Visual Perception and Acuity of Hand Surgeons Using Loupes.

Perrin, Philippe; Bregger, Romy; Lussi, Adrian; Vögelin, Esther (2016). Visual Perception and Acuity of Hand Surgeons Using Loupes. Journal of hand surgery - American volume, 41(4), e9-e14. Elsevier 10.1016/j.jhsa.2015.12.033

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PURPOSE To assess the visual performance of Swiss hand surgeons in an environment similar to their workplace. The influence of Galilean (lenses only) and Keplerian loupes (lenses and prisms), the surgeon's age, and the credibility of a self-assessment of his or her own optical performance were evaluated. METHODS Sixty-three hand surgeons between 29 and 68 years of age with 70 loupes were included in the study (Galilean n = 35, Keplerian n = 35). The visual performance as surgeons was self-assessed on a modified visual analog scale and objectively measured with miniaturized visual tests in a simulated clinical setting. We evaluated the influence of the optical device by comparing Galilean and Keplerian loupes and the influence of the surgeon's age by comparing 2 subgroups: < 40 years and ≥ 40 years. RESULTS The correlation between self-assessment and objective visual performance was weak, with a Spearman rank correlation coefficient of 0.25. The near visual acuity with habitual optical aids showed considerable variability, with a range of 300% in the dimension of the smallest detected structure. The near visual acuity was significantly lower in the older group ≥ 40 years than in the younger group < 40 years with both Galilean and Keplerian loupes. Keplerian loupes allowed a significantly higher visual performance than Galilean loupes. Surgeons 40 years or older using Keplerian loupes had a similar visual acuity to surgeons younger than 40 years with Galilean loupes. CONCLUSIONS The magnified near vision of hand surgeons showed an important individual variability. Self-assessment was not a valuable instrument for surgeons to estimate their own near vision. Hand surgeons older than 40 years should use higher magnification loupes. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic III.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Preventive, Restorative and Pediatric Dentistry
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Handchirurgie

UniBE Contributor:

Perrin, Philippe; Lussi, Adrian and Vögelin, Esther


600 Technology > 610 Medicine & health








Veronika Picha

Date Deposited:

27 Apr 2016 11:57

Last Modified:

27 Apr 2016 11:57

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Loupes, acuity, hand surgeons, microsurgery, visual perception




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