Basic Instruments in Eyelid Surgery

The instruments that are used in oculoplastic surgery are critical for the technician to have a good grasp of. Often they are used in the clinic and during assisting of procedures. Here are a list with photos of the basic instruments in oculoplastic surgery and their uses.

Wescott Scissor

This scissor is the bread and butter for oculoplastic surgeons. It is used to cut stitches in the clinic and used during surgical procedures.

Castroviejo needle driver

The Castroviejo needle driver is used as the instrument to hold a needle for suturing. Any procedure that involves suturing (laceration, surgical procedure) will use this instrument

Punctal Dilator

This instrument is used to dilate the punctum or entrance to the tear duct. It is used anytime a patient comes in with a complaint of “tearing”.

Bowman Probe

This instrument is slid into the tear duct entrance to test if it is scarred or not. Often not used in the office because it can be painful to do this. The Bowman probe comes in different sizes. 00 is the smallest going up to 9.

Punctal Irrigator

This instrument is used to irrigate water through the tear duct system. It is usually attached to a 3 cc syringe and water is flushed through the tear duct system. Every patient who has tearing will need this instrument as their tear duct system will get tested.

Nasal Speculum

This instrument is used to examine inside the nose. Often it is used after tear duct surgery to make sure the stent is in place and the hole that was created for tear duct surgery is still open. It is not often used but is needed at times.

Toothed Forcep

There are many different types of forceps. Some are toothed and others are not toothed. A toothed forcept means that the ends have a small hook to them to pick up tissue. Tooth forceps are used to hold tissue during procedures. It is very difficult to use this instrument to hold suture so toothed forceps are generally not used for suture removal. There are different size toothed forceps such as .12, .5, Paufich, Adson. Each type is used based on the surgeon’s preference.

To the left is a magnified version of the teeth of the forcep. One can see how that can be used to grip and hold tissue.

Below is a Paufich toothed forcep. One can see the teeth at the end of the instrument (though they are small). Over time you will be able to quickly know toothed vs nontoothed forceps.

Desmarre Retractor

This instrument is used to hold the lid. As one can see it has a smooth surface that is curved. The desmarre retractor can be used to evert or flip over the eyelid. Often the assistant holds the eyelid in a certain position with the Desmarre retractor while the surgeon works.

Eyelid Speculum

Rarely used in the office, this instrument forces the eyelid open. Often it is used in surgery when procedures are being done on the eye itself. It is very difficult to tolerate without anesthesia or some numbing of some kind.

Jeweler’s Forcep

This is the forcep that is used primarily to remove suture. It does not have teeth as can be seen on the photo on the left. The jeweler’s forcep can easily grasp stitches for removal. It is very difficult to use a non-toothed forcep such as this for surgical procedures so it is not used.

Q tip

Not an instrument per say but used so often for so many procedures that it should be mentioned here. The q tip (aka cottonoid, Cotton tip applicator) is used to absorb blood during procedures and is used for almost every procedure.

Prosthesis suction Cup

Used to remove and insert prosthetic eyes into the eye socket.