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The Eyegenie, invented by Dr Chris Putrino, is an eyelid retractor that allows the practitioner to grip the external eyelid accurately and comfortably without having to make any direct skin-to-skin contact with the patient.
Dr Putrino had become frustrated with the lack of instrumentation during routine clinical tasks involving manipulation of the eyelids.
'Much to my surprise the only eyelid retractors available were internal retractors, requiring an invasive and time-consuming clinical task,' he explains. Ophthalmologists have historically used an internal mechanical retractor known as an ocular speculum to maintain prolonged eyelid retraction during surgery.
After discussions with friends and colleagues, Dr Putrino realised there was a gap in the market and as a result founded the company Ocular Innovations. He says that the Eyegenie was the eventual product of some rigorous development and testing, which had included more than 400 prototypes in the process.
Assembly
There are two components to the Eyegenie assembly, manufactured separately under controlled sterile environment, which clip firmly together.
The blue V-shaped handle provides controlled resistance to ensure delicate manipulation of the created profile aperture. Both ends of the V-shaped handle bars consist of an enlarged oval moulded region with star studded grooves to allow the user to form a comfortable grip with thumb and forefinger.
The white T-shaped primary disposable tips, made from a similar plastic, have a smooth 90-degree curve to allow the assembled unit to be held parallel and temporally to the patient's face and orbit. This allows the practitioner a complete ocular view with no fingers or hand in the way.
The 'T' bar end is curved and angled into a 'C' shape to allow for a more evenly distributed pressure to be applied during lid manipulation, maximising comfort for the patient. This provides a downward facing semi-circle for the upper lid and an upward facing semi-circle for the lower lid (standard bi-tip configuration).
The semi-circular shaped points which make direct contact with the eyelid skin are coated with a non-latex thermoplastic gripping elastomer, tested for its biocompatibility in reducing any provoked biological response. The plastic tips are disposable, intended for single use to reduce cross contamination.
The Eyegenie can be used in three ways:
? The standard bi-tip
? Reversed bi-tip
? Mono-tip design.
These are designed to allow for variations in orbit and lid anatomy. The manufacturers' instructions include a tabulated list of a range of eye orbit and lid characteristics along with advice on possible Eyegenie configurations to match.
Application
Eyegenie can be easily incorporated into the routine eye examination and contact lens practice. It can be used in external ocular health examinations, slit-lamp examinations, contact tonometry, contact lens insertion and removal, eye drop and ointment applications, foreign body removal and during corneal topographic assessments.
It is simple and relatively safe to use. Clean disposable and replaceable tips are provided to give hygienic and finger-free access to the eye.
Ocular Innovations is also marketing the device to patients. The Eyegenie is particularly useful at times when patients have difficulties with controlling their eyelids at will, leading to frustration for both the clinician and patient. Invariably, these will also be the patients that are more sensitive to outdoor elements, prone to allergies, have a ptosis or are more susceptible to ocular diseases such as glaucoma, where ocular health assessment is vital and can only be carried out with eyelid retraction.
In addition, patients with eye conditions that are categorised as an 'occupational hazard', such as viral conjunctivitis, where it is in everyone's interest to have as little skin-to-skin contact as possible, would benefit from reduced direct contact and disposable equipment to hand.
Summary
The Eyegenie is another addition to the optometric clinical tool bag adopted for daily use or simply for use with specific cases. We have used it on a cross-section of patients and found it easy to use. It improves eye assessment and patients respond well to it.
Hilco Europe will be demonstrating the Eyegenie at Clearview Training's East Midlands CET Conference on May 20 2007. For details, www.clearviewtraining.co.uk
Andrew Ho is a pre-reg optometrist based in London and Jane Macnaughton is director of Clearview Training and visiting lecturer, City University, London