Primary care physicians (fp, peds, em, im) need a set of basic eye equipment to evaluate and treat eye disease effectively.
To get an idea of what the equipment costs, you can visit a number of online optometry/ophthalmology equipment suppliers such as EyeSupplyUSA. Ebay is a good source for used equipment and for getting an idea on prices. I have no financial relationship with either site.
The first and most important are a distance visual acuity chart and a near visual acuity chart.
And you need a pinhole occluder to see if decreased visual acuity is due to a refractive error or something worse.
Next you need a slit lamp and a Goldman applination tonometer.
Then you need two different types of ophthalmoscopes. The first is the direct ophthalmoscope and the second is an indirect ophthlmoscope. There are two different kinds of indirect ophthalmoscopes. The one that most primary care physicians are familiar with is the monocular indirect ophthalmoscope. But the most helpful indirect ophthalmoscope is the binocular indirect ophtalmoscope–this is the ophthalmoscope that eye doctors (optometrists and ophthalmologists) use to examine the retina.
The binocular indirect ophthalmoscope takes some practice to master but any physician who does even occasional eye exams will find it very helpful (and there are tons of useful YouTube videos that show you how).
And finally the most important piece of equipment for primary care physician diagnosis and treatment of eye diseases are one or two excellent practical eye texts. The ones I use and recommend are in the Resources section at the end of the post.
Eye doctors use incredibly cool instruments which primary care physicians don’t need and can’t afford. But I think any doctor might enjoy seeing them. So here are some YouTube videos on the latest and greatest tools for eye specialists.
In the old days, eye doctors would check the patient’s glasses prescription with a manual lensometer. And then he or she would prescribe new glasses using the phoropter and streak retinoscope for the objective refraction and then refine the prescription with a subjective refraction using the phoropter. These old tools still work but here’s what most modern eye doctors now use [these videos are only for technology fans]:
OPD-Scan III: Benefits for Optometry
Dr. Matossian’s OPD-Scan III presentation
Marco TRS-5100 (Total Refraction System)
John Warren, OD Discusses XFRACTION
Resources:
Clinical Procedures for Ocular Examination, 3/e, 2004, McGraw-Hill. Nancy B. Carlson, OD and Daniel Kurtz, OD, PhD.
The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease, 6/e, 2012, Walters Klower. Adam T. Gerstenblith and Michael P. Rabinowitz.
