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Technology – Advanced Eye Care

We use the most up-to-date technology to ensure the best eye care possible. Here are some of the different types of tests and equipment you may experience on a visit to our Practice.

optos

Optos Optomap for retinal photos

The optomap Retinal Exam is used by your eye doctor to get an ultra-widefield view of the retina (the back of the eye). While eye exams generally include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the retina is critical to verify that your eye is healthy.

This can lead to early detection of common diseases, such as glaucoma, diabetes, macular degeneration, and even cancer. The exam is quick, painless, and may not require dilation drops.

spectralis

Heidelberg Spectralis OCT for scanning the retina

Whether it is glaucoma, pre-op surgical assessment or adjusting anti-VEGF therapy, confidently detecting and assessing small changes may change your treatment decision. In diagnostic imaging, motion artifact is the number one problem limiting confident detection of small change.

SPECTALIS® solves this problem by using cSLO technology to track the eye and guide OCT to the selected location. TruTrack™ Eye Tracking comes from a long history of image alignment know-how. Not only are the scans guided on first examination, but TruTrack™ automatic retinal recognition technology enables follow-up examinations to be scanned in the same exact location without relying on subjective operator judgment.

hrt

Heidelberg III Retinal Tomograph (HRT)

The Heidelberg Retinal Tomograph (HRT) set the standard for analyzing 3D structural change to the retina, especially in examining the optic nerve head. This capability lead to outstanding predictive clinical results in the National Eye Institute's (NEI) Ocular Hypertension Treatment Study and the European Glaucoma Prevention Study.

At our office The Heidelberg HRT III offers different analysis modules tailored to evaluating structural changes for retinal edema, glaucoma, diabetic retinopathy, macular degeneration as well as many neurological problems such as brain tumors and Multiple sclerosis.

Retinal Thickness

The retinal thickness measurements of the HRT Retina Module create a complete map of the scanned area without interpolating data. Compared to the Edema Index, Retinal Thickness maps may be more useful for tracking disease changes as therapy continues. The 3-D maps are helpful for showing and explaining retinal abnormalities to the patient.

Retina Thickness 3-D Map Images

  • Age-related Macular Degeneration (AMD)
    Diabetic Macular Degeneration (DME)
    Cystoid Macular Edema (CME)
    Macular Hole

Reflectance Map

The reflectance image is an additional tool on the HRT which helps to reveal retinal abnormalities. The reflectance image captures differences in the surface appearance of the retina and enables interpretation of both the Edema Index and the Retinal Thickness maps.

corneal_topography_right_ax

Corneal topography

Corneal topography is a non-invasive medical imaging technique for mapping the surface curvature of the cornea, the outer structure of the eye. Since the cornea is normally responsible for some 70% of the eye's refractive power, its topography is of critical importance in determining the quality of vision.

The three-dimensional map is therefore a valuable aid to the examining ophthalmologist or optometrist and can assist in the diagnosis and treatment of a number of conditions; in planning refractive surgery such as LASIK and evaluation of its results; or in assessing the fit of contact lenses. A development of keratoscopy, corneal topography extends the measurement range from the four points a few millimeters apart that is offered by keratometry to a grid of thousands of points covering the entire cornea. The procedure is carried out in seconds and is completely painless.

300px pachymeter_by_itucker_at_flickr

Corneal pachymetry

Corneal pachymetry is the process of measuring the thickness of the cornea using contact methods, such as ultrasound[1] and confocal microscopy (CONFOSCAN), or noncontact methods such as optical biometry with a Scheimpflug camera (such as SIRIUS or PENTACAM), Optical Coherence Tomography (OCT, such as Visante) and online Optical Coherence Pachymetry (OCP, such as ORBSCAN). Corneal Pachymetry is particularly essential prior to a LASIK procedure for ensuring sufficient corneal thickness to prevent abnormal bulging out of the cornea, a side effect known as ectasia. The instrument used for this purpose is known as a pachymeter. Conventional pachymeters are devices that display the thickness of the cornea, usually in micrometres, when the ultrasonic transducer touches the cornea. Newer generations of ultrasonic pachymeters work by way of Corneal Waveform (CWF). Using this technology the user can capture an ultra-high definition echogram of the cornea, somewhat like a corneal A-scan. Pachymetry using the corneal waveform process allows the user to more accurately measure the corneal thickness, verify the reliability of the measurements that were obtained, superimpose corneal waveforms to monitor changes in a patient's cornea over time, and measure structures within the cornea such as micro bubbles created during femto-second laser flap cuts.

Corneal Pachymetry is essential for other corneal surgeries such as Limbal Relaxing Incisions. LRI is used to reduce corneal astigmatism by placing a pair of incisions of a particular depth and arc length at a steep axis of corneal astigmatism. By using the corneal pachymetry the surgeon will reduce the chances of perforation of the eye and improves his surgical outcome. Newer generations of pachymeters will help surgeons by providing graphical surgical plans to eliminate astigmatism.

Corneal pachymetry is also considered an important test in the early detection of glaucoma. In 2002, the five-year report of the Ocular Hypertension Study (OHTS) was released. The study reported that corneal thickness as measured by corneal pachymetry was an accurate predictor of glaucoma development when combined with standard measurements of intraocular pressure. As a result of this study and others that followed, corneal pachymetry is now widely used by both glaucoma researchers and glaucoma specialists to better diagnose and detect early cases. Newer generation pachymeters have the ability to adjust the intraocular pressure that is measured according to the corneal thickness.

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