instrumental strategies

An Anterior Segment Imaging System

This devices captures and stores still-digital images and live streaming videos.

BRIAN J. BLOUNT, O.D.

For whatever reason, anterior-segment imaging was missing from our practice until last year. I don't know why this was, except that it did not register on our practice radar. At Vision Expo West, our Marco rep suggested we place one in our practice for evaluation. What happened once we incorporated the Marco iDoc anterior-segment camera was a bonus for our doctors, patients and practice.

The iDoc's features

I was initially interested in Marco's iDoc (integrated digital ophthalmic camera) because of its features. The instrument easily connected to my Marco G4 slit lamp and the installation was clean and well integrated and the camera itself takes up a small footprint.

The iDoc collects high quality digital still and streaming video images that are easy to acquire. For still images, simply focus the image and adjust the light intensity, then click the shutter switch. The software is simple to download and intuitive to use.

After entering a patient's personal identifying information, we can take pictures within minutes. There are several preset exposure settings designed to quickly find the optimal setting for different applications. You can choose from an array of settings for light iris, dark iris and posterior segment (through a condensing lens). The only operator adjustment required is the slit lamp light intensity to properly expose the digital photographs.

You may also select custom-exposure settings and adjust settings for brightness, shutter speed, gain or white balance. There is also a Gamma correction feature.

Benefits

Our practice now has permanent anterior segment digital photographic records for electronic medical records and patient education. We have the ability to quickly and objectively document and assess treatment progress and can demonstrate to our patients what their condition is, as well as how it is progressing.

iDoc Camera HEIGHT: 7 inches WIDTH: 3.25 inches WEIGHT: 2 pounds COST: $7,200 +/- adaptor and software

The high-quality images are clearly seen on our exam lane computer monitor. The iDoc is a wonderful educational tool for our patients. I can finally demonstrate cataracts, corneal ulcers, incomplete blinks, pterygium, pingueculae and other ocular conditions in situ.

In addition, the practice now has a permanent record for later comparison. It provides medical-legal documentation of ocular conditions. In cases where patients are experiencing decreased acuities, anterior segment photography also allows you to establish the cause of a loss of vision caused by media opacities. From a financial aspect, it is a billable procedure using CPT code 92285 Photography — External.

Three years ago our practice made a conscious effort to become what was touted as an "office of the future." We invested in EMR and integrated optometric diagnostic equipment. The Marco iDoc has fit right into our high-tech plan.

Not only does the Marco iDoc fit perfectly into a high-tech practice environment, it would also fit well as a relatively low-cost addition to a practice stepping up to anterior segment imaging. In my opinion, most well equipped practices do not survive — they thrive. OM