At MEDLamp we are constantly testing our products and improving the designs as needed. Recently we updated the MEDLamp design to provide more adjustment when the adapter is at its lowest orientation. This adjustment allows the LED to be pointed slightly higher for putting light where it is needed. We identified this need primarily while performing equine dental operations where the user is typically squatting and looking up at the mouth.
MEDLamp version 1.4 is now the current release, and you can find more details on the current design here.