# Pupillary reflex penlight



## jibbz (Dec 31, 2009)

Hi everyone, 

i'm looking for a penlight as a gift for an optometrist/optician mainly for checking pupillary reflexes. I've seen the Welch Allyn Penlite (retails for around £55 in the UK) but was hoping you may be able to suggest alternatives? I've tried out a couple of medical torches but these are usually too bright to shine in the eye (usually run on 2 AAA batteries). Would any of you have ideas and suggestions for a good quality penlight suitable for this purpose? 

All your help would be very much appreciated.

jibbz


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## Dances with Flashlight (Dec 31, 2009)

The Peak Eiger 2XAAA penlight is absolutely great. Here's a link to a review:

https://www.candlepowerforums.com/threads/244743

Note that the Peak is available is any one of eight different power levels from #1 (lowest power) to #8 (highest power). My doctor thought the #6 I showed him was too bright for this purpose. I believe a level #3, medium beam, cool tint, in Peak's stainless steel body with a momentary switch, would be ideal.


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## Flying Turtle (Dec 31, 2009)

The Preon (one or two AAA) might be a good choice. The low levels could be about right for a doc.

Geoff


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## jibbz (Jan 1, 2010)

Wow, thanks for both the recommendations, they really do look superb. I'm tempted to order both the Peak Eiger and Preon 2 

With regards to the Peak Eiger (great review btw DWF), does this not have a multiple output option like the Preon? I've attempted to look through the Peak website but it's not the best website for a mere novice like me.

Also am i right in thinking that the warm color option for the Eiger is a closer match to the light of an incandescent bulb?

cheers
jibbz


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## Dances with Flashlight (Jan 1, 2010)

A multiple power option is in the works for the Eiger but not yet available. And yes, the natural tint Eiger is very, very warm - close to incandescent. Is such a warm tint preferable for this use?


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## Snow (Jan 1, 2010)

I have used my Quark AA with neutral tint for this purpose. The warm tint does not really matter for the pupillary exam, but it is great for rendering tissue in accurate colors on other examinations.


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## jibbz (Jan 1, 2010)

Wasn't really sure if i needed the warm or cool tint, but based on the above advice i'll stick to the cool tint.

Snow - the Quark AA goes down to 0.2 lumens, is this the output you have it set to for pupillary reflex checks? I ask because the Preons lowest output is 2.2lumens, would that be too bright for this purpose?


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## divine (Jan 1, 2010)

jibbz said:


> Snow - the Quark AA goes down to 0.2 lumens, is this the output you have it set to for pupillary reflex checks? I ask because the Preons lowest output is 2.2lumens, would that be too bright for this purpose?


I just shined my Preon at my eye, and it appears too bright. 

A Quark or a Novatac or Ra Clicky would do very well. Maybe even a Liteflux LF2XT or LF2X or MJP Extreme.

That should give you a pretty good price range, and all lights have a very low low.


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## Mdinana (Jan 2, 2010)

I gotta say, the cheapie disposables are fine. If you need something a little brighter, a regular Mag is fine.

Based on 13 years of experience shining things in eyes.


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## Snow (Jan 2, 2010)

jibbz said:


> Wasn't really sure if i needed the warm or cool tint, but based on the above advice i'll stick to the cool tint.
> 
> Snow - the Quark AA goes down to 0.2 lumens, is this the output you have it set to for pupillary reflex checks? I ask because the Preons lowest output is 2.2lumens, would that be too bright for this purpose?


 

I don't think 2.2 lumens is too bright. I sometimes use the settings higher than that with the Quark, I just don't shine it directly into the eye, more at an angle.


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## vertigo_2_20 (Jan 22, 2010)

Did a quick search and a bulb for a Topcon slit lamp is 450 lumens, one for a Marco is 800. I don't know how bright 2.2 lumens is, but it's obviously nowhere near as bright as these lights are, and they are shined in the eye a lot longer than a penlight is during pupillary constriction or even photostress recovery tests. I would also wager that a BIO is significantly brighter, and this is also (sometimes) shined in the eye for a lot longer than a penlight would be. I compared my direct ophthalmoscope to my Fenix P2D on its lowest setting (rated 12 lumens) and it was only slightly dimmer, and that, which is much dimmer than the BIO, can also be used for relatively extended periods of time.

