( See “Don’t Ditch the Direct Ophthalmoscope. “It is a big step up from the traditional 90D and 78D lenses, offering better optics and less internal reflectivity,” says Steven Ferrucci, OD, chief of optometry at the VA Ambulatory Care Center in Sepulveda, Calif.Īnother valuable lens is the Digital High Mag (Volk Optical), which allows for a more magnified and stereoscopic view of the macula and optic nerve. It has the ability to provide views past the equator, which is useful when performing a non-dilated exam. In particular, the Digital Wide Field Lens (Volk Optical) seems to be a favorite among the doctors we interviewed. Gerson generally dilates at intervals of every few years in young, healthy patients who have no family history of retinal disease.įor viewing the retina, newer generation non-contact slit lamp lenses are gaining increased popularity. Then, assuming this baseline exam shows no pathology, Dr. Jeffry Gerson, OD, of WestGlen Eyecare & Omni Eye Centers of Kansas City, recommends a dilated retinal exam on all new patients. 1 While there are no specifics on frequency of dilation in the risk-free patient, the guidelines recommend using the initial dilated examination to guide the timing of subsequent dilations. The American Optometric Association’s Clinical Practice Guidelines recommend a comprehensive exam in asymptomatic, risk-free patients every two years between the ages of six to 60, and then annual exams thereafter.
But what about younger, healthier patients? How often should they be dilated? To answer these questions, we’ve enlisted the help of a few leaders in optometric retina care for their insights.Īs our patients get older, their risk for eye diseases increases, which requires more frequent dilated exams. So, how exactly have these technologies changed the way we evaluate our patients? Is it time to get rid of our ophthalmoscopes? How has retinal imaging changed the way we look at the fundus? And, what techniques and technologies must we incorporate into our practices to appropriately manage our patients? How we understand retinal changes, and ultimately manage our patients, is rapidly evolving. Advanced retinal imaging technologies, coupled with increased understanding of macular disorders and the importance of the optometric role in detection, have provided us with real-time, quantitative and qualitative analysis of pathology.
The management of posterior segment diseases has changed dramatically over the past several decades.
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