In the haze of the pandemic, we battle the quarantine blues with newfound pursuits, from baking to home obstacle courses. In our home, Mario Kart has become a family pastime. This video game requires a combination of choosing the right vehicle — a caterpillar car is just not the right choice against a sports coupe — and applying your skills to race to the finish line.

When it comes to ophthalmology and diagnostic technology, the process is much like Mario Kart — we not only choose the right diagnostic platforms but also must utilize them in the most effective way to manage our patients efficiently and safely. The best combination of diagnostics and office flow allows us to get home earlier as well, and that is the ultimate finish line. So, in the immortal words of Mario, here we go!

IN THIS ISSUE

Karen Jeng-Miller, MD, MPH, and Chirag Shah, MD, MPH, discuss streamlining retina office flow in a busy verticalized multispecialty practice. Their overview touches on fundamental concepts, from carefully selecting the right diagnostic modalities for your subspecialty to managing them effectively to minimize bottlenecking. Reimagining our patient interactions as telehealth visits requires efficient diagnostic modalities that allow for safe, asynchronous evaluations. If used properly, these tools can further allow for appropriate staffing, which has multiple downstream effects.

The expansion of available therapies for corneal pathology necessitates a broader diagnostic armamentarium to evaluate the entire corneal anatomy. W. Barry Lee, MD, FACS, provides a comprehensive dive into the advances in corneal tomography to better image our patients, both in the office and perioperatively. Dr. Lee further discusses how these newer imaging modalities can be used for a multitude of keratopathies more thoroughly than what was available previously and can lead to increased capture rates and better outcomes.

Sarah Nehls, MD, provides an analysis of the preoperative cataract evaluation by focusing on modern techniques. The plethora of diagnostic options may seem counterintuitive to an efficient evaluation, but the exact opposite is true as the chair time and counseling involved with an unhappy patient with a refractive surprise far outweigh any time investment in a comprehensive preoperative evaluation. Dr. Nehls provides practical tips to mitigate the number of unhappy 20/20 patients.

Daniel Lee, MD, provides an expansive review of perimetry, a vital yet cumbersome tool that until recently was mired in historical protocols. Dr. Lee gives us a glimpse of exciting new possibilities, focusing on patient accessibility, testing frequency and reproducibility that can dramatically alleviate the dread we feel when ordering traditional perimetry.

Lastly, S.K. Steven Houston III, MD, dives into ultrawidefield imaging as a key diagnostic modality to reduce patient wait times in the diagnostic suite and allow for more productive chair time with the patient. Dr. Houston has extensively reported on his use of metrics to manage his office encounters and integrate telehealth into our practices even before the pandemic, and this article highlights some of his tips for those who have yet to settle into a new normal.

STREAMLINING OUR ENCOUNTERS

The pandemic has forced us to re-evaluate nearly every part of our professional lives and has made the pursuit of efficiency necessary to protect our patients, our staff and ourselves from exposure. We rely on our ancillary tools to make appropriate decisions. Integrating methods to not only select the most appropriate diagnostics but to innovate processes that streamline patient encounters will be paramount to safety.

Find the right car, and we just might stay ahead of the pandemic. OM

Caesar Luo, MD, FACS, is a retina specialist with Bay Area Retina Associates in California. Email him at cluo@bayarearetina.com.

Disclosures: Dr. Luo reports relationships with Allergan, Alimera, Iridex, Novartis and Regeneron.