FWIW, the Welch Allyn penlight is very nice. It's well constructed, has a good weight to it, and I like the switch. However, I think it's overpriced (they gave them to us for free, which makes me think they must have a high markup on them), especially considering they're only using a xenon bulb, which is not only inefficient but gets hot. I like it a lot, though, especially since it was free, but am looking for one that's similar but has multiple light output levels. It needs to be selectable through a twist mechanism or something, though, as I can't be cycling through every time I need to use it during an exam. Is this how the Preon works, or is there one somebody can recommend? I like Fenix, and am currently looking into the LD05, but it looks like you have to cycle through the output levels.


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## ryujinmaru (Jan 23, 2010)

sorry for hijacking the thread, but i too am looking for a penlight fit for the purpose of pupillary light reflex, but also with a higher setting for say a more intimate female examination involving instruments (in a purely professional medical setting, NOT in a perverted sense!). as a result of the latter, i would guess a neutral/warmer tint would be better. my old arc AAA PE is not bright enough and the bluish tinge is not ideal for visualising the back of the throat.

the preon does look good, but does it come with option of neutral LED? or are there any better suggestions please?


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## CaNo (Feb 6, 2010)

Just an FYI, I too am looking for a penlight. But through experience, the LF2XT are too bright for my patient's eyes (low setting), the Preon's are not concentrated enough, and the cool tint hurts patient's eyes. So basically you want a concentrated incandescant light, or a good warm tint mini light with good concentration.... any suggestions?


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## flasherByNight (Feb 6, 2010)

crazy, I was literally just about to start this thread 
I was thinking the preon would be perfect...


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## divine (Feb 6, 2010)

CaNo said:


> Just an FYI, I too am looking for a penlight. But through experience, the LF2XT are too bright for my patient's eyes (low setting), the Preon's are not concentrated enough, and the cool tint hurts patient's eyes. So basically you want a concentrated incandescant light, or a good warm tint mini light with good concentration.... any suggestions?


Are you sure? I believe the LF2XT has a low that is near the lowest low you can get. On the lights I own that have a low similar to the minimum level of the LF2XT, I can look directly at the emitter in darkness without hurting my eyes.

Maybe take a look through the manual to find out how to get the lowest brightness setting the light can do.


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## Monocrom (Feb 7, 2010)

I have a Peak Eiger 2AAA penlight (level 8).

You'll definitely want to get the lowest output (level 1), and spend extra for the momentary switch too.


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## seylerc (Feb 16, 2010)

I am in the same boat, but am interested for veterinary use. I would need a multimode light that goes down to a very low intensity, and is available in a warmer light like incandescent.

So is the consensus that the Peak Eiger is the way to go? Are there any others that would work? I saw it mentioned earlier that cheap disposables would do well (I am assuming this means some of the stuff on DX and similar). I was looking through there and could not find anything with a low enough lumen rating. It seems these days most people want in a small package is an overwhelming amount of light (I already have a light that fits this bill, and would not use it for a PRL lol).

Sorry to expect so much on my first post. I have actually been looming around for a bit, but finally registered.


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## divine (Feb 16, 2010)

I think when people say disposable, they mean a photon/button cell type light. That one might be a problem (or inconvenience) for a vet, because if you drop it, I would suspect some animals could try to eat it.

Maybe tie a lanyard to one.


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## Frank E (Feb 17, 2010)

I use a cheapo medical penlight which is supposed to be throat illuminator (which cheapos don't function well as, poor intesnity poor colour rendition) and pupillary reflex light, (though I have a Welch Allyn opthalmoscope). They are available at most medical bookshops. Not sure about giving one as a gift though, or indeed any tool of the trade to a professional, they'll probably have one.


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## barnefko (Feb 17, 2010)

Hi
One year of working at the ER with a romisen RC-G2 in my pocket.
I would definetly NOT recommend any multimode lights because of the sheer possibility to hit the eyes with a max-brightness-hotspot and the confusion possible with multimodes. We all now that hitting the eye with a 220 lumen hotspot can have serious consequences

Anyway: i use my G2 every day. For investigating the different cavernous spots (nose/mouth) the hotspot is perfect. For investigating the pupilary reflex it is safe to use the spill, which is low enough to not hurt the retina. 
You NEVER NEVER directly turn on the light aiming at the eyes - with no flashlight whatsoever. You always move from the side toward the eye so you see the pupillary reflex kicking in when the spill hits the eye.


My G2 survives falls, is cheap, doesn't hurt if it gets stolen/lost, uses common AA batteries and survives being desinfected with alcohol xx times a day.


just my two cents

greets from the ER


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## the_guy_with_no_name (Feb 17, 2010)

Here's 2 diff choices for you to consider.

