Penlight for medical purposes

[silviacrazed]

Got one at home. It uses a cool-white Cree XR-E and has horrible color rendering. It's also insanely throwy, with a small die emitter and a deep smooth reflector. I like that it runs on AA and comes in blue, but I'm a bit boggled why they continue to market it for close-up medical work without updating the emitter and/or stippling the reflector.

Thanks for the input. Do you have a recommendation for a dim light for checking pupil reaction?

 

[dss_777]

It's just so hard to suggest something without having a baseline to compare it to. The Nichia 219 equipped Preon 2 is an intriguing choice because of the color rendition benefit, but not being a medical doctor I can't tell you if the low setting would be too bright for the PLR exam. And is an overly-bright light really an issue for your patients?

We've got the P2 with 219 and a WA macro-view otoscope/peds specula at home. I can compare them, if you'd like, but that may not be relevant. Is the light from your otoscope too bright for PLR exam?

 

[Poppy]

It's just so hard to suggest something without having a baseline to compare it to. The Nichia 219 equipped Preon 2 is an intriguing choice because of the color rendition benefit, but not being a medical doctor I can't tell you if the low setting would be too bright for the PLR exam. And is an overly-bright light really an issue for your patients?

We've got the P2 with 219 and a WA macro-view otoscope/peds specula at home. I can compare them, if you'd like, but that may not be relevant. Is the light from your otoscope too bright for PLR exam?

You can have your wife watch your pupil then if she shines the light at the pupil, she should see it constrict. If it does then the light is bright enough. If she can't get it to constrict without it hurting you, then it is too bright.

I have a DQG IV AAA with a XPG2 with a 4A neutral tint. at a low of 3 lumens, I think that it works fine, I don't think I would want it any brighter. I suspect that a cool white might be too annoying. IIRC The 4A is pretty close to the Nichia 219

 

[BuaidhNoBas]

I'm a physician and currently have a Preon 2 in my white coat pocket. The low setting is plenty bright (borderline too bright) for pupillary reflexes, and the high setting will fill up a room and be dangerous to shine into someones eyes. I would DEFINITELY recommend the High CRI (Nichia 219) version from Illumination Supply that was mentioned earlier if you go this route, as the color is terrible with my light and I don't like it much for mouth exams. It should be noted that the light always comes on in the low setting, which is a nice safety feature when thinking about pupillary exams.

I just ordered a Peak Eiger 2xAAA body from RMSK, along with a Nichia 219 head from Oveready to try out - hoping the momentary switch will give me enough control to do pupils on a lowish setting, then higher for mouth exam without taking my hand off the switch. If the momentary switch proves too twitchy, one can always twist the head and set a low level before doing the exam. All the pieces should be here tomorrow, and I'll try to report back after I've had it on the wards for a couple of days.

I actually liked my old Welch Allyn incandescent penlight with the green switch up top (color was great, brightness was just right) but it got a short in it after a couple of years of use and I decided to go the LED route. That's always an option if you can't find any good LED alternatives.



Oh, by the way, first post! Hi all, I will likely be posting a "Recommend me a light for...." thread in the near future.

 

[Charles L.]

Hi, and welcome to CPF! I grabbed my Preon2/Nichia last night and tested the Low on myself again. Wouldn't describe it as comfortable, but it is tolerable for a second or two. It certainly looks good in the pocket of a white coat. I'd forgotten how much I like that light -- have to put it back in the EDC rotation.

If you're already ordering from Peak and Oveready, I'm not sure you'll need recommendations -- sounds like you're well on your way to flashaholic status

 

[dss_777]

FWIW, the Preon 2 w/ Nichia 219 on low is slightly brighter than the otoscope at the highest brightness setting. This was according to my highly calibrated Mark I eyeball, and confirmed by SWMBO. The expert opinion was that it's a little bright for PLR.

I also learned that "too bright" is indeed painful with real patients, and more so for those with light colored eyes. I thought that was very interesting. Who knew?

I guess the P2 is good for throats, not so good for eyes, and a cool tool nonetheless.

 

[dss_777]

I'd also add this: the P2 is a slippery little bugger, and the switch is kinda wimpy. It's easily activated in the pocket, and easily bumped to higher levels when on. I've heard the FourSevens Penlight is actually better in that regard, too bad no one is modding it with the N219...

