The combination otoscope and ophthalmoscope made an all in one tool for examining the ears and the throat was available to physicians in the 1930s. The combination otoscope and ophthalmoscope in the image is from the 50s or the 60s. The batteries are stored in the handle and illuminates both an otoscope head and an ophthalmoscope head. Three cone speculum, in plastic, are included. There are also extra bulbs in the case.