US1237121A - Speculum. - Google Patents

Description

Patented Au 1.4, 1917.

. 2 SHEETSSIHE.EIT I.

lnvenTor. George A. Suffq G. A. SUFFA.

SPECULUM.

APPLICATION FILED JULY 27, 1916.

Patented Aug 14 1917. 2 SHEETS-#SHEET 2.

Ihveni'or.

George A. Suffa A1 Tys TNT 'FFICFE.

SPEGULUM. Y i

Specification of Letters Patent.

Patented Aug. 14, 1917.

Application filed July 27, 1916. Serial No. 111,730.

To all whom it may concern:

Be it known that I, GEORGE A. SUFFA, a citizen of the United States, and resident of Boston, Massachusetts, have invented an Improvement in Specula, of which the following description, in connection with the ac-' companying drawing, is a specification, like characters on the drawing representing like parts.

This invention relates to an improvement in that class of devices known in the medical profession as specula. And, it more specifically relates to an improved speculum for the eye, being an ins'trumentality functioning to separate and to hold the lids of an eye apart and away from the eyeball pending operation on the eye. The specula generally employed at present are provided with a pair of practically flat end pieces, resting against the eyeball. When an operation takes place there'is quite frequently an attendant spasm of the lids or a muscular contraction or squeezing which produces a relatively powerful pressure, forcing the speculum against the eyeball, entailing serious results.

This novel construction is provided with a headpiece having preferably a pair of rigid side plates carrying each a pair of arms which have a plurality of variant mountings and connections to afiord a wide range of rapid, accurate and minute adjustments of the two arm-end members which engage the eyelids and function to hold them apart. This apparatus is so constructed as to provide a relatively increased space for operating movements of the surgeon and also obviates all pressure upon the eyeball and attendant squeezing thereof and holds the lids in constant, fixed, predetermined position. The devices for holding the eyelids are shaped to conform to the convexity of the eyeball and to the concavity of the eyelids.

The object of this invention. is to provide an improved eye speculum.

A more specific object is to provide an eye speculum which obviates pressure upon the eyeball, affords a relatively great operating space and is susceptible to a-Wide range of accurate, rapid, minute and self-retaining adjustments.

Other objects of the invention will more fully appear from the following description and the accompanying drawings and will be pointed out in the annexed claims. I

In the accompanying drawings, there has been disclosed a structure designed to carry out the objects of the invention, but it is to be understood that the invention is not confined to the exact features shown, as various changes may be made within its reasonable scope.

In the'drawings: I

Figure 1 is a side elevation of the device;

Fig. 2 is a section 011 the line 2-2 of Fig. 1;

Fig. 3 is adetatil of the ball and socket connection; 1

Fig. 4 is a section on the line 44 of Fig. 2; I

Fig. 5 is a section of an eyeball with the blades in place;

Fig. 6 is a view similar to Fig; 5 but with the blades retaining the eyelids apart, and raised to prevent squeezing;

Fig. '7 is a frontelevation of a modification;

Fig. 8 is a side elevation of the device showing use of but one arm;

Fig. 9 is a section on the line 99 of Fig. 7 and Fig. 10 is a section on line 1010 of Fig. 7

Fig. 11 is a side elevation of the device on. the side of the head opposite to that of Fig. 1.

The structure here shown is that embodiment selected to disclose the novel inventive idea. It comprises broadly a holding means such as a head gear preferably having a pair of rigid plates securely held to the head of the patient. Upon these plates thus positioned are mounted the eyelid engaging members which have been termed blades.

The mounting of the blades with relation lar and for sake of clarity and brevity one only is described.

The holding means preferably comprises a metallic plate 1 which has an aperture 2 to admit of the passage therethrough of an ear. This plate 1 is provided with means for securely positioning the plate to a head and for this purpose the plate is provided with slots 3 at each end. These slots are preferably cut so that the metal may be outwardly turned upon itself to engage and hold a link +1 at the front end and a buckle 5 at the rear end. The strap 6 is secured to the link a and, passing around the head, is adjustably secured by a buckle to the front end of the opposed plate member, not necessary to be shown. The rear slot of the opposed plate member has a strap secured thereto which similarly passes around the rear of the head and is adjustably secured by the buckle 5. A strap 7 is provided with loops 8 at its lower ends which receive the straps 6 therethrough. This strap 7 is passed over the head and is adjustably positioned by means of the buckle 9.

