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A Photo Opportunity

Retinal imaging technology facilitates diagnosis and grows practice revenue.

JEFFRY D. GERSON, O.D., F.A.A.O.

It wasn’t that long ago that all that was needed to be at the “top of the game” for diagnosing retinal diseases was a 20.00D and a 78.00D hand-held lens. Although hand-held lenses remain a crucial part of the diagnostic process, a multitude of additional retinal-imaging devices are now available.

Here, I discuss the latest in retinal imaging technology.

Digital cameras

Digital retinal cameras can employ multiple frequencies for imaging different retina layers. The technology’s ability to “slice” through layers, similar to an MRI, enhances pathology visibility, enabling views not evident with traditional photography or upon clinical examination.

With the recognition that peripheral pathologies, such as reticular changes or drusen, are sometimes indicative of posterior pole changes to come, cameras that can acquire peripheral retina images are now mainstream in optometry practices.

Many O.D.s offer healthy patients retinal screenings via wide-field retinal photography. These screenings, for which the patient pays out of pocket, provide patients with peace of mind and a baseline, should pathology be discovered, while generating additional revenue for practices.

OCT

OCT devices afford resolution tantamount to a histology slide, but in a live patient. In addition, OCT does not limit the practitioner’s view to the retina. For instance, measurement of the choroid helps to predict retinal disease and enables practitioners to monitor for change.

As is the case with digital retinal cameras, some optometrists employ the technology to offer patients retinal health screenings, some of which reveal billable pathology.

FAF

FAF is the ultimate in seeing the retina beyond the “color.” The technology has been “around” for many years, but is just now becoming commercially available. Specifically, autofluorescence is able to aid practitioners in uncovering peripheral changes that help predict AMD outcomes, studies reveal. Although a specific code for billing FAF doesn’t exist, the technology pays for itself by helping practitioners to identify pathologies that can’t be seen with any other currently available technology and thus, prompting follow-up visits to monitor for progression.

Dark adaptation

Like FAF, chromatic dark-adapted kinetic perimetry was once restricted to a lab. The technology, which is now available to practitioners, can help detect AMD before any clinically visible signs are seen, allowing for early intervention.

It provides a reimbursement comparable with visual fields for glaucoma through appropriate coding, but, more importantly, it helps endear patients to you long-term because they will want to continue to see the doctor who is helping to prevent their AMD from affecting their vision.

Long-term benefits

Thanks to the aforementioned technology, practitioners can now assess both retinal structure and function, enabling early detection and intervention of retinal disease. The ability to diagnose and manage early instills patient loyalty, increases practice revenue and prompts patient referrals. OM

DR. GERSON HAS BEEN PRACTICING FOR 17 YEARS. HE SPECIALIZES IN ALL THINGS RETINA. E-MAIL HIM AT JGERSON@HOTMAIL.COM. TO COMMENT ON THIS ARTICLE, E-MAIL OPTOMETRICMANAGEMENT@GMAIL.COM.