Below is my checklist when visiting rural or isolated eye clinics. This is not a list for the O.R. but rather for outreach activities when seeing patients with or without other eye health workers. Depending on the location/situation you may not need some of these supplies.
Ophthalmic Check List For Outreach ( Rural / Isolated ) Eye Clinics
- Ocular prostheses – trays (sets) can be purchased from a number of Indian vendors at the Academy meeting.
- Carbon paper-? no photocopy machine.
- Bandage contact lens – useful in reducing symptoms in patients with bullous keratopathy, span, etc.
- Absolute ( dehydrated ) ethanol alcohol injection – for a blind painful eye. ( two syringes, one needle procedure )
- C – EDTA ( 2.7% ) solution for band keratopathy.
- Extra slit lamp bulbs – bring the longer-lasting and leave a gift.
- Wills Eye Manual and other paper back reference books for teaching/showing ( also available online AAO / ONE ).
- Drops – glaucoma, antibiotics, steroids, antihistamine, dilating, proparacaine/tetracaine, Natamycin ( shake well ), BSS ( 15 ml ) which can be used to prepare 2 1/2 or 5% Betadine solution for conjunctivitis or bacterial/fungal ulcers. Piolocarpine 2% – when doing laser pupilloplasty, sphincterotomy or PI.
- Povodone-iodide ( Betadine ) 10% and rubbing ( isopropyl ) alcohol.
- Emesis bowl for soaking surgical instruments for I and D ( hordeolum ), etc.
- Ciprofloxcin( Cipro ) and / or doxycycline tablets.
- Ibuprofen, acetaminophenn ( Tylenol ), and acetazolamide ( Diamox).
- Gloves – sterile / soap / hand sanitizer / hand tissues.
- Sterile Q tips; 2 by 2 gaze ( which can be used as eye patches ).
- 30G,18G, and 27G ( 1 1/4 inch ) needles for peribulbar, etc.
- Dexamethasone ( 4 mg/ml ) vials.
- Lots of goniogel – like agents ( lidocaine jelly 2% ) – leave as a gift ?
- Extra pens, pencils, and black utility marker pen to cover/ hid expiration dates – leave as a gift?
- Portable diode laser ( ? Iridex, etc. ) ; condensing lenses.
- Portable Yag laser ( ? Laserex. etc. ).
- 3 mirror lens – leave as a gift ?
- 78 D or 68 D condensing lens – leave as a gift ?
- WD 40 / duct tape – I lubricate all slit lamps, tables, O.R. stools, etc.
- Glycerin cornea – leave as a gift ? ( available from Alabama Eye Bank ).
- Extra flashlights esp. one that has a red light. Or a red filter such as the top of the peanut butter bottle. Need red light to evaluate white, dense, mature cataracts. All white cataracts should not have surgery. If you automatically operate on all dense mature cataracts you will have some blind unhappy patients post-op. Even with white cataract should still be able to distinguish colors. Check also for light projection and for RAPD.
- Small surgical instrument set for chalazion, etc.
- Sterile lidocaine ( Xylocaine ) 2% with epinephrine.
- Small mirror – so the patient can show you where / what is the concern.
- Home-made fluorescein/proparacaine combination drops ( 0.5 ml of 10% fluorescein in 15 ml proparacaine or tetracaine bottle ) to check IOP.
- Ketoconazole and acyclovir tablets.
- Batteries.
- Small screwdrivers – Phillips, Allyn, etc.
- Tape ( paper, etc. ), paper clips, thumbtacks, rubber bands
- Paper ( letterhead ) / prescription pad / index cards / Post-It.
- Direct ophthalmoscope.
- Camera.
- Snellen visual chart ( #’s better than letters ).
- Snellen near the visual card.
- Surgical loops.
- Extension cord / surge protector
- Systemic antibiotic (? cefuroxime, cefazolin, vancomycin)
- Glycerin drops to clear edematous cornea
- Eye irrigating solution
- Handheld cautery. Can also use matches, candle and muscle hook to obtain hemostasis. Heat the nuscle hook and use it as cautery.
- Name tag (MD)
Usually, I forget something I need. So, I have prepared this checklist. I hope this is useful.
Finally, be receptive to learning. Bring patience.
Peace,
Baxter