1) Olight T10
Five brightness levels
190 down to 6 lumens
The modes are changed by twisting the front of the light and the current mode is always remembered.
Small, compact and very bright light if and when you need it.

2) Zebralight H30
3 Brightness Levels
80,20,4 lumens
Very Compact size
Always starts on low mode.
keep the switch depressed for more than 1 sec and it automatically cycles through the modes.
Great floody light, no disturbing hotspots, comes with a clip,headband & lanyard so its easy to use hands free too!

I own both of these and they are sturdy, well made lights.

tgwnn


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## RobertM (Feb 17, 2010)

You might want to considering reading the Welch Allyn Penlights? thread from May of last year. It has good recommendations and insight.

-Robert


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## RAGE CAGE (Feb 17, 2010)

Monocrom said:


> I have a Peak Eiger 2AAA penlight (level 8).
> 
> You'll definitely want to get the lowest output (level 1), and spend extra for the momentary switch too.


 

+1 on the PEAK Eiger 2 AAA level 1 and the smooth stainless steel body and momentary switch are easily disinfected or you could throw the body in an autoclave.


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## Databyter (Feb 17, 2010)

Heres something. It's light and effective, convenient and disposable.

http://www.amazon.com/dp/DIAGNOSTIC/?tag=cpf0b6-20

Comes in a six pack.

Too cheap for a gift you say? 

I dunno, it's the thought that counts, and this is thoughtfull for the purpose, You could toss in a really nice mini for the other parts of the examination. These are great for always having in your shirt pocket all day long.


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## CaNo (Jun 5, 2010)

the_guy_with_no_name said:


> 2) Zebralight H30
> 3 Brightness Levels
> 80,20,4 lumens
> Very Compact size
> ...



The low in the Zebralight H501w is perfect for this application. I have been using mine as of late, and the tint is equivalent to that of the sun, so it is not disturbingly uncomfortable. When I first posted on this thread, I thought you would need a concentrated incan beam, but I was proven wrong with this light. It's flood like attributes help ease the tension in one's pupils and is almost the same as looking into the light of a zippo lighter. The pupils still contract and dialate as needed without damaging the patient's vision.:twothumbs


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## phrenik (Jun 24, 2010)

Hello, I'm in a very similar boat. I just graduated as a male nurse [BSN] studying for my boards [blah] anyway, I have been wasting time looking at all the nursing gear, flashlights for pupillary response being one of them. I am not a flashlight guru or anything thereof, the opposite if anything, but have done some research .
One of the ones that I was looking at is the quark aa2 that some people have mentioned, if you look at their website they have a neutral white and warm white option available. I have heard the neutrals would work [they are more "white" if i can give a metaphor like a piece of paper white] and are not as beaming like HID's on expensive cars like the regular version. But I would stay on the safe side and stick with the warm white, which is closer to incand. 
+ a pro is this "Power: Two AA Batteries (0.9V~4.2V total)
Output: Maximum - 206 lumens; Moonlight - 0.2 lumens
Runtime: Maximum - 1.3 hours; Moonlight - 30 days"
-- It runs on AA batteries, has MANY levels, lowest being 0.2 lumens, and max 206 lumens. So it has multiple applications beyond the medical setting. And some special S.O.S beacon etc hidden modes.
aircraft grade aluminum, etc etc. However it is a bit big for general XX times usage in a day. at 5 some inches long, and .82 inches diameter at 2.2 oz. it also looks tactical vs more elegant of a medical setting.

The next one is as others have suggested as well the preon 2. It also comes in a neutral white and warm white - limited time only, VS the regular super white version.

it has 3 regular modes [besides the hidden sos etc] 
Low: 2.2 OTF Lumens, 23 hours
Medium: 22 OTF Lumens, 6 hours
High: 160 OTF Lumens, 0.8 hours
and Length: 5.05 inches
Diameter: 0.55 inches
Weight: 0.8 ounces

Also it looks fantastic imo. I have read through some threads here, and it seems some people have problems with the clicker making a grinding noise or something, and one person noted a light whine but most have not noticed any noise coming from it. 

I would be using the spill to check reflex so I think the preon 2 may be the way to go in warm white.


