we require additional space for expansion or for the addition of a new doctor.
But sometimes, more space isn't available because of reasons beyond our control.
The following are some creative solutions to make better use of the space you
already have and to get more bang for your rental buck.
how small can an exam room be? This one is 6 feet wide by 7 feet long. A total
of 42 square feet -- compared to older rooms that can be as large as 200 square
feet. How is this possible? The need for space and the willingness to be
flexible will invite some creative solutions.
don't need to use a large, bulky exam chair. A height-adjustable office
chair will do just fine. If you want to get fancy, use a motorized chair
available from beauty supply houses.
existing arms from older stands and remount to wall-hung poles to conserve
space while providing a more modern look. You can also mount poles on
cabinets to replace outdated instrument stands. Wall-hung desks available
from medical supply companies fold up and permit narrow exam lanes.
POINT: The eye chart doesn't have to be 20 feet away from the
patient. Twenty feet (6 meters) is considered optical infinity. It does,
however, create 1/6D of accommodative stimulation. This is considered
clinically insignificant because of the depth of focus of the eye.
Because the depth of focus varies between individuals and lighting
conditions, 20 feet produces an insignificant amount of accommodative
stimulation. A distance of 13 feet (4 meters) creates 1/4D of accommodative
stimulation. The difference between 20 feet and 13 feet is only 1/12D. If 1/6
is insignificant, certainly 1/12 is less significant. But more importantly, we
have a known amount of stimulation that's not zero. If we add 1/4D of minus to
refractive findings, the punctum remotem of the eye will be truly at
optical infinity. Similarly, a 20-foot distance requires one prism diopter of
convergence. The difference in lateral convergence is only 1/2 prism diopter.
Using a mirror system, a room that's 7 feet long will provide a measurable
accommodative stimulus of 1/4D. Adjusting the size of the eye chart to
compensate for the shorter distance will yield proper acuities.
two rooms were created out of one 10-foot by 8-foot room. Equipment is shared
between the two rooms, which cuts equipment costs and reduces space.
wall-mounted arm either to the left or the right side. Use longer,
counter-balanced arms to eliminate frequent adjustments of chair height.
closet doors allow access to instruments when open. When closed, they
provide privacy to the adjoining room
Not every exam room has to be fully equipped. You can designate some rooms for
refractions, and others for dilated fundus exams and pathologies. Here, only a
slit lamp and binocular indirect ophthalmoscope are needed
doctor had a 12-foot square room and desperately needed additional rooms to see
patients. I divided the room into three work areas as shown.
layout allows a 13-foot chart distance using mirrors
area allows pre-testing, topography and fundus photography.
room layout allows a 24-foot chart distance using mirrors.
allows doctor to pass easily between rooms.
Optometric Management, Issue: December 2000