENERAL EQUIPMENT CARE
This module will provide you with some principles for safe equipment management and care.In order to work in a safe manner and provide safe care to our patients, we are required to be familiar with the equipment prior to use. We must also check that the equipment is functioning and will not cause harm to the patient or ourselves.
We are also responsible for ensuring we use the equipment for its intended purpose and help prolong the life of the equipment through proper use and storage.
- EYE CARE EQUIPMENT
Equipment needs to form part of our planning for eye care. This must start when eye care programmes are being designed and should include those who will be using the equipment. Without careful planning, it is likely that our equipment will not perform optimally and might even fail completely. And without working and effective equipment, our eye care programmes will not achieve their potential.
- EQUIPMENT FOR EYE CARE
In many low- and middle-income countries, it is often the people who are poor or with a disability – or both – who find it most challenging to access and pay for health care. When people do come to us for eye care, it is therefore vital that we provide quality services efficiently and effectively. To achieve this goal, we must ensurethat our equipment is well maintained and that we have enough spare parts and consumables for it to function with minimum interruptions. To cope with the sometimes inevitable breakdowns, we also need systems that will respond quickly to carry out repairs and replace broken or worn-out parts.
- CARE OF OPHTHALMIC SURGICAL INSTRUMENTS
- PURCHASING INSTRUMENTS AND CONSUMABLES
If you are being offered an instrument or a new brand of consumable, ask for a sample to test to be sure that the quality is of a high standard.
- INSTRUMENTS AND CONSUMABLES
This issue addresses similar concerns around surgical instruments and consumables. For an eye unit to function, instruments must be carefully managed so that they remain in good repair and can be replaced quickly if needed. Consumables, such as stationery, spare parts, surgical supplies, and medicines, are fast-moving and must be managed so that they are always available and do not go out of date. To make this possible, systems must be in place that support scheduled maintenance and repair activities, monitoring of stock levels, and co-ordinated purchasing of instruments and consumables.
- CPD: TEST YOURSELF INSTRUMENTS AND CONSUMABLES
These continuing professional development (CPD) Test Yourself questions are based on the contents of this issue.
- USEFUL RESOURCES: INSTRUMENTS AND CONSUMABLES
- BASIC CARE AND MAINTENANCE OF OPHTHALMIC EQUIPMENT
Maintenance of medical technology will only be effective if backed up by consistent policies on planning and management.
- BUYING USED OPHTHALMIC EQUIPMENT
- OPHTHALMOLOGY PROCEDURES MANUAL
The ophthalmology component of the National Health and Nutrition Examination Survey (NHANES) uses two major instruments to complete the tests. The Humphrey Matrix Visual Field Instrument uses Frequency Doubling Technology (FDT) perimetry to test for visual field loss from glaucoma. The Canon CR6-45NM ophthalmic digital imaging system is used to assess the presence of diabetic retinopathy, age-related macular degeneration, and other retinal conditions. This chapter provides a description of the equipment and supplies as well as setup and calibration procedures for this component.
- GUIDE TO OPHTHALMIC EQUIPMENT (FOR NON-OPHTHALMIC PEOPLE)
Ophthalmologists and other eye care professionals use many devices to diagnose and treat eye problems. This guide introduces some of the more commonly used devices and is mainly written for persons who are not eye care professionals wishing to know what each device looks like and to understand how it is used.
- OPERATING THEATRE PROCEDURES AND EQUIPMENT
This chapter provides basic set of instruments for intraocular surgery.
- DONATIONS: HOW TO ENSURE YOU REALLY BENEFIT
- OPHTHALMIC EQUIPMENT SURVEY 2010: PRELIMINARY RESULTS
The purpose of this equipment survey (commissioned by this journal) was to obtain an overview of the key issues and challenges faced by eye health providers with regard to their equipment.
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