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## CaNo (Jun 25, 2010)

phrenik said:


> Hello, I'm in a very similar boat. I just graduated as a male nurse [BSN] studying for my boards [blah] anyway, I have been wasting time looking at all the nursing gear, flashlights for pupillary response being one of them. I am not a flashlight guru or anything thereof, the opposite if anything, but have done some research .
> One of the ones that I was looking at is the quark aa2 that some people have mentioned, if you look at their website they have a neutral white and warm white option available. I have heard the neutrals would work [they are more "white" if i can give a metaphor like a piece of paper white] and are not as beaming like HID's on expensive cars like the regular version. But I would stay on the safe side and stick with the warm white, which is closer to incand.
> + a pro is this "Power: Two AA Batteries (0.9V~4.2V total)
> Output: Maximum - 206 lumens; Moonlight - 0.2 lumens
> ...



Are you really going to carry that bulky Quark 2xAA as a Pupillary reflex light? 

For the sake of flashlights being flashlights, the Quark 2xAA is a phenomenal light. But you will look unprofessional shining something like that in people's eyes, especially in front of their family members. So basically out of the two that you mentioned, I would say Preon 2 in WW is more professional looking, less bulky, and more convenient with front pocket carry.


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## phrenik (Jun 25, 2010)

^^ yea that was my initial thoughts also, but it was for the sake of comparison because of its lower light/lumens and warm light system capability.

Definitely agree with you though, once i score my job [its a tough market, at least in my state] ill by the preon2 warm white without hesitation.


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## LEDninja (Jun 25, 2010)

Doctors have been using penlights with incan 222 bulbs for years. Warm white.
So a warm Preon 2 is closest to what they are used to. But a neutral Preon 2 would give more accurate colour defination.
All the other LED lights would be too blue. Also beware lights that are too bright.


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## Chrontius (Jun 25, 2010)

Anyone else thinking of an Icon Solo?


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## phrenik (Jun 27, 2010)

LEDninja said:


> Doctors have been using penlights with incan 222 bulbs for years. Warm white.
> So a warm Preon 2 is closest to what they are used to. But a neutral Preon 2 would give more accurate colour defination.
> All the other LED lights would be too blue. Also beware lights that are too bright.



That is interesting, I wonder if it would benefit my practice to go with the neutral white. These are the times I wish there was a dealer around my area that had these two available for me to use/practice and look at with my own eye which is better, and to test what may be better for a patient [probably have a friend or family member come with me as a guinea pig for pupillary tests ]


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## Paul_in_Maryland (Jul 26, 2010)

*Re: Pupillary reflex penlight: Preon vs. Preon 2*

I'm reading lots of love for the warm version of the Preon 2. What about the 1xAAA Preon? My daughter starts med school in 2 weeks, and I just bought her a 1AA Preon in warm, so she can see tissue clearly when looking down throats, into ears, and into wounds and skin infections. What about for looking into eyes? Will its low go even lower than the Preon 2?


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## CaNo (Aug 31, 2010)

*Re: Pupillary reflex penlight: Preon vs. Preon 2*



Paul_in_Maryland said:


> I'm reading lots of love for the warm version of the Preon 2. What about the 1xAAA Preon? My daughter starts med school in 2 weeks, and I just bought her a 1AA Preon in warm, so she can see tissue clearly when looking down throats, into ears, and into wounds and skin infections. What about for looking into eyes? Will its low go even lower than the Preon 2?



I would like to say since it is a single cell light, it should have a lower low. When carrying the Preon 2 in my labcoat, it tends to stay in the pocket better than the Preon I. Also it has more of that professional/traditional length of an incan pupillary light. 

But with that said, nowadays, I carry my Preon I on 10440 for the best of all worlds. A low for the pupil tests, a medium for everyday lighting, and a monster high to see what lurks within the distance. You made the right choice in getting her a warm Preon I. I just hope it doesn't slip out of her pocket during a Trauma, Code or Rapid Response situation...


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## thespankin (Nov 12, 2012)

I know this is an old thread, but I wanted to add my thoughts as I am currently interviewing for an ophthalmology residency, and I'm picky about lights. I settled on a 4sevens Preon 2 with a high CRI emitter as my go-to penlight. The high CRI matches most of the incan penlights I've seen, and the beam doesn't have any annoying doughnuts when you use it up close. The 2 lumen low is definitely not too bright, and to be honest, sometimes I use the middle brightness setting (e.g. in trauma evaluations when you really need to see if the eye can react to _any_ light at all). I find that the multi-level function comes in handy, since I use it for more than just the pupillary exam. I also prefer the 2AA Preon to the 1AA, since the longer penlight fits perfectly in my white coat, and it's less likely to get lost in a pair of scrubs.


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