Incorporating Ultra Widefield Imaging Into Your Practice
Here's how one practice has benefited from the Optomap exam.
By Joseph I. Markoff, Ph.D., M.D., Philadelphia

I first encountered the Optomap Panoramic200 imaging system at the Association for Research and Vision in Ophthalmology (ARVO) meeting in May 2003. I was astounded to see a wide-angle view of my retina in a fully lighted room through a 1.5-mm pupil. I'd never seen my retinal periphery before (with all my floaters). I realized the Optomap could add significant value to my practice in terms of documentation, patient education and practice marketing.

Documentation

The Optomap uses dual scanning laser technology to produce and store digital retinal images. Unlike traditional hand-drawings, the Optomap objectively and conveniently creates permanent images of patients' retinas.

For many patients, an Optomap can serve as a baseline to compare future examinations. Easy image retrieval lets me track disease progression in patients with diverse disorders such as diabetic retinopathy, age-related macular degeneration (AMD) and choroidal nevi. Ultra widefield images of the disc now replace my nerve drawings in patients with glaucoma.

When this asymptomatic patient refused a dilated exam, the Optomap revealed a previously undetected Hollenhorst plaque.

Patient education

The Optomap exam is a convenient tool for patient education. Even when a scan is normal, I review all relevant structures, reassuring patients of their retinal health.

Ultra widefield imaging also is useful for educating patients with known pathology. I use Optomap images to explain treatment goals such as laser therapy for diabetic retinopathy and AMD.

Practice marketing

If you were to ask your patients what they like least about their eye examination, they'd probably say having their pupils dilated. In my practice, when insurance doesn't cover the cost of an Optomap exam, a high percentage of patients are willing to pay a fee for an opportunity to see their retina and possibly avoid the inconvenience of being dilated. More importantly, they share their satisfaction with friends and family, bringing new patients to your practice.

The Optomap's versatile digital storage system makes it ideal for sharing information not only with patients, but also with colleagues. You can send referring physicians an image of their patients' retinas, educating them about ophthalmic pathology and comanaging patients.

Out with the old?

Although ultra widefield imaging effectively screens for most pathology, dilated exam and fluorescein angiography are still the gold standard when medically indicated. Nevertheless, the Optomap is a valuable tool for any eyecare professional who wishes to document and educate his patients.

Dr. Markoff founded Philadelphia Eye Associates and is an attending surgeon at Wills Eye Hospital.