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- Endoscope Removal: The endoscope is carefully withdrawn once the assessment/treatment is complete.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