SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

A choice instrument for dry eye clinics

The versatility of Topcon’s CA-800 makes it ideal for expanding practices.

By Robert Stoneback, Associate Editor

Richard Adler, MD, now has much more room in his clinic.

This is so thanks to the Topcon CA-800 corneal analyzer, which combines the strengths (and footprints) of anterior segment photography, corneal topography and meibography into one device. This makes it “the instrument of choice” for doctors looking to establish a dry eye clinic, says Dr. Adler.

Dr. Adler, director of ophthalmology at Belcara Health in Baltimore, says the CA-800’s ability “to jump-start [a] dry eye clinic” comes from this versatility, which folds corneal topography, corneal staining photography and meibography, and more, into a single unit.

The CA-800 corneal analyzer is capable of dry eye testing, corneal staining photography, meibography and more.

“I cannot imagine a series of modalities better than these three” for dry eye clinics, he says, adding that it is the only instrument he knows of that has all three features.

And these are billable procedures: the CA-800 represents a reimbursement trifecta.

This flexibility does not come at the expense of the device’s corneal topography testing, which is “absolutely on par” with dedicated machines, says Dr. Adler. It’s helpful not just in examining dry eye disease but in contact lens fitting, keratoconus diagnosis and cataract surgery planning, he says.

The CA-800 is a standalone 24 placido ring corneal topographer. It measures over 6,200 points and analyzes over 100,000 points to provide a complete evaluation of the anterior corneal surface. Other features include pupillometry, contact lens fitting software and white to white measurement, according to Topcon.

MEIBOGRAPHY TESTING

The fact that meibography testing is included in the CA-800 is a unique and “incredibly useful” feature, according to Dr. Adler. He calls the technology very underappreciated, and an enormously valuable way of documenting eye disease and other issues. It can be used to record not just dry eye, but also blepharitis, contact lens intolerance and damage from chronic glaucoma medication use.

“I can’t begin to tell you how many ophthalmologists and optometrists are unaware of meibography,” he says. Topcon’s analyzer is one of only three devices he knows of that can perform meibography.

The CA-800 can compare images from two separate meibomian gland exams, and also uses infrared technology for a more comfortable, non-contact scan. Making patients more comfortable also makes it easier to take images of their eyes.

A meibography test is also much easier for patients to understand as it uses X-ray-like images of the glands. This visual can profoundly impact patient compliance, more so than reading a numerical measurement such as topography or osmolarity, says Dr. Adler.

Dr. Adler has since removed the dedicated meibography camera from his clinic, as the CA-800 can do its job and more.

BETTER ACCESS AND CARE

Dr. Adler’s clinic became more efficient upon adopting the CA-800, as well. Since patients only need to be brought to one device, time is no longer lost transferring them from one exam room to another. It may seem insignificant at first, but time spent moving dozens of patients a day around the clinic adds up, especially for older patients, Dr. Adler says.

The ability to easily switch to different modalities to assess dry eye is just as helpful.

“Technicians are able to simultaneously acquire multiple objective measures relevant to dry eye during their routine screening process,” Dr. Adler says. “One of the keys to a successful dry eye center is the efficiency of the screening process. The Topcon CA-800 naturally facilitates this efficiency even within the limited space of a technician’s screening room.”

With the CA-800, it’s simple for staff to switch between testing modes and check any patient, even those who don’t recognize they have dry eye. Some patients don’t think of dry eye as a disease, and won’t think to mention it to a physician.

“There’s tremendous opportunity to use this device to catch the folks [with dry eye] who are being missed,” Dr. Adler says.

The CA-800 enhances not just the ergonomics of the dry eye screening process, but its economics as well. Doctors interested in incorporating topography, corneal staining photography and meibography are no longer obligated to the expenses of purchasing separate instruments for each function.

“The availability of the multiple modalities in a single device provides an immediate cost savings as compared to purchasing separate instruments for each function,” reports Dr. Adler.

“FLAT LEARNING CURVE”

The CA-800’s features are accessible from its single, touch-based screen, Topcon reports. That ease of use is important to Dr. Adler since staff uses the analyzer every day.

The analyzer is “embarrassingly easy to use,” he says. He was first introduced to it at a trade show, and he didn’t need instruction in its operation. By pressing a button, the machine nearly much works on its own.

“It’s an enormously flat learning curve,” making the CA-800 “remarkably intuitive and easy,” he continues.

“I believe it stands out, based on simultaneous accessibility of those [dry eye] modalities.” OM

Dr. Adler is a consultant for Allergan and for Topcon.