Design of an Eye Speculum With Vibrational Anesthesia for Pain Management

An eye speculum is a device that holds the eyelids and lashes out of the way during ophthalmologic procedures. As described by Lam, et. al, ophthalmological surgical pain is usually controlled using eye drops [1]. However, in many cases the major source of pain or discomfort for the patients is not due to the surgery itself, but rather due to the eye speculum forcing the eye lids open [1]. Eyeball and eyelid physiological variation from patient to patient can cause variations in patient pain, and make it difficult for one speculum design to universally work for most patients [1]. Some eye specula include tubes for aspiration that is used to remove excess tear production on the eyeball surface. As aspirating speculum may aggravate dry eyes after surgery, the aspirating capabilities are ideally optional and at the discretion of the surgeon [2]. Fayers, et. al., found that vibration-assisted anesthesia during upper eyelid surgery had a beneficial pain reduction effect [3]. Additionally, vibrational anesthesia has been used in cosmetic and dental facial procedures [4, 5], but the inclusion of a vibrational anesthetic component to an eye speculum is novel. A new eye speculum was design to minimize eye speculum patient pain, and be more universal with respect to patient eye shapes. It allows single-handed use by the surgeon, and optional eyeball aspiration. Most uniquely, it also incorporates an optional vibrational anesthesia component. The educational pedagogical aspects of this project were previously described by one of the authors. [6]