• RETURN TO THE BASICS

A strategy for evaluating the retina is to carefully examine the entire vitreous, fundus and optic nerve, via performing direct ophthalmoscopy, slit lamp funduscopy and by making more widespread use of contact fundus lenses and advanced examination techniques, such as scleral depression. If you do this effectively, you will accurately identify subtle retinal lesions and optic nerve abnormalities.
(A Look into Retinal Diagnostics, p.18) bit.ly/2vI260j

• GATHER FURTHER TESTING

Treatments can be confirmed or altered with further testing, specifically with electrophysiology test results. In our electrodiagnostics clinic, a patient who had a normal VF and results outside the normal limits on the OCT was able to avoid an erroneous glaucoma diagnosis because of PERG findings, which served as a kind of diagnostic tiebreaker.
(Integrate VEP and PERG, p.22) bit.ly/2vIvN1d

• KEEP YOUR EYES PEELED

As DED diagnostics continue to mature, essential testing and timelines for those tests will be established. In fact, a standard of care for DED may be right around the corner, given the DEWS II report’s “best clinical approach” to DED, which is comprised of a screening questionnaire, TBUT, tear film osmolarity and ocular surface staining via fluorescein and lissamine green.
(Dry Eye, p.41) bit.ly/2vIofe

• USE FUNDUS AUTOFLUORESCENCE FOR BLUNT TRAUMA DIAGNOSIS

Choroidal rupture can be observed as a hypoFAF line, while RPE hyperplasia that occurs as the rupture heals may appear as hyperFAF. Imaging of commotio retinae demonstrates hypoFAF with increased hyper FAF in areas where the RPE is damaged.
(Retina, p.43) bit.ly/2vIyH6c

• UTILIZE OCT-A TO MANAGE GLAUCOMA

Perfusion measurements, or OCT-A flow index of the optic disc, provide metabolic information of retinal ganglion cells and nerve fibers. This is important because optic disc flow has been shown to decrease 25% in glaucoma patients compared with “normal” eyes, reveals a 2014 study in Ophthalmology. Further, the flow index was highly correlated with the VF pattern standard of deviation for glaucoma, the study also shows.
(Glaucoma, p.48) bit.ly/2vI1dEQ

• USE DIAGNOSTIC TESTING TO BUILD NETWORKS

Inform local neurologists of your practice’s ability to evaluate the ganglion cell complex in patients who have cerebrovascular accidents or multiple sclerosis.
(Interdisciplinary Care, p.52)bit.ly/2vICznx

• KNOW YOUR BASELINE

When measuring anything in your practice, establish related metrics that enable you to either act or not act on the data.
(Business, p.72) bit.ly/2vIqyP1

• REMEMBER INTERPRETATION AND REPORT

A diagnostic test is not complete until the physician’s interpretation and report has been finished. There should be a distinct space within the medical record for each test performed.
(Coding, p.73) bit.ly/2vI6IUb

• MARKET YOUR TECHNOLOGY

You have a gold mine of marketing material in the technology within your practice. Consider before and after-type pictures, such as a resolving central serous chorioretinopathy imaged with OCT.
(Social media, p.76) bit.ly/2vIB8FT OM