The blade-carrying instrumentality is afforded a wide range of adjustment by means of its mounting on the plate which, in this selected embodiment, is disclosed as a ball and socket device. This device is preferably so constructed that the ball may be demounted and removed as may the other connections, for convenience and to facilitate more eiiicient sterilization of the parts. Herein, the bracket 10 is L-shaped, the base being fixed to the plate 1 and apertured to receive therethrough a pin 11 by which means the upright 12 is pivotally mounted. The upper ends of the upright portion of the bracket 10 and of the upright 12 are terminally separate and are cupped, as indicated in dotted lines in Fig. 3, inorder to engage more effectively the ball 13. The ball 13 preferably is pitted, to present roughened surfaces to the cupped ends thereby aiding in immovably retaining the ball in its socket. A set screw 14; is provided to draw the upright 12 closer to the bracket. This set screw is passed between the bracket 10, its milled head end 15 abutting against the bracket, and is received in threaded engagement in the apertured upright 12. A red 16 is carried by the ball 13, the ball being preferably centrally apertured and the rod passed therethrough. The rod is longitudinally and rotarily movable through the ball and is adjustably held in a predetermined position by means of the set screw 17 which is received in threaded engagement in the ball 13, its innor end bearing upon the positioned rod and effectively preventing relative move ment. The rod 16, outwardly extending, terminates in a second adjustable connection. A ring 18 is preferably provided on this outer end of the rod 16 and receives therein an enlarged substantially cylindrical portion 19 of a bar 20. This bar 20, preferably angularly shaped (shown as square) is provided with this middle por- 'tion 19. The square portions of the bar 20 above and below this middle portion carry the arms which bear the eyelid blades. In this selected embodiment, this portion 19 has a peripheral slot 21 which is engaged by the end of a set screw 22 received in threaded engagement within the rod ring 18. This set screw 22 serves the function of retaining the bar in a fixed adjusted position with reference to the rod 16 and, loosened, permits free movement of the bar with relation to the rod while the end of the set screw, remaining within the pcripheral slot, prevents longitudinal movement of the bar portion in the ring.

Each of the arms 23 is provided with an independent adjustment longitudinally the bar 20. This structure permits a rapid and accurate positioning of the arms through a relatively wide range. In this embodiment the arms 23 are similar and each is secured to a block 24 longitudinally moi able on the bar 20 and held against any rotative movement by the angularity of the bar and the aperture in the block symmetrical therewith. A set screw 25 is received through a second adjusting block 26 in threaded engagement therewith and, upon turning in, functions to hold the adjusting block 26 against longitudinal movement. By such adjustment the approximate desired position of the arm is rapidly attained. A more accurate and minute adjustment is attained through the threaded stem 27 fastened at one end to an arm 23. This stem 27 is received in threaded engagement within a threaded aperture in an ear 28 extending from the block 26. Upon the proper positioning of the block 26 on the bar 20, the threaded stem is turned by means of its milled head 29 so that relatively minute changes of position of the arms with relation to the plate 1 and head are effected.

Each of these thus adjustable arms is preferably curved, as shown in Fig. 2, to present opposite the eye a blade 30 secured to each arm and adapted to engage an eyelid. These opposed blades 30 are preferably shaped to accord with the contours of the eyeball and eyelid. They are, as shown, substantially cupped and the lip 31, as shown in Fig. 5, is inserted under the eyelid. The

lips 31, in their longitudinal and transverse dimensions, are also shaped to conform to the configuration of such dimensions of the eyelids so that the eyelids may be substantially completely engaged and retained away from the eyeball, the opposed pair of blades functioning to remove the upper and lower lids from the eyeball, as shown in Fig. 6, upon the proper adjustment of each of the threaded stems 27. The outwardly projecting lips of the V-shaped blades, see Figs. 5 and 6, obviously function to retain the edge portions of the eyelid and the eyelashes out of the way of the surgeon.

There is thusv presented a durable and easily, rapidly and accurately operably adjusted eye speculum. Pressure on the eyeball and squeezing of the same is obviated beyond mishap and a relatively'wide space, due to the curved arm and holding construc tion, is afforded the operating surgeon while the eyelids are positively and securely held apart and away from the eyeball. Further, it is obvious that from the construction, here shown in this selected embodiment, the parts are readily demountable for sterilization, replacement or repair. The arms, and fastened stem, may readily be removed upon the demounting of the blocks 24 and 26 which are slid off the bar upon release of the set screw 25; the bar is removed by passing it through the ring 18 when the set screw 22 is turned to remove it from the slot 21; and, as stated, the ball of the universal joint is easily removed from its socket upon release of the set screw 15.

