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Use of ophthalmic endoscope (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Ophthalmic Endoscope Use
Also known as: Endoscopic Eye Examination

Summary

An ophthalmic endoscope is a special tool used by eye surgeons to visualize the interior structures of the eye. This procedure supplements primary eye surgeries by offering a more detailed view, aiding in the diagnosis and treatment of various eye conditions.

Purpose

This procedure helps address complex eye issues that require a detailed internal view of the eye structures. The main goals are to support accurate diagnosis, assist in intricate surgical interventions, and improve surgical outcomes.

Indications

  • Persistent eye conditions requiring detailed internal inspection
  • Complications during primary eye surgeries
  • Retained intraocular foreign bodies
  • Complex retinal detachments or vitreous haemorrhage

Preparation

  • Patients may be instructed to fast for a few hours prior.
  • Adjustments to current medication may be necessary, especially anticoagulants.
  • Preoperative assessments like visual acuity tests or imaging studies (e.g., OCT or ultrasound).

Procedure Description

  1. Anesthesia: The patient receives local or general anesthesia.
  2. Accessing the Eye: Surgical entry is made into the eye, often through existing surgical openings.
  3. Endoscope Insertion: The ophthalmic endoscope is carefully inserted through a small incision.
  4. Visualization: The endoscope provides a magnified view of the eye interior on a monitor.
  5. Assessment & Treatment: The surgeon assesses the condition and performs necessary interventions.
  6. Endoscope Removal: The endoscope is carefully withdrawn once the assessment/treatment is complete.
  7. Closure: The incision is closed, and the procedure is finalized.

Duration

Typically, this procedure takes about 30 to 60 minutes, depending on the complexity.

Setting

It is performed in a hospital operating room or a specialized outpatient surgical center.

Personnel

  • Ophthalmic Surgeon
  • Surgical Nurse
  • Anesthesiologist (if general anesthesia is used)
  • Ophthalmic Technicians

Risks and Complications

  • Infection
  • Intraocular bleeding
  • Retinal detachment
  • Increased intraocular pressure
  • Adverse reactions to anesthesia

Benefits

  • Enhanced visualization of eye structures
  • Improved surgical precision and outcomes
  • Better management of complex eye conditions

Recovery

  • Patients will be monitored in the recovery area until the anesthesia wears off.
  • Follow-up appointments will be scheduled to monitor healing.
  • Avoiding strenuous activities and eye strain is generally advised for a few weeks.
  • Use of prescribed eye drops to prevent infection and inflammation.

Alternatives

  • Traditional intraocular examination methods (e.g., ultrasound biomicroscopy)
  • Non-invasive imaging techniques (e.g., OCT, fundus photography)
  • Each alternative has its own limitations in providing detailed internal eye views.

Patient Experience

Patients might feel minimal pain during the procedure due to anesthesia. Post-procedure discomfort and mild pain around the eye are typical and managed with pain relievers. Blurred vision or glare can occur temporarily, which should improve with recovery.

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