On-Call Preparedness

The American Society of Ophthalmic Trauma is dedicated to ensuring ophthalmologists are prepared to cover on-call emergencies and manage eye trauma. We have created the following list of recommended equipment needed at Level I and Level II Trauma Centers that would be needed to adequately assess and repair truly emergent ophthalmic conditions, including open globe repair. While individual surgeons and healthcare centers can customize the items based on their individual preferences and needs, this should hopefully serve as a useful reference.

Additionally, the American Society of Ophthalmic Trauma has collated online resources in our knowledge hub, as well as in-person hands-on wet lab training and didactics at our Annual Meeting. 

Operating Room Equipment needs for damage control ophthalmology at trauma centers:

  •    Ophthalmology-specific operating microscope
  •    Phacoemulsification machine with anterior vitrectomy capability
  •    Phacoemulsification pack(s) and handpiece for the machine
  •    Anterior vitrectomy packs and setup
  •    BSS for phacoemulsification machine
  •    Phacoemulsification machine-compatible BIPOLAR 18g ‘eraser’ wet-field cautery
  •    Intraocular magnet
  •    Cataract Tray (important components below)
  •    Vitrectomy Tray (important components below)
  •    Oculoplastics tray (important components below)
    •    Jaffe speculum/lid retractor
    •    Barraquer solid speculum small
    •    Barraquer wire blade speculum
    •    Lieberman wire speculum
    •    Sterile rubber bands x2
    •    Retractor Gass Retinal Detachment Hook
    •    Von Graefe muscle hook #3 x2
    •    Retractor Jameson muscle hook large
    •    Retractor fixation hook w prongs small
    •    2 prong skin hook 5.125" x 1.5mm x2
    •    Desmarres lid retractor (small, medium, large x2 each)
    •    Curette New Orlean lens loop
    •    Utrata capsulorhexis forceps 
    •    Cyclodialysis spatula
    •    Retractor Schepens Orbital 14mm
    •    Micro needle holder curved without lock
    •    Micro needle holder castroviejo curved with lock
    •    Castroviejo delicate straight needle holder with lock 5.625"
    •    Westcott tenotomy scissors blunt  curved
    •    Westcott tenotomy scissors sharp curved
    •    Gills Vannas Scissors straight
    •    Pierse Colibri 0.1mm forceps w teeth
    •    Castroviejo 0.5mm forceps w teeth
    •    Castroviejo Suturing forceps 0.3mm  w teeth x2
    •    Castroviejo 0.12mm forceps w teeth
    •    Paufique Suturing Wide Handle 3.375" with tying platform
    •    Mcpherson tying angled forceps smooth
    •    Bechert tying forceps angled smooth
    •    Bishop harmon iris forceps 0.4mm delicate
    •    Scissor knapp iris straight
    •    Scissor stevens tenotomy curved 4.5"
    •    Curved halsted mosquito  x6
    •    Straight mosquito x2
    •    Straight castroviejo caliper
    •    Y hook lens manipulator straight
    •    Sinsky hook straight
    •    Anis phaco chopper
    •    Koch nucleus spatula
    •    Rosen phaco splitter
    •    Drysdale nucleus manipulator straight
    •    Kuglen iris hook straight
    •    Bard-Parker Knife Handle #9
    •    Bard-Parker Knife Handle #3 Safety
    •    Metzenbaum Dissecting Scissors Curved 5.5"
    •    Wescott Tenotomy Scissors Blunt Right 4.625"
    •    Freer Septum Elevator 7.5"
    •    Frazier Suction Tip 7Fr or 8Fr
    •    Castroviejo Double Ended Lacrimal Dilator Straight 5.5" or Ziegler Double Ended Lacrimal Dilator Curved 5.125"
    •    Bowman Probes (sizes 0000-000, 00-0, 1-2, 3-4, 5-6, 7-8)
    •    Lacrimal Pigtail probe
    •    Sewell Orbital Retractor and/or malleables
    •    Mini Monoka lacrimal stents
      •    Suture
    •    10-0 nylon on spatulated needle (e.g. CS160-6 needle 9001 ethicon)
    •    9-0 nylon on spatulated needle (e.g. TG140-8 needle 7717 ethicon)
    •    8-0 nylon on spatulated needle (e.g. TG100-8 needle 1714 ethicon)
    •    7-0 or 8-0 polyglactin on spatulated needle (e.g. TG140-8 needle J547 ethicon)
    •    6-0 double-armed polyglactin on on spatulated needle (e.g. S29 needle J555 ethicon)
    •    7.0 vicryl 
    •    6-0 vicryl 
    •    5-0 vicryl
    •    6-0 plain gut  or 6-0 express gut
    •    5-0 fast absorbing gut 
    •    4-0 silk on reverse cutting needle (e.g. P-3 needle 641G ethicon)
    •    4-0 silk on tapered round needle (e.g. RB-1 needle K871 ethicon)
    •    2-0 silk on a reel (e.g. LA55 ethicon)
    •    6-0 plain gut or fast-absorbing gut for skin repair 
  •    Ophthalmic viscosurgical device
  •    Paracentesis blade
  •    Keratome blade (typically 2.4mm blade)
  •    Crescent blade
  •    Sterile cyanoacrylate glue
  •    Topical ophthalmic prednisolone 1% drops
  •    ‘VIGAMOX’ brand-name topical ophthalmic moxifloxacin 0.5% drops (this formulation can be injected directly into the eye)
  •    Topical ophthalmic atropine 1% drops
  •    Topical Tetracaine 0.5% drops
  •    Topical Proparacaine 0.5% drops
  •    Topical tropicamide 0.5% drops
  •    Topical tropicamide 1.0% drops
  •    Topical phenylephrine 2.5% drops
  •    Topical 5% betadine 
  •    Dexamethasone 4mg/1ml vial
  •    Artificial tear ointment
  •    Bacitracin/Polymyxin ophthalmic ointment
  •    Erythromycin ophthalmic ointment
  •    Neomycin/polymyxin/dexamethasone ophthalmic ointment
  •    Fluorescein 1mg ophthalmic strip
  •    Intracameral antibiotics (can be compounded or packaged)
  •    Intravitreal antibiotics (can be compounded or packaged)
  •    Subconjunctival antibiotics (can be compounded or packaged)
    •    e.g. Cefazolin 1mg vial