There is illustrated in Fig. 8, a modification of the speculum which discloses the same organization differing only in its provision for a single blade to engage the one eyelid. Such form is useful in that class of operations known in the profession as the intra-capsular cataract extraction. In this operation it is essential to raise the upper eyelid and retain it away from the eyeball. This device also firmly holds the lid against the muscular contractions of the patient and obviates the dangerous squeezing of the eyeball between the blade and the bone structure of the head adjacent the eye. In this form, only the upper blade arm 23, and associated parts, is employed although the bar 20 remains intact in order that, in transposition to employ it on the other side of the head, the bar may be inverted so that the set screw 22 will not be positioned against the patients head.

In the modification shown in Figs. 7, 9 and 10, there is disclosed a form which is peculiarly adapted for the intra-capsular operation. This selected embodiment of such modified form is provided with a horizontal head strap 6 which goes around, and avertical strap 7 which goes over, the patients head. A buckle 9 is provided to afiord a plurality of adjustments as in the other form here disclosed. The horizontal strap 6 is provided, as is the similar strap of the firstmentioned speculum, with a suitable adjusting means in order properly to fit the head. In this modified form, a rigid member, preferably a metallic'plate 33, is secured to the head straps 6 and 7. A preferred means of effecting such positioning is by cover- .ing the metal plate 33 with a fabric, such The rod 16 of this modified form is pro vided with a universal mounting on the plate 33 by means of a similar ball and socket connection. The base of this substantially L-shaped bracket 36 is securely affixed to the metal plate 33, as by a rivet 37, the covering being cut away for this purpose. As shown in Fig. 10, the upright portion of this bracket is cupped as at 38 to conform to the contour of the ball 13 and departs from the previously mentioned form in that it is not providedwith terminally separated portions. The complementary upright 12 is, similarly to the other form, pivotally mounted on the base of the bracket 36. A set screw 14:, having a milled head 15, is provided to draw the upright 12 toward the bracket upright portion in order to effect the retention of the ball 13 in fixed position. The adjustably positioned ball 13 is apertured to receive therethrough the rod 16 which may be held in a plurality of longitudinally adjustable positions in the ball 13 by means of the set screw 17 which is received in threaded engagement in the ball 13, its inner end being in adjustably tensioned contact with the rod 16 and effectively preventing relative movement.

In this embodiment, the rod 16 is thus adjustably held in a substantially vertical position with relation to the patients head. Anovel lid-engaging member is shown in Figs. 7 and 9. Herein, this member, a blade 39, is aflixed to the lower end of the rod 16 in any suitable manner, as for example, by soldering. As shown in the drawings, the lower end of the rod 16 has a countersunk portion 40 to which this blade 39 is soldered. The blade 39, preferably made of a piece of sheet metal, in this embodiment is shown as having a longitudinal opening 41 and a terminal lid-engaging lip 42. This lip 42 is,

like the blades of the previously mentioned form, curved to conform substantially. to the convexity of the eyeball and hence to the concavity of the eyelid to be raised by this instrument. This form provides a means for retaining the upper lid well away from the eyeball and at the same time affords a good operating space to the surgeon, It 7 functions to hold the lid against'any muscular contraction, spasmodic or otherwise of the patient and obviates the dangerous pressure upon and squeezing of the eyeball during the operation.

It is to be understood that the construction disclosed herein is illustrative but not restrictive and that the same may be modified within the meaning and scope of the claims which follow.

Having thus described my invention, what I claim as new, and desire to secure by Letters Patent, is:

1. An eye speculum comprising a holding means to be secured to a patients head, a rigid member secured to said holding means, said rigid member being adapted to be held against the head and being shaped to conform to the adjacent head portion, an instrumentality provided with a member shaped to engage an eyelid, and means for adjustably securing said instrumentality to said rigid member to enable said eyelid member to engage beneath the eyelid, retain it away from the eyeball and thus prevent squeezing of the eyeball.

2. An eye speculum comprising a holding means secured to a patients head, a rod sev cured to said holding means by a universally adjustable mounting, means for longitudinally adjusting the rod in said mounting, an arm adjustably carried by the rod, means on said arm to engage the lid of an eye to retain it away from the eyeball and to prevent squeezing of the eyeball.

3. An eye speculum comprising a holding means secured to a patients head, a rod secured to said holding means by a universally adjustable mounting, means for longitudinally adjusting the rod in said mounting, a pair of arms adjustably carried by the rod, means on said arms to engage the lids of an eye whereby they are retained apart away from the eyeball and squeezing of the eyeball is prevented.

