Lid Speculum Types: Wire vs Solid Blade, Nasal vs Temporal, Infant to Adult

A lid speculum holds the eyelids open during eye surgery or a procedure. Choose it by four things. The blade: open or closed wire blades are light and gentle, and solid blades keep lashes and lid margins out of the field. The approach: a nasal or temporal speculum keeps its frame on the side away from where you are working. The size: infant, pediatric and adult blades run from 4 to 20 mm. The opening: a simple spring, an adjustable screw or a lock that holds a set opening.

Why are so many specula called Barraquer?

The Barraquer family of Barcelona and later Bogotá shaped modern eye surgery across three generations. Ignacio Barraquer invented many cataract instruments and procedures, a number of which carry his name, and is remembered for extracting the lens by suction in 1917. José Ignacio Barraquer is called the father of corneal refractive surgery. The simple wire Barraquer speculum is still the base that many later patterns modify: Kratz-Barraquer, Floyd-Barraquer and Grandon-Barraquer all start from it. The Castroviejo speculum carries the name of the corneal surgeon Ramón Castroviejo.

Wire or solid blades?

• Open wire blades are the lightest and press least on the globe. They suit short procedures and cooperative patients.
• Closed wire blades close the loop so lashes are held back better while staying light.
• Solid blades cover the lid margin completely, keeping lashes and meibomian secretions out of the field. Fenestrated solid blades let fluid drain through.
• K wire and V shaped blades (Lieberman) are shaped to open the lids wide with a low profile.

Which specula do we make?

Nasal or temporal approach?

The approach names where the speculum's hinge and arms sit. A temporal speculum keeps them on the temple side, out of the way when you work from the nose side, and a nasal speculum does the reverse. Surgeons who operate from the temporal side, common in cataract surgery, usually want the arms nasal. Reversible specula such as the Kershner and the Chu turn round to suit either.

How do you choose the blade size?

Blade size is the length of the blade that sits under the lid. Premature and infant specula start at 4 to 5 mm, pediatric sizes run around 7 to 10 mm, and adult blades 10 to 20 mm. A blade that is too long presses on the globe, and one that is too short slips. For examination of infants and the retina, see also our scleral depressor guide. Titanium versions weigh less than steel.

How should specula be cleaned?

Clean the blades and the spring or screw mechanism straight after use. Flush the channel of aspirating specula until clear. Check that wire blades are not bent, because a bent blade presses unevenly on the lid. Never leave instruments in saline, because it causes corrosion. Our instrument care guide gives the full routine, and the CDC guidance on cleaning instruments before sterilization explains why cleaning comes before the autoclave.

Frequently asked questions

What is the difference between a wire and a solid lid speculum?

Wire blades are light and press gently. Solid blades cover the lid margin and keep lashes out of the field.

What size speculum for an infant?

Infant blades start at 4 to 5 mm. We make premature, infant and pediatric patterns. Choose by the child's lid fissure.

What does nasal approach mean?

The hinge and arms of the speculum sit on the nasal side, leaving the temporal side clear.

Can titanium specula be autoclaved?

Yes, both our steel and titanium specula are autoclavable.

Related instrument guides

• Scleral depressor types
• Ophthalmic cannula types
• Westcott scissors and blade breakers
• Oculoplastic and lacrimal instruments

Order lid specula

See the full lid speculum range. For a set for a hospital, a clinic or a distributor, send us your list and we will send you a quote.