Gonioscopic devices
A gonioscopic attachment can attach to a gonioscope and can include atraumatic retention elements that are configured to engage an eye to retain the gonioscope relative to the eye. The gonioscopic attachment can be configured to position the gonioscope so that at least a portion of the concave distal surface of the gonioscopic optical element is spaced apart from the eye, and/or so that the curvature of the distal surface is angularly offset from the curvature of the eye. The gonioscope can include a fixation point configured to be visible to the subject when the gonioscope is positioned on the eye. In some embodiments, the retention elements can be incorporated directly into the gonioscope. A coupling mechanism can couple the gonioscope to a lid speculum. The gonioscope can include a light pipe, which can be configured to directly light into the eye.
1. A gonioscopic attachment configured to attach to a gonioscope for use on a subject's eye, the gonioscopic attachment comprising:
a generally C-shaped body having an open side, the body configured to receive a gonioscope to removably attach the body to the gonioscope;
a first arm positioned on the side of the body opposite the open side, the first arm extending distally from the body;
one or more first retention elements disposed on the first arm, wherein the one or more first retention elements extend to a position that is distal from the body by a first distance;
a second arm positioned on the body at one side of the open side, the second arm extending distally from the body;
one or more second retention elements disposed on the second arm, wherein the one or more second retention elements extend to a position that is distal from the body by a second distance that is less than the first distance;
a third arm positioned on the body at another side of the open side, the third arm extending distally from the body; and
one or more third retention elements disposed on the third arm, wherein the one or more third retention elements extend to a position that is distal from the body by a third distance that is less than the first distance;
wherein the first, second, and third retention elements are configured to engage an eye to retain the gonioscope relative to the eye.
2. The gonioscopic attachment of claim 1 , wherein one or more of the first arm, the second arm, and the third arm comprises a tapered distal end that is configured to slide under tissue adjacent to the eye when pressed against the tissue.
3. The gonioscopic attachment of claim 1 , wherein the retention elements are sufficiently blunt so as to deform tissue of the eye without piercing into the tissue of the eye when pressed against the tissue of the eye.
4. The gonioscopic attachment of claim 1 , wherein the first distance is at least about 100% larger than the second distance and the third distance.
5. The gonioscopic attachment of claim 1 , wherein the first distance is no more than about 300% larger than the second distance and the third distance.
6. The gonioscopic attachment of claim 1 , wherein the body is configured to flex when the gonioscope is attached to the body such that the body applies a clamping force on the gonioscope.
7. The gonioscopic attachment of claim 1 , wherein the retention elements are configured to position the gonioscope so that at least a portion of a concave distal surface of the gonioscope is spaced apart from the eye.
8. The gonioscopic attachment of claim 7 , wherein the retention elements are configured to position the gonioscope so that at least about 50% of a concave distal surface of the gonioscope is spaced apart from the eye.
9. The gonioscopic attachment of claim 7 , wherein the retention elements are configured to position the gonioscope so that the curvature of the concave distal surface is offset from a corresponding curvature of the eye by an angle between about 3 degrees and about 20 degrees.
10. The gonioscopic attachment of claim 1 , wherein the body comprises a plurality of engagement features configured to engage the gonioscope at locations that are disposed on a first generally circular path, wherein the plurality of retention elements are disposed on a second generally circular path, and wherein the second generally circular path is offset from the first generally circular path by an angle between about 5 degrees and about 30 degrees.
11. A gonioscopic attachment configured to attach to a gonioscope for use on a subject's eye, the gonioscopic attachment comprising:
a body configured to removably attach to a gonioscope having gonioscopic optical element that includes a concave distal surface, wherein the body is generally C-shaped having an open side;
a first arm extending distally from the body;
a second arm extending distally from the body;
a third arm extending distally from the body;
a plurality of retention elements disposed on the first arm, the second arm, and the third arm such that the plurality of retention elements are configured to be stationary relative to the gonioscopic optical element, wherein the plurality of retention elements are configured to engage an eye to retain the gonioscope relative to the eye, wherein the plurality of retention elements and the first, second, and third arms are configured to position the gonioscope so the curvature of the concave distal surface is offset from the corresponding curvature of the eye.
12. The gonioscopic attachment of claim 11 , wherein the plurality of retention elements are sufficiently blunt so as to deform tissue of the eye without piercing into the tissue of the eye when pressed against the tissue of the eye.
13. The gonioscopic attachment of claim 11 , wherein the retention elements are configured to contact the sclera of the eye when the gonioscope is positioned for viewing an anterior chamber of the eye.
14. The gonioscopic attachment of claim 11 , wherein at least one of the retention elements is disposed on a distal portion of each of the first, second, and third arms.
15. The gonioscopic attachment of claim 11 , wherein:
the first arm extends distally from the body by a first distance; and
the second arm extends distally from the body by a second distance;
wherein the first distance is larger than the second distance.
16. The gonioscopic attachment of claim 15 , wherein the third arm extends distally from the body by a third distance that is substantially the same as the second distance, wherein the second arm is positioned at a first end of the body, wherein the first arm is positioned at an apex of the body opposite of the open side, and wherein the third arm is positioned at a second end of the body.
17. The gonioscopic attachment of claim 15 , wherein the first distance is at least about 50% larger than the second distance.
18. The gonioscopic attachment of claim 15 , wherein the first distance is at least about 1,500% larger than the second distance.
19. The gonioscopic attachment of claim 11 , wherein the open side is configured to removably receive the gonioscope, and wherein the body is configured to flex when the gonioscope is attached to the body such that the body applies a clamping force on the gonioscope.
20. The gonioscopic attachment of claim 11 , wherein the plurality of retention elements are configured to position the gonioscope so that at least about 50% of the concave distal surface is spaced apart from the eye.
21. The gonioscopic attachment of claim 11 , wherein the body comprises a plurality of engagement features configured to engage the gonioscope at locations that are disposed on a first generally circular path, wherein the plurality of retention elements are disposed on a second generally circular path, and wherein the second generally circular path is offset from the first generally circular path by an angle between about 5 degrees and about 30 degrees.
22. The gonioscopic attachment of claim 11 , wherein the first arm has a tapered distal end that is configured to slide under tissue adjacent to the eye when pressed against the tissue.
23. A gonioscope assembly comprising:
a gonioscope; and
the gonioscopic attachment of claim 11 .