4. An eye speculum comprising a holding means secured to a patients head, a member secured to said holding means by an adjustable mounting, a bar adjustably carried by said member, a pair of arms mounted on said bar, means on said bar to retain the arms in a plurality of adjusted positions, and means on the arms to engage the lids of an eye whereby they are retained apart away from the eyeball and squeezing of the eyeball is prevented.

5. An eye speculum comprising a holding means to be secured to a patients head, members secured to said holding means on opposite sides of a patients head, a pair of arms adjustably secured to each of said opposed members, means on each pair of arms to engage the eyelids of an eye, and means for universally adjustably securing each of said opposed members to said holding means to enable said eyelid-engaging means to engage the eyelids, retain them away from the adj aoent eyeball and thus prevent squeezing of the eyeball.

6. An eye speculum comprising a rigid plate, means for adjustably securing the plate to a patients head, a rod carried by said plate and adjustable in a plurality of positions thereon, a terminal ring carried by said rod, a bar, the bar having a cylindrical portion received in said ring, means for adjustably retaining said portion in said ring, an arm on said bar on each side of said cylindrical portion, means for adjustably supporting each of said arms on its bar portion, and means on each of said arms to engage the lids of an eye whereby they are retained apart away from the eyeball and squeezing of the eyeball is prevented.

7. An eye speculum comprising a rigid plate, means for adjustably securing the plate to a patients head, a rod adjustably mounted on said plate, a bar adjustably carried by the rod, a pair of arms slidably mounted on said bar, means on said arms to engage the eyelids, a threaded stem fixedlysecured to each arm, a block adjustably secured to each bar, and an car on each block, each of said ears having a threaded aperture to receive and engage one of the stems, whereby through adjustment of the stem and block a plurality of rapid and accurate adjustments of the arms is afl'orded.

8. An eye speculum comprising a hold ing means to be secured to a patients head, an instrumentality provided with a member shaped to support and conform to a portion of an eyelid, and means for adjustably securing said instrumentalities to said holding means to enable the said member to engage beneath the eyelid, retain it away from the eyeball and thus prevent squeezing of the eyeball.

9. An eye speculum comprising a holding means to be secured to a patients head, an instrumentality provided with a member presenting a surface longitudinally and transversely curved to conform to the shape of an eyeball, and means for adjustably securing said instrumentality to said holding means to enable the said member to engage beneath the eyelid, retain it away from the eyeball and thus prevent squeezing of the eyeball.

10. An eye speculum comprising a holding means secured to a patients head, an instrumentality secured to said holding means by an adjustable mounting, and means on said instrumentality to hold an eyelid away form an eyeball, comprising a blade having a portion adapted to 'be inserted between an eyelid and eyeball, the surface adjacent the eyeball being concaved to correspond to the shape thereof, the 0pposite surface being convexed to correspond to the inner surface of the eyelid whereby the blade may be inserted between the eyelid and eyeball to hold the eyelid away therefrom without liability to pressure upon the eyeball. I

11. An eye speculum comprising a holding means secured to a patients head, an instrumentality secured to said holding means by an adjustable mounting, and means on said instrumentality to hold an eyelid away from an eyeball comprising a substantially V-shaped blade, one member thereof having opposed surfaces shaped respectively to correspond to the convexity of an eyeball and to the concavity of the inner surface of an eyelid, whereby the eyelid may be engaged and held away from the eyeball; the other member of the V-shaped blade being shaped to engage and retain the edge portions of the eyelid and the eyelashes'whereby the eyeball is freely presented for operating purposes without liability to pressure.

12. An eye speculum comprising a supporting instrumentality secured around a patients head, means on said instrumentality operable to adjust the same to various head sizes, a complementary supporting member secured to said instrumentality and passing over the upper portion of the head, means on said member operable to adjust the same, whereby the instrumentality is firmly supported on the patients head; means secured to said supporting instrumentality by an adjustable mounting, and a member on said adjustably mounted means to engage the lid of an eye whereby it may be firmly supported from said supporting instrumentality and held away from the eyeball in a relatively immovable position and squeezing of the eyeball thereby prevented.

13. An eye speculum comprising a holding means secured to a patients head, a member secured to said holding means by an adjustable mounting, a threaded instrumentality carried by said member, and means for engaging an eyelid carried in threaded engagement by said instrumentality whereby a plurality of accurate minute adjustments are provided for said eyelid engaging means.

In testimony whereof, I have signed my name to this specification.

GEORGE A. SUFFA.

Copies of this patent may be obtained for five cents each, by addressing the Commissioner of Patents,

Washington, D. 0.

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