Article Date: 12/1/2000

Frequently, 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.

Just 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.

 

A Eyechart
B You 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.
C Remove 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 You can also mount poles on cabinets to replace outdated instrument stands.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.
D Mirror

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.

 

Here, 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.

A Swing wall-mounted arm either to the left or the right side. Use longer, counter-balanced arms to eliminate frequent adjustments of chair height.
B Storage Space
C Bypass closet doors allow access to instruments when open. When closed, they provide privacy to the adjoining room

POINT: 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

 

This 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.

A Eyechart
B This layout allows a 13-foot chart distance using mirrors
C Mirror
D This area allows pre-testing, topography and fundus photography.
E Eyechart
F This room layout allows a 24-foot chart distance using mirrors.
G Doorway allows doctor to pass easily between rooms.
H Mirror


Optometric Management, Issue: December 2000