Our Diagnostic Center

Our practice has always been on the forefront of adopting diagnostic technology to help diagnose, manage and treat patients' eye conditions. Our practice is commited to providing patients with the best possible eye care possible. Our practice uses the newest technology to help diagnose and monitor our patients. Read below for more information about our Diagnostic Center and the technology that we use daily in our practice.

Posterior Ocular Coherence Tomography (OCT)

Our doctors use state of the art computerized equipment to diagnose and treat glaucoma. Our practice was one of the first in the region to use the Cirrus OCT Scanning Laser to diagnose glaucoma earlier and more accurately as well as look at retinal issues. The Cirrus OCT uses specteral domain technology to provide a high definition image of the optic nerve and retina. This test gives a micrometer interpretation of the reitna and optic nerve tissue which gives us a greater view and understanding of what is happening underneath the macula and what is happening to the nerve fiber layer leaving the optic nerve.

This test is indispensible when dealing with the patients who have glaucoma as we are able to help diagnose earlier to prevent vision loss and to monitor glaucoma patients for progression and subsequently evaluate and alter the treatment plan if needed. It also can be used to evaluate other optic nerve disorders like optic neuritis, coloboma, optic nerve drusen and other optic nerve conditions.

The Cirrus OCT is an amazing tool when looking at retinal issues including macular degeneration and diabetic retinopathy. This test analyzes the macular region of the eye and makes a 3-dimensional view through the retina. Until this technology was available, there was no way this could be done. Now we can review the macular area for swelling, hemorrhages, and new blood vessel growth underneath the macula. It gives us the ability to diagnose retinal issues quicker and then determine when referral to the retinal specialist is needed. We use the OCT for many different macular and retinal conditions like macular degeneration, diabetic retinopathy, retinal hemorrhages, retinal tumors and lesions, histoplasmosis, retinitis pigmentosa, central serous retinopathy, macular drusen and many other conditions.

This test does not require the patient to be dilated and no medications are injected into the patient like in Fluorescein Angiography. This test take only a few minutes to perform on each eye and requires no response from the patient. The patient must only look at a large target in the machine. Results are available immediately which leads to quicker diagnosis and faster treatment if needed.

Anterior Ocular Coherence Tomography (OCT)

Our Cirrus OCT also has the capability to perform imaging of the anterior chamber and cornea of an eye as well. This is used for patients with glaucoma to ascertain if they have adequate drainage angles to allow fluid to leave the eye. This test is also performed when looking at various corneal conditions and with pre and post LASIK patients. 

This test is non-evasive and does not require dilation. It takes only a few minutes to perform and the results are immediate.

 Digital Retinal Imaging

Our doctors use digital retinal imaging to document the retinas of our patients. They say "a picture is worth and thousand words" and in retinal photography it is the same. It allows our doctors to monitor the retina and macula for changes in pigmentation, scarring and changes overtime.

Digital retinal imaging is commonly performed on patients with macular degeneration, diabetic reitnopathy, ocular histoplasmosis, pathological myopia, albinism, Stargardt's macular dystrophy, retinitis pigmentosa cone rod dystrophies, retinal detachments and many other macular and retinal conditions.

Digital retinal imaging is also use to help document the optic nerve as well. Conditions like glaucoma, pseudotumor cerebri, optic nerve drusen, optic neuritis, optic atrophy, optic nerve swelling and other conditions are documented using fundus photography.

 Visual Fields

Our practice uses Humphrey Visual Field Analyzers to test a patient's peripheral vision. This test measures changes or missing areas in the patient's central and side vision. Peripheral vision tests are ordered for many different conditions including neurologic, eyelid disorders, optic nerve issues and retinal issues which may affect a patient's central or side vision.

Visual fields are imperative in monitoring nerve fiber layer changes in glaucoma. It is a key test in managing these patients for progression of the condition.

We use these tests to monitor diseases of the peripheral retina like retinitis pigmentosa or cone-rod dystrophies as well. We also use visual fields to look for central vision loss as well.

