By Aaron Lech, OD, FAAO
Nov. 30, 2022
The comprehensive exam is only as valuable as the data you can collect and your ability to use that data to compare the patient’s own eye health to what you saw during previous visits. I have an instrument, ZEISS CIRRUS OCT, in my practice that is making it easier for me to do this.
Visualize at the Level of Microns
The CIRRUS OCT allows me an unparalleled, micron-level view of the optic nerve, retina and macula. It goes without saying that this instrumentation is a medical eyecare game-changer. That’s why I invested in it before investing in a retinal camera.
Whether viewing the anterior segment or post-anterior segment, OCT technology gives you a comprehensive view of the eye, and can provide indications on what further testing, if any, is needed.
Eye Health Screening as a Baseline for Every Patient
I have every patient sit for evaluation using the ZEISS CIRRUS OCT, regardless of age or health history. With multiple images, a year apart, of any aged patient, I can tell if there has been even a subtle change in the retinal tissue, optic nerve or macula. The ability to compare a patient’s own diagnostic data, year-to-year, rather than just making the comparison to “generalized” normative data, can make a huge difference in your ability to make early diagnoses. You may get a five-year, or more, jump compared to functional testing on treating a sight-threatening condition like glaucoma.
If I start capturing data on a patient’s retinal nerve fiber layer at age 35, and notice by 45 that I see sustained change in the eye, I can be alerted to a developing problem, even if the patient’s optic nerve still would not be considered abnormal from a single exam compared to normative data. By detecting sustained change sooner, I know that by age 50, it will be in the abnormal range. This allows me to initiate treatment earlier, slowing progression of the disease, and averting long-term vision loss in their later years.
Keep Young Eyes Healthy
It’s common to think of advanced medical technology like OCT as being most valuable to diagnosing, directing and tracking treatment for older patients. While it’s true that many older patients are helped greatly by this technology, it’s also essential to the care I provide to younger patients.
For example, I recently diagnosed central serous retinopathy in a teenager. The higher levels of anxiety and stress experienced by young people today may make this condition more common than it used to be. The year-to-year comparison of my teenage patient’s eyes with the CIRRUS OCT allowed me to notice very subtle changes to the patient’s retina that I probably would not have noticed without this technology. This was a key insight when compared to the patient’s decreased acuity.
I was then able to discuss the importance of stress management with the patient and their parents, and provide guidance for managing this condition. Thankfully, the condition is now resolved.
Early Intervention Good for Patients & Practice
Anytime you are able to make earlier diagnoses you are elevating the level of care you provide while also building your practice. When patients can depend on your diagnostic ability, referrals become the norm. That the technology also enables you to monitor disease states means that you often can monitor a patient in-house rather than sending them unnecessarily to another provider for specialized care. The early diagnosis combined with the ability to retain patients in your practice means you can grow organically by maximizing care of the patients who already see you.
ZEISS CIRRUS has an impressively wide array of conditions and patient needs that it can address. For instance, in our practice, we use this technology to care for not just glaucoma, macular degeneration and diabetic patients, but for our dry eye and scleral lens patients as well.
In addition, OCT Angiography, essentially a noninvasive eye angiogram captured in seconds, has even allowed us to observe early diabetic changes in patients who had yet to be diagnosed. The wide application of this instrument contributes to our premium care offering and profitability across our clinic.
Efficiently Capture Advanced Data
ZEISS CIRRUS OCT is so user-friendly that I saw a demonstration of a 13-year-old successfully using the technology to do a test on someone who doesn’t speak the same language. Our techs need just four minutes to capture an entire set of anterior and posterior segment images. These images act to inform my visit with patients, allowing me to much more quickly zero in on a working diagnosis, and where I might need to provide the greatest attention and patient education during my time in the exam room.
Integration with a Diagnostic Data Management Platform Provides Fast, Easy Access
ZEISS CIRRUS integrates with ZEISS FORUM, a data management platform. This technology allows me to keep all images and diagnostic data of a patient from all current testing modalities in our office in one place. Through the use of FORUM’s Retina Workplace dashboard or Glaucoma Workplace dashboard, for example, photos, OCT data, visual field results and other relevant information are housed in the same software which unlocks important diagnostic analysis.
Then, it becomes simple for me to call up all relevant images and data for a particular patient’s condition in the exam room, and show them the genesis for the diagnosis I have made and why I am recommending a specific treatment plan.
Build a Professional Brand for High