DR VINEET SEHGAL

MBBS MD (AIIMS)
FELLOWSHIP IN GLAUCOMA
CONSULTANT - INCHARGE
GLAUCOMA SUBSPECIALITY
SHARP SIGHT CENTRE
EX CONSULTANT- MEDANTA
MEDCITY
ASSISTANT EDITOR- DJO
(NTSE SCHOLAR, ASSISTANT EDITOR-
DJO)
Overview
Common Instruments
Instruments for lid surgery
Chalazion surgery
Entropion/ectropion surgery
Ptosis surgery

Evisceration/ Enucleation surgery

Dacryocystorhinostomy surgery
Orbitotomy surgery
Squint surgery
Ocular Speculum
Barraquers Eye Speculum
Most common eye speculum

Fenestrated blades

Light weight

Minimal pressure on the globe

Available in pediatric(14 mm)

and adult sizes( 16- 18 mm)
Universal Eye Speculum
(Williams)
Screw adjustment- holds
the speculum open

Controlled retraction

Used in corneal surgeries

like DALK, ALTK

Greater rise in IOP

Eye speculum with guard (Lancaster)

Solid blades

Keeps lashes away from the

field of surgery

Predominantly used in squint

surgery
Chalazion surgery
Chalazion Clamp
Has a solid plate like end
and a fenestrated ring

Fenestrated end on the

conjunctival side to aid
incision

Achieves localization,
support and hemostasis
Chalazion Scoop
Small round scoop like end

Helps in non traumatic

curetting of chalazion
Entropion/Ectropion Surgery
Snellens Entropion clamp
Right and left variety

Plate design supports the lid

Helps achieve hemostasis

Jaeger Lid Spatula

Slight convex surface

Lid surgeries- entropion ,

ectropion , ptosis

Protects globe

Provides support

Helps in creating dissection

planes during orbitotomy
Desmarres Lid Retractor
Retraction of soft tissues

Ptosis , orbitotomy, buckling,

DCR surgeries

Double eversion of eyelids

Used to unroll AMG over

corneal surface
Ptosis surgery
Berkes Ptosis Clamp
Used to support and clamp
the levator muscle during
levator resection

Helps achieve hemostasis

Crawfords Fascia Lata Stripper
Used in ptosis surgery
during autologous fascia lata
harvesting

Proximal slot for holding

fascia lata

Harvests fascia lata through a

small incision
Wrights Fascia Needle
Needle tip bent at 900

Large eye for passing

harvested fascia lata.
Castroveijos calipers
0-20 mm range

Used to measure exact

distances
Evisceration/Enucleation Surgery
Mules Evisceration Scoop
Used to scoop out the
intraocular contents i.e uveal
tissue

Has a gentle curve to slide

along corneal surface
Enucleation Spoon
Has a groove for the optic
nerve to pass through

Supports the globe and aids

in giving slight traction to
the optic nerve
Enucleation Scissors
Curved scissors- pass along
the orbital wall smoothly

Blunt end- non-traumatic

to the globe

Help to maximize the

length of the optic nerve
resected
DCR Surgery
Nettleships Punctum Dilator
Used to dilate the puncta
prior to any probing

Available in multiple sizes,

corresponding to probe sizes
Bowmans Probes
Available in sizes ranging from
0000 to 4

Size 0=1mm diameter, with

0.1mm gradation

Used for probing nasolacrimal

duct

DCR surgery

Therapeutic probing in pediatric

population
Freer Periosteum Elevator

Slight concavo-convex ends

Used to lift periosteum and

lacrimal sac from underlying
fossa
Mullers Self Retaining Retractor
Helps to retract the skin
incision in DCR surgery

Helps to achieve hemostasis

Self - retaining
Kerrison Bone Punch
Available in multiple sizes
Size 0=1mm
Size 4=5mm

Cutting end up or down

designs

Predominantly used to create

an ostium in DCR surgeries
Orbitotomy surgery
Bard Parker handle
with blade

Slot for attaching disposable

blades

Pen like grip

Used to make incisions

Kellys Malleable Retractor

Used to retract soft tissue

during orbitotomy

Increases the field of view

Helps to achieve hemostasis

Tenotomy Scissors
Fine blunt tipped scissors

Used to separate Tenons from

underlying sclera

Used in buckling surgery,

enucleation, eviseration,
squint surgery
Strabismus surgery
 Strabismus/ muscle hook
Used to hook extra-ocular
muscles

Squint , buckling surgeries

Scleral perforation repairs

Jameson Muscle Hook

Green Muscle Hook

Serriphine
Used to clip long end of
sutures

Squint surgeries, ptosis

surgery
Castroveijos needle holder
Needle holder with or
without locking

Used to hold 4-0 to 7-0

sutures

Used to suture periocular

skin incisions, extraocular
muscles , explants in retinal
detachment surgery.
 Ignacio Barraquer

Thank you