Gutierrez Eyelid Plate Plus Mario Gutierrez O D

Gutierrez Eyelid Plate Plus Mario Gutierrez, O. D. , F. A. A. O. San Antonio, Texas

Why Develop the Plate? • Although there are some good MGD expression paddles available, I felt they could be awkward to use. So a few years ago, I developed the angled Gutierrez Eyelid Plate.

• This enables us to comfortably express a patient’s meibomian glands with a normal posture and arm position that we are all accustomed to while performing gonioscopy.

• But then I realized, that by adding a few more features, the plate could become a very convenient and effective tool for our practices- especially by attaching it to our slit lamp table(with pouch). Our plate evolved to The Gutierrez Eyelid Plate Plus (GEPP).

Eye lid Eversion Having the tool handy by the slitlamp, makes lid eversion really easy for evaluating contact lens patients for GPC, lost contacts, and for helping locate foreign bodies embedded under the lids.

• The scale makes it very handy to take measurements – such as pterygium encroachment and HVID measurements

The millimeter scale on the GEPP makes lid measuring really easy-such as evaluating levator function testing (as shown). The angled ends of the GEPP allows excellent control of the plate to allow close to the eye placement for better accuracy. I use the unit everyday, for ptosis evaluations, measuring MRD (lid to cornea reflex distance), measuring the lid crease, in addition to assessing levator range.

The plate can be used for scleral depression while performing BIO. With the angled edge placed between the lid and the orbit (as in the first photo), the GEPP can help stabilize the lid for various slit lamp associated procedures such as punctal occlusion and foreign body removal.

The angled edges allow close placement of the plate for good visibility and stability in measuring the cornea plane. One can easily get a estimate of the distance from the lateral orbital rim to the cornea plane, which can later be accurately assessed with exophthalmometry. The close placement of the plate allows for a close and quick measurement of a patient’s HVID and palpebral fissure height

One of my favorite features is the pupil size gauge. Pupil measurements are quick and accurate.

MGD Expression • The original function of the plate was to make meibomian gland expression easier for the doctor and more comfortable for the patient-and that is what it does!

• It works well with the MG Expressor roller (Gulden). This allows gentle rolling pressure to better empty the glands(see expressed plugs in bottom picture).

The Guterrez Eyelid Plate Plus is available in both acrylic and stainless steel designs My advice is to keep an acrylic plate attached to each slit lamp for general purpose, and Have the stainless steel available for procedures as it is autoclavable.

Gutierrez Eyelid Plate Plus • Mario Gutierrez, O. D. , F. A. A. O. • President/ CEO South Texas Vision Associates, P. A. • Adjunct Clinical Professor University of Houston College • • • of Optometry Adjunct Clinical Professor UIW Rosenberg School of Optometry 5212 Broadway San Antonio, Texas 78209 (210) 829 -8083 mariogut@flash. net www. visionsource-alamohts. com