A Deeper Look Inside Your Eyes: Optomap Widefield Imaging
When you hear that word, what do you think? A part of the body, a part of the eye. Something my eye doctor wants to check. Rods and cones. The back of the eye. Dilation. Disease.
These are just a few thoughts that might come to your mind. In my mind, as an eye doctor, many more thoughts come to mind. The beautiful complexity of the retina and how it works astound me to this day. The various neurological and chemical processes that occur in synchronized precision in order for us to experience the colors and shapes of the world ensconce a sense of wonder and awe.
Yet, with complexity comes complication.
Primary Care of the Posterior Segment by Larry Alexander is a 600+ page textbook that all optometrist and ophthalmologist encounter during their education. In the book, page upon page of description and colored illustration portray all the possible anomalies and disease that can afflict this tiny and immensely important part of the human body and visual system.
The shear amount of disease possibilities that can happen in the retina mean that it is pertinent to examine the retina rountinely, preferably ever year. In order to fully view the retina, an eye doctor must get past a large barrier being the colored part of the eye, or the iris. The iris expands or contracts based on the amount of light it is exposed to. It expands in dim conditions and contracts in bright conditions.
The traditional way of "removing" this barrier is to dilate the eyes. Dilation involves using a
pharmacological eye drop that forces the iris to expand temporarily. Once the eyes are dilated, lenses and lights are used to view the retina.
While dilation is the mainstay and standard of care in optometry, it does present unpleasant side effects. Light sensitivity lasts for many hours afterwards due to the large size of the pupil. Dilation also temporarily paralyzes the lens of the eye, which in turn compromises up close vision. Additionally, certain individuals experience a stinging sensation upon instillation of drops or simply have a strong aversion to getting eye drops in the eye.
Recently, an amazing breakthrough in medical imaging technology has allowed us to capture a image of the retina without dilating. The Optomap Widefield Retinal Imaging system allows us to capture a complete picture of the retina all the way into the periphery.
Use of this technology allows us many advantages in management of eye health
- Captures a full image of the retina in one shot
- Allows for better patient education, since the patient can also view the image of his/her retina as the doctor explains the findings
- Provides excellent baseline data for comparison - if I find a retinal condition on one of my patients, I can then track as the years progress
- Saves the patient from dilation drops and their side effects
And let me tell you, I would not be singing praises for the Optomap if it were not for cold hard clinical cases in which the Optomap proved to be vital.
A case that will always stand out to me revolves around a 13 year old young man I had the pleasure of seeing in my first year of practice. This was my first time seeing this patient, and he had a history of always vehemently refused any sort of drop in his eyes. We presented the Optomap as an alternative to him and his father, which they gladly took us up on.
Our Optomap image revealed a retinal detachment in the young man's right eye. I immediately sent him to a retinal surgeon where he had surgery to repair the detachment. The patient did not have any symptoms when he saw me, however the retinal surgeon later told me that if the retinal detachment had gone on for much longer without treatment, that it would have completely robbed the young man of his sight in his right eye.
There are many other disease processes that can be seen in the retina. Sometimes, conditions such as high blood pressure, high cholesterol, or diabetes may be detected in the retina before they are formally diagnosed by your primary care physician! (A future EYE Digest article will talk more about this).
In conclusion, the Optomap presents us with a fantastic breakthrough in imaging technology. I personally regard it as one of the most important diagnostic tools in my office. If you wish to have Optomap imaging performed for your eyes and or want to learn more about this fantastic technology, do not hesitate to contact us or make an appointment.
-Dr. Aaron Neufeld
Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.
Contact him with questions or ideas for future articles at (650) 948-3700 or firstname.lastname@example.org