Emergency Department Equipment needs for damage control ophthalmology at trauma centers:

  •    Slit lamp on mobile rolling base
  •    Hand-held portable slit lamp
  •    Indirect ophthalmoscope (e.g Keeler, Heine)
  •    Cobalt blue light / wood’s lamp
  •    Topopen or iCare tonometer
  •    Ophthalmic Bscan ultrasound 
  •    Topopen covers / iCare rebound probes
  •    Near vision card / Rosenbaum card
  •    Pen light
  •    Jeweler forceps
  •    Toothed adson forceps 
  •    0.5mm toothed forceps 
  •    Toothed 0.12 forceps x2
  •    Desmarres retractors x2
  •    30g needles
  •    27g needles
  •    1cc syringe w luer lock
  •    3cc syringe with luer lock
  •    Corneal protector/shield
  •    Westcott scissors or straight iris scissors
  •    Castroviejo needle holder
  •    20D ophthalmic lens
  •    90D ophthalmic lens
  •    Fluorescein strips
  •    pH paper
  •    Bandage contact lens (soft plano contact lens disposable)
  •    Kontour contact lens (various sizes)
  •    Bowman Probes (sizes 0000-000, 00-0, 1-2, 3-4, 5-6, 7-8)
  •    Rigid eye shields
  •    Steri strips
  •    Barraquer wire blade speculum
  •    Cotton tipped applicators
  •    4×4 gauze
    •    Suture
      •    6-0 or 5-0 polyglactin suture on spatulated needle
      •    6-0 nylon, 5-0 fast absorbing gut, or 5-0 polypropylene on spatulated needle
      •    6-0 plain gut or 6-0 fast absorbing gut
  •    Medication Availability
    •    Lidocaine 1% with epi 1:100,000
    •    Proparacaine drops
    •    1% tropicamide drops
    •    Phenylephrine 2.5%-tropicamide 1% drops
    •    Atropine drops 1%
    •    Pilocarpine drops
    •    Timolol 0.5% drops
    •    Brimonidine 0.2% drops
    •    Dorzolamide 2% drops
    •    Prednisolone acetate 1% drops
    •    Sterile cyanoacrylate (e.g. dermabond)
    •    Povidone 0.5% drops