3/23/2016. Diagnostic Services Taylor Pannell CRA, OCT-C. Services Available. Important info for the Tech to know. Visual Fields

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Scot Adams
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Services Available Diagnostic Services Taylor Pannell CRA, OCT-C Static and Kinetic Visual Fields Pachymetry Anterior and

Photography Specular Micrography Corneal Topography Color Vision Testing Ret Cam, Handheld Fundus Camera Automated visual

(static test) Visual Fields Visual Fields test the sensitivity to light in the central and peripheral retina.

$(OD, OS, OU) What is the patient s current refraction and VA? Is the patient dilated?$ $(this changes the patient s refraction) 4 Pachymetry Posterior and Anterior segment OCT Posterior OCT Posterior segment scans$

1 Services Available Diagnostic Services Taylor Pannell CRA, OCT-C Static and Kinetic Visual Fields Pachymetry Anterior and Posterior Segment OCT Fundus Photos FAF,FA,ICG Slit Lamp Photography Confocal HRT Biometry, Ascans, and Bscans,UBM External Photography Specular Micrography Corneal Topography Color Vision Testing Ret Cam, Handheld Fundus Camera Automated visual field Tests only 30 of the patients field of view 24-2, 30-2, 10-2 Standard, Fast VA: 20/200 or better Machine runs test (static test) Visual Fields Visual Fields test the sensitivity to light in the central and peripheral retina. Manual visual field Tests up to 100 of the patients field of view VA:20/200 or worse Technician runs test (kinetic test) Important info for the Tech to know Which test? (24-2, 30-2, 10-2) Which eye needs testing? (OD, OS, OU) What is the patient s current refraction and VA? Is the patient dilated? (this changes the patient s refraction) 4 Pachymetry Posterior and Anterior segment OCT Posterior OCT Posterior segment scans Takes thickness measurements of the retina RNFL and Macular thickness scans HD line scans 3D visualizations Ultrasound with light Anterior OCT Anterior segment scans Looks at the cornea, iris, and angles Single, dual, or quad scans HD Scans 5 6 1

2 OCT Angiography Fundus Photography Color and Monochromatic images of the retinal structures Shows blood flow of the microvasculature in the retinal layers 7 Standard fields Fundus Photography Fundus Photos Continued Fields of View Fundus Photos Continued Making the invisible visible Auto Fluorescence Green and Red Light Fundus Auto Fluorescence Infrared Infrared Auto fluorescence Blue reflectance (Red Free) Fundus auto fluorescence 11 2

Fluorescein Angiography and ICG What test is being requested? What eye is being tested?

(fundus photos and HRA) Early first minute of testing. Mids 3 to 5 minutes.

(if they are not ordering color photos) Which eye is the transit eye?

3 Fluorescein Angiography and ICG What test is being requested? What eye is being tested? OCT, Fundus Photos, HRA Photos When was the patient dilated?(fundus photos and HRA) Early first minute of testing. Mids 3 to 5 minutes. Lates - 5+ minutes Another Use for Dye What fields does the doctor want to see during the dye test? (if they are not ordering color photos) Which eye is the transit eye? Slit Lamp Photography Goniography Diffuse Lighting - location of abnormalities Thin slit shows: anterior chamber depth and location of corneal abnormalities Scleral scatter shows corneal opacities 18 3

Biometry Measurements Slit lamp photos Takes measurements before having cataract surgery Which eye needs to be photographed? Is there a sketch of where the pathology is located?

4 Biometry Measurements Slit lamp photos Takes measurements before having cataract surgery Which eye needs to be photographed? Is there a sketch of where the pathology is located?(on request form) Uses the measurements listed below, biometry provides us with the power lens the patient needs for surgery. K readings Axial length measurements White to White measurements Anterior Chamber Depth Lens Thickness External Photography IOL Master Which eye is having surgery? Has this patient had a previous surgery? (What kind?) What is the target refraction?( if other than plano) Is the type of IOL indicated? 1:10 full face (45 and 90 ) 1:5 Raccoon view (45 and 90 ) Dogs eye view Birds eye view 1:2 Specular Micrography External Photos What eye needs to be documented? What view does the doctor want to see? Measure Endothelial cell layer of the cornea Counts cell density 4

Color Vision Testing Corneal Topography D15 100 Hue COTs are used to

colorblindness with more colors and hues.

A-Scan B-Scan In order for us to do the best possible job, we need as

$Dilation time VA/Current Refraction( for visual fields) Previous$ surgeries( for IOL Master) Thank You Images generously provided by the

5 Color Vision Testing Corneal Topography D Hue COTs are used to quickly measure and confirm corneal curvature, topography, and astigmatism. Quick assessment of color blindness Looks more in depth into colorblindness with more colors and hues. Atlas Topographer Galilei Topographer 26 Other Testing Confocal HRT A-Scan B-Scan In order for us to do the best possible job, we need as much information as can be provided. Always include: A Diagnosis Test being requested UBM Eye requested Dilation time VA/Current Refraction( for visual fields) Previous surgeries( for IOL Master) Thank You Images generously provided by the Flaum Eye Institute Diagnostic Team Questions? All other images provided by: 5

Dr. Harvey Richman, OD, FAAO, FCOVD Diplomate American Board of Optometry Executive Committee AOA Third Party Center Founder Ask the AOA Coding

Dr. Harvey Richman, OD, FAAO, FCOVD Diplomate American Board of Optometry Executive Committee AOA Third Party Center Founder Ask the AOA Coding Experts 92000 Codes Special Ophthalmological Services Describe