Imaging and Current/Future Technologies in Medicine & Primary Eye Care
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- Melvin Franklin
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1 I. What s New in Imaging for the Primary Eye Care Practice A. Digital Refraction Analyzers B. Corneal Topography C. Optical Coherence Tomography (OCT) and Retinal Imaging D. Wide-Field Retinal Imaging, e.g. Optos Daytona E. Multispectral Retinal Imaging F. Dry Eye & Meibomian Gland Dysfunction 1. LipiView, LipiScan and DMI 2. Oculus Keratograph G. Convergent Technologies 1. SLO s & Wide Angle Fundus Photography 2. Fundus Automated Perimetry 3. OCT Overlays II. What s New in Medical Imaging A. Use of OCT s 1. Multiple Sclerosis & Ganglion Cell Loss 2. Pre-Surgical Applications B. Visual Fields New Applications 1. Pituitary Tumors 2. Neurological Screenings C. New Devices D. Discussion III. Medical Informatics
2 A. Personalized Medicine B. Electronic Health Records C. Health Exchanges IV. Eye Care & Medical Screenings A. Glaucoma Tonometry, Pachymetry B. Fundus Cameras C. Pediatric Screenings D. Contact Lens Applications E. Retina, Optic Nerve, Cornea OCT s, etc. F. MRI s 1. Papilledema 2. Idiopathic Intracranial Hypertension G. Mammography H. Prostate I. Miscellaneous B. Mammography V. Case Analysis A. Differential Diagnosis B. Analog Thinking Processes 1. The Problem of Linear Thinking 2. Multiple Functionality C. Digital Thinking Processes
3 VI. Digital Refration Analyzers A. Wavefront Refraction vs AutoRefraction B. Placido Disc Analysis C. Autokeratometry D. Topography 1. Anterior Corneal 2. Internal 3. Instantaneous 4. Refractive 5. Gradient 6. Elevation E. Pupillometry F. Retro-illumination photography G. Wavefront Aberrometry H. Photopic and Mesopic Refraction VII. Eye Care Analytics A. Optical Pathway Integrity 1. Wavefront 2. Refractive 3. Structural B. Functional Analysis 1. Visual Acuity a. Dynamic Visual Acuity b. The Quiet Eye
4 c. Augmented & Virtual Reality d. Contrast Sensitivity e. Illumination f. Day and Night Vision g. Point Spread Function C. Software Analysis 1. Limitations a. Severe Keratoconus b. Amplitude limits (refractive error, K readings) D. Interpretation & Patient Education 1. Wavefront Analysis a. Lower Order Aberrations b. Higher Order Aberrations 2. Refraction Analysis a. Central vs. Peripheral b. Astigmatism i. Axial ii Posterior Corneal iii Internal iiii Axis Determination c. Fogging d. Cycloplegia e. Day vs. Night Vision E. Inter-Professional Analysis a. Eye Care Analytics
5 b. Face Test VIII. Clinical Grand Rounds A. Clinical Presentations 1 through Case Presentation 2. Patient Outcomes 3. Discussion B. Clinical Presentation 1 1. Normal Optical Pathway 2. Peripheral refractive error 3. Myopia Control 4. Presbyopic eye care analytics 5. Spectacle Correction 6. Contact Lens Correction 7. Refractive Surgery Options C. Clinical Presentation 2 1. Degenerative Myopia 2. Irregular Astigmatism 3. Subluxated Lens a. Marfan s Syndrome b. Trauma 4. Inter-Professional Management 5. Contact Lens Evaluation
6 a. Topography b. Wavefront Summary D. Clinical Presentation 3 1. Corneal Ectasias 2. Keratoconus & Pellucid Marginal Degeneration: The Kissing Cousins a. Eye Care Analytics b. Patient Education, Management, & Outcomes E. Clinical Presentation 4 1. Cataract Evaluation 2. Geriatric Eye Care Analytics 3. Driving Simulations 4. Surgical Recommendations F. Clinical Presentation 5 1. Night Driving 2. Role of the Tear Film 3. Pterygia 4. Photopic & Mesopic Refractions 5. Treatment Strategies H. Clinical Presentation 6 1. Trefoil and Tetrafoil 2. Point Spread Function 3. Managing astigmatism
7 4. Prescribing Considerations 5. Higher Order Aberrations F. Clinical Presentation 7 1. Choose the Diagnosis 2. Eye Care Analytics a. Topography b. Internal Topography c. Optical Clarity i Point Spread Function ii Visual Simulations iii Wavefront Summary d. Refractive Options e. Surgical Intervention f. Patient Education and Management IX. What the Primary Care Provider Nees to Know? A. For the Optometrist How and what tests to order B. What an internist or PCP needs to know. C. Integration Software, Electronic Health Records D. Miscellaneous X. The Future Eye Exam XI. Special Topics A. Pediatric Eye Care Analytics B. Patients with limited Autonomy
8 C. Vision for Elite Athletes D. Population Studies 1. Harlem United 2. The Washington Jesuit Academy E. Practical Considerations & The Future Eye Exam F. Measuring Patient Outcomes & Eye Care Analytics XII. XIII. Inter-Professional Teams The Future Questions & Answers
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