Also visual fields are needed when someone has had a stroke or head inury which may lead to peripheral vision loss. Other indications for visual fields include unexplained reduced visual acuity, headaches and conditions that affect the visual pathways in the brain.

This test takes 5-7 minutes to perform on each eye and does not require the patient to be dilated in order to have the test.

Digital Corneal Mapping

Our practice uses digital corneal mapping, also known as corneal topography, to help diagnose and manage corneal conditions as well as help guide our doctor in contact lens fitting. Digital corneal mapping is a non-invasive scan of the cornea, the clear outer structure on the front of the eye.

The cornea is the window into the eye and it is responsible for most of a patient's refractive error. Digital topography maps the curvatures of the front surface of the cornea. It helps us determine the proper fit of contact lenses based on the curvatures of each patients' eyes.  It is also essential in evaluating patients for LASIK refractive surgery. It also help us diagnose corneal conditions like keratoconus which is see in the scan to the right and other corneal conditions.

Pachymetry

Pachymetry is an ultrasound measurement of the corneal thickness. This test is perfomed on patient's with corneal conditions, glaucoma and before have LASIK refractive surgery.

For this test, the eye is anesthetized with eye drops and a small probe is placed in the center of the cornea. Pachymetry readings take only a few seconds to obtain.

Each patient who is suspect for glaucoma will have the thickness of their corneas taken. Standard eye pressure readings were based on calculations of a normal thickness cornea. It did not take into account if someone has a very thin cornea or a very thick cornea. By measuring this, we can determine if an eye pressure is abnormally elevated due to thickness of the cornea or if the pressure is low due to a thinner than normal cornea. We use this to determine if glaucoma treatment is needed.

 B-Scan Posterior Ultrasound

B-scan ultrasonography is an ultrasound of the eye and is used to help in the clinical assessment of patients with a vast amount of ocular and orbital diseases. Many times standard clinical examination techniques alone are not able to visualize various conditions. With the posterior ultrasound, it gives the doctors the ability to see areas that they may normally not be able to evaluate.

B-scan is most useful when the patient's eye(s) are difficult to exam due to corneal, lens or vitreal opacities are present. Severe swelling of the eyelids or other eyelid conditions may also limit visibility of the eye and B-scan can be used for these conditions as well.

With new technology, B-scan ultrasoundnography is performed by placing a probe on the outer surface of the eyelid. A small amount of gel is placed on the probe before applying it to the eyelid. The doctor or technician then gently moves the probe slightly to image the internal structures of the eye.

Gonioscopy

Gonioscopy is a test that allows the doctor to evaluate the internal drainage system of the eye. This is where the eye fluid inside the eye drains slowly through a meshwork of tissue and out of the eye. This drainage area is located 360 degrees internally at the junction of the cornea (the clear outer covering of the eye), to the conjunctiva (the white of the eye) and the iris (the muscle which gives us our eye color). If the drainage angle is narrowed or blocked with pigment, it can lead to an increase in internal eye pressure which can cause glaucomatuos optic nerve damage. If our doctors suspect you may have glaucoma, they may perform this test to view these internal structures of the eye. 

Dry Eye Testing

Millions of people suffer from dry eye symdrome in the United States. Our doctors test and treat patients daily with dry eyes. Dry eyes are able to be diagnosed by examining the anterior surface of the eyes. We use special diagnostic dyes (fluorescein, Rose Bengal and/or Lissamine Green) to look for staining patterns of the cornea and the conjunctiva, the white of the eye.

We also look at tear production with a Schirmer or Zone Test which involves placing a small filter paper or thread under the lower lid to measure the rate of tear production. From these test results, our doctors will determine the proper course of treatment for the condition.

Adenoviral Infection Testing

Viral red eyes are contagious and it is important that our doctors inform the patient of how to help avoid spreading the condition to others in their family and work.

Our doctors use the Rapid Pathogen Screening Test to identify the cases of adenoviral infections which are extremely infectious. This test is a quick in office test where the tear fluid is collected from the effect eye and then tested. This test takes ten minutes to know the results.

If a patient is positive for an adenoviral infection then extensive counseling on infection control is needed and treatment to try and resolve the condition quicker may be needed.