UK Locums: The £0 Fundoscopy Lens: How to Save Your Clinic (and Your Sanity)
We’ve all been there. You’re just about to perform fundoscopy, you click open your Volk case, and... it’s empty. Your stomach drops. Images of GOC hearings flash before your eyes, and you're already wondering how you'll pay the bills if you get struck off for a missed fundus check.
Before we panic, a quick trip to our trial lens set might be all we need to get through the day.
The Ingenious "In a Pinch" Hack
Using a few lenses from a trial set to create a makeshift fundoscopy lens is a clever hack that many of us have never tried. While it is certainly no substitute for the real thing, it is an ingenious, free solution for those "emergency" moments.
It’s a testament to the principles of optics that a seemingly random combination of lenses can replicate the function of a purpose-built instrument. Here is how we can build our own.
The Formula: The +76.00D DIY Lens
To get a view similar to our standard lenses, we need to combine:
- Two +20.00D lenses
- Two +18.00D lenses
The combined power of these lenses is +$76.00D$. For context, a "Super 66" Volk lens is +$66.00D$, while a 90D is +$90.00D$. This makeshift stack sits right in the "sweet spot" for a clear view of the fundus.
How to Use It
- Stack them: Hold the four lenses together, aligning their central optical axes as closely as possible.
- Position: Hold the stack in front of the patient's eye at a working distance similar to your normal lens.
- Steady hands: You’ll need to hold them very still to achieve a clear, magnified view.
The Pros and Cons
Like any "MacGyver" solution, this has its trade-offs:
The Upside:
- Cost: It’s a fantastic zero-cost solution.
- Accessibility: Trial lens sets are available in virtually every practice we walk into.
- Effectiveness: It provides a surprisingly clear view, allowing us to examine the optic nerve and macula when we have no other tools available.
The Downside:
- Cumbersome: Keeping four lenses perfectly aligned while holding a slit lamp joystick is a skill in itself!
- Optical Aberrations: Unlike a properly designed aspheric lens, this setup will have significant distortion around the edges.
- Temporary Fix: This is a "today only" solution. We still need to replace our proper kit as soon as possible.
Clinical Adaptability
While this may not be a technique we use every day, it’s a great example of the problem-solving and adaptability that’s crucial to our clinical practice. It reminds us that sometimes the best solutions are the simplest—and in this case, the most inventive!
Have you ever had to use this hack? What other impromptu solutions have you come up with in your practice? Let us know in the comments!
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