The College of Optometrists

Does anyone else use an ultarsound pachymeter? How do you clean/sterilise the tip?

had one on trial a few weeks ago, and just cleaned it with alcohol wipes. I think this was what the manufacturer recommended.

Lisa

Great. Thats what I understood from the manufacturer but where does this sit with the College advice on re-usable devices. Should I clean it with Milton and leave it for 30-60 minutes between uses?

Our ultrasound biometer cant be sterilised with milton we just wipe it with sterets.

I think manufacturers guidance is usually that the tip will be damaged by repeated sterilisation with milton, so this may not be an option. College guidance in this situation is that the need for the test must be carefully considered, and the risks explained to the patient before going ahead.

Paper published in OPO January 2003 on the use of cling film over a scan probe for biometry, didn't seem to affect results!

Lisa

Thats really interesting not sure i want to guinea pig my private patients though!! Might experiment on members of my family first! thanks for the tip

fair enough! never tried it myself, but worth a try if you're concerned I suppose.

I think someone did a similar paper on goldmann tonometry with cling film! not sure about the results though. We're onto disposable heads for that now, which aren't too bad. I've also known a few people who tried sterilising all their tonometer heads in milton, as per college guidelines, and found that after just a month or too the tonometer heads were useless, with the prism becoming fogged up and impossible to use.

For Goldmann I use the Tonosafe disposable heads. I take it that there are no such things for the pachymeter?

not that i've found Patrick. We use tonosafe too now, and although I wasn't a fan to begin with, I'm fairly used to them now. They're certainly much better than the "tondom" covers we tried before that!!

As for the pachymeter, the tip is an integral part of the machine, as it emits and detects the u/s wave. Not sure why pachymeter manufacturers can't come up with some sort of disposable cover though - presume it must be something to do with the physics of ultrasound, although I believe disposable covers are used in other types of ultrasound, eg. gynaecology.

My hospital clinic disinfect Goldmann heads in Milton in between patients, and they are fine. Don't think they always get the full hour, though...

The hospital wher i work uses disposable tonometer heads, they spend £10,000 per year on them and are verry seriously considering getting an NCT.

interesting! presumably they would use NCT for non glaucoma patients only? We use tonopen (with the little covers) for alot of non glaucoma pts, where IOP is just for "screening". Not sure how the cost of these covers compares with disposable prisms though. (and purely from personal experience I find tonopen results rubbish - probably better with a good NCT.)