 

[tubed]

my 2 cents from another (cheaper) physician.
I've used two different ones in the last 3 years. Both bought to emphasize:
light weight and small
one hand operation
must come on in low and low must be <10 lumens
didn't want to spend too much

I first got one of the older vesions of the Olight i3 - met all criteria and loved it. I liked it so much I moved it to my keychain. Now I'm using a Lumapower L21 - b/c I wanted to go with a clicky switch. I like that a lot too.
Beware, the new/current version of the i3 may not come on in low.

As for color rendition- there have been ALOT of LONG discussions about that in this forum. (a search will reveal days worth of comments). there seem to be 2 camps. Those that think it matters and recommend a variety of high CRI or other emitters and those that think it doesn't. I'm in the second camp.

The concept behind the "emitter doesn't matter" philosophy is that most exam rooms/patient rooms are already filled with a mix of poor quality artificial (i.e flourescent) light and maybe some sunlight and that one's eyes adjust accordingly.
I now believe this. My lumapower emits a greenish white light and at first (for like 2 seconds) everything in the mouth seems bleached out but then color rendition seems to creep in somehow. I find i can see whites, reds, pinks quite well.
But to each his own.

 

[rlapporte]

Thanks for the reply. I used to use the same Welch Allyn but I found that it turned on way too easily and then I had a dead light in my pocket. Did you get the new light yet? Welcome to the forum...I'm a relative newbie as well.

Best,

Rob

I'm a physician and currently have a Preon 2 in my white coat pocket. The low setting is plenty bright (borderline too bright) for pupillary reflexes, and the high setting will fill up a room and be dangerous to shine into someones eyes. I would DEFINITELY recommend the High CRI (Nichia 219) version from Illumination Supply that was mentioned earlier if you go this route, as the color is terrible with my light and I don't like it much for mouth exams. It should be noted that the light always comes on in the low setting, which is a nice safety feature when thinking about pupillary exams.

I just ordered a Peak Eiger 2xAAA body from RMSK, along with a Nichia 219 head from Oveready to try out - hoping the momentary switch will give me enough control to do pupils on a lowish setting, then higher for mouth exam without taking my hand off the switch. If the momentary switch proves too twitchy, one can always twist the head and set a low level before doing the exam. All the pieces should be here tomorrow, and I'll try to report back after I've had it on the wards for a couple of days.

I actually liked my old Welch Allyn incandescent penlight with the green switch up top (color was great, brightness was just right) but it got a short in it after a couple of years of use and I decided to go the LED route. That's always an option if you can't find any good LED alternatives.



Oh, by the way, first post! Hi all, I will likely be posting a "Recommend me a light for...." thread in the near future.

 

[BuaidhNoBas]

Thanks for the reply. I used to use the same Welch Allyn but I found that it turned on way too easily and then I had a dead light in my pocket. Did you get the new light yet? Welcome to the forum...I'm a relative newbie as well.

Best,

Rob

I tried to post a couple days ago but it must have gotten lost - I have it now, and like it. Regarding your worry about being too bright - it is very bright, but if you use the twisty head you can set a low level and it will stay. If you use the momentary switch, it won't let the light get to 100% brightness - which in your case would be good. In addition, I put the clip from my Preon on there just to see how it would work, and it made the light even dimmer - I went ahead and adjusted the switch so that it could get brighter, but you could just leave it there and leave it relatively dim. It's funny, I just got done with my second night shift with this light and I had a little old lady comment that the new lights didn't hurt her eyes like the old ones did

I find that it's pretty easy to turn the light on at a dim level using light pressure, then bear down on it to get brighter for a mouth exam. In my case, I have the stainless 2xAAA body and it's pretty slick - I wish the aluminum had been in stock because I think I would have preferred the knurling for grip.

Regarding color rendition, it's better than my Preon but it's still an LED and not quite as good as an incandescent. When I switched to the Preon, I remember being very disappointed in color rendition; that has gotten better over time as I've gotten used to it but I still think incandescent is probably the best for this. I'm still undecided whether the Nichia is appreciably better for picking out exam details, but things certainly look better.

 

[rlapporte]

Thanks for the detailed response. Have you ever used the High CRI Preon?
Rob

I tried to post a couple days ago but it must have gotten lost - I have it now, and like it. Regarding your worry about being too bright - it is very bright, but if you use the twisty head you can set a low level and it will stay. If you use the momentary switch, it won't let the light get to 100% brightness - which in your case would be good. In addition, I put the clip from my Preon on there just to see how it would work, and it made the light even dimmer - I went ahead and adjusted the switch so that it could get brighter, but you could just leave it there and leave it relatively dim. It's funny, I just got done with my second night shift with this light and I had a little old lady comment that the new lights didn't hurt her eyes like the old ones did

I find that it's pretty easy to turn the light on at a dim level using light pressure, then bear down on it to get brighter for a mouth exam. In my case, I have the stainless 2xAAA body and it's pretty slick - I wish the aluminum had been in stock because I think I would have preferred the knurling for grip.

Regarding color rendition, it's better than my Preon but it's still an LED and not quite as good as an incandescent. When I switched to the Preon, I remember being very disappointed in color rendition; that has gotten better over time as I've gotten used to it but I still think incandescent is probably the best for this. I'm still undecided whether the Nichia is appreciably better for picking out exam details, but things certainly look better.

 

[BuaidhNoBas]

Thanks for the detailed response. Have you ever used the High CRI Preon?
Rob

No I sure haven't - if it was an option when I got my Preon, I definitely would have gotten it (and I keep going to Illumination Supply and looking at the High CRI Preon they have for sale, but I haven't pressed the buy button yet). I do really like the Nichia 219 that's in the Eiger, and I think the colors are better with it, although I still like incandescent the best. I know it's been said earlier in the thread that High CRI bulbs don't make a difference, but the Nichia seems better to me in regards to color rendition than the bulb in my Preon (not even sure what is in it, I've had it a while).

The Eiger is definitely a "twitchier" light in that if you use the momentary switch you have a to have a soft touch. The Preon works out of the box. I'm still undecided on what I think is the best - will need to use the Eiger for a bit. Can't go wrong with the Preon, though.

 

[rlapporte]

Thanks for the advice. I appreciate your time.

Rob

No I sure haven't - if it was an option when I got my Preon, I definitely would have gotten it (and I keep going to Illumination Supply and looking at the High CRI Preon they have for sale, but I haven't pressed the buy button yet). I do really like the Nichia 219 that's in the Eiger, and I think the colors are better with it, although I still like incandescent the best. I know it's been said earlier in the thread that High CRI bulbs don't make a difference, but the Nichia seems better to me in regards to color rendition than the bulb in my Preon (not even sure what is in it, I've had it a while).

The Eiger is definitely a "twitchier" light in that if you use the momentary switch you have a to have a soft touch. The Preon works out of the box. I'm still undecided on what I think is the best - will need to use the Eiger for a bit. Can't go wrong with the Preon, though.

 

[DoctaDink]

I'm a physician, and recently got the Preon2 with Hi CRI Nichia, and find it very nice for throat illumination. Have found my Welch-Allen otoscopes inadequate for good throat exam ( I use to have an old WA Otoscope with detachable head/throat illuminator that worked great, but it is long gone). Virtuovice, a Japanese physician, did a recent Youtube video review of this light.

 

[rlapporte]

I bought the Preon2 and returned it. The light quality was good, but I thought that the button was cheap and unpredictable if that makes sense. I also don't really like strobe functions in a penlight. I have since bought the highly-regarded McGizmo Haiku. I haven't brought it to work yet because I've been off for a few days but it might work out pretty well for physical exams. The downside is that it's a lot bigger and heavier to carry around at work, and I'm sure it'll draw some attention which is not something I'm looking for in an ER. Oh well. Perhaps I'll get my V11r modified to use a Nichia high CRI since I seem to gravitate toward a rotary. I think my ideal light would be a HDS rotary, Nichia high CRI, and a clip. So far that doesn't exist as far as I know. Thanks for you suggestion DoctaDink. I'll look at the video.

Best,

Rob

I'm a physician, and recently got the Preon2 with Hi CRI Nichia, and find it very nice for throat illumination. Have found my Welch-Allen otoscopes inadequate for good throat exam ( I use to have an old WA Otoscope with detachable head/throat illuminator that worked great, but it is long gone). Virtuovice, a Japanese physician, did a recent Youtube video review of this light.