instrumental focus

Upgrade in-House Capabilities

Portable OCT allows digital imaging in small offices.

Kelly Kersick, O.D.

When an ocular disease suspect patient would present to my rurally located practice, I'd have to refer him to a different practitioner in St. Louis for further testing.

The reason: My practice simply doesn't have the space or money to employ large diagnostic devices. Thanks to iVue, from Optovue, however, patients no longer have to travel for a further evaluation.

Here, I explain the attributes of iView, the new diagnostic opportunities the device has afforded me and a recent patient experience with the instrument.

iVue Scanner Head Dimensions HEIGHT: 12.5 inches WIDTH: 5.6 inches LENGTH: 12.5 inches WEIGHT: 5 lbs

A view of iVue

The iVue is a compact, portable fourier-domain version of the company's RTVue optical coherence tomographer (OCT). (Visit www.optometric.com/article.aspx?article=102134) As a result, it provides the same scanning speed (26,000 A-scans per second) and resolution (5-micron) as the RTVue and includes scanning and reports for the retina, retina nerve fiber and cornea.

It differs from the RTVue, however, in that it's mounted on a standard slit lamp-style base (you can mount it to a small table as well), and it is comprised of a small scanning head (5 lbs), a control module, laptop PC and foot switch.

The device provides me with fast quality images and a view of the fine details of one's condition. This enables early detection and assists in my management decisions.

Further, my staff and I have found that the iVue is very easy to use, as its order for obtaining diagnostic data is simple to follow. The device does come with onsite training, but we found little learning curve existed for my techs or me.

Small town convenience

Because I now employ the iVue, patients have told me they greatly appreciate no longer having to make the trek to St. Louis for further testing, especially many of my elderly patients who fear driving in the city.

In addition, patients have said they're impressed with the technology. This has translated to them identifying me as a tech-savvy practitioner, which, in turn, has created patient loyalty and referrals.

New diagnostic opportunities

Several new diagnostic opportunities have resulted from the implementation of the iVue. I've been able to make accurate diagnoses of diabetes, age-related macular degeneration and glaucoma.

Additionally, I've successfully used the device to assess the corneas of our LASIK pre-operative patients.

Because the device actually shows the patient an OCT scan of their eye, I've found that it's helped to instill patient compliance to the medications and management I've prescribed.

In other words, these patients can see the reason further testing is warranted, why I've decided to increase dosages or why I don't need to medicate as aggressively as before. And, seeing is believing.

Identifying the culprit

A patient who was recently diagnosed with multiple sclerosis recently presented to my practice for a second opinion. She said she'd been to rheumatologists, primarycare physicians and neurologists, all of whom told her, her poor vision resulted from inflammation secondary to her multiple sclerosis.

After using the iVue on this patient, I was able to determine that the patient's poor vision was due to a bilateral retinal pigment epithelium detachment. This wasn't exactly the diagnosis she wanted to hear, but she said she appreciated finally knowing what was wrong.

In another patient, we used the device to diagnose a small retinal detachment. Without this technology, we wouldn't have caught it.

Because the iVue is compact, affordable and enables the accurate diagnosis and management of several ocular diseases, it has increased the quality of care in my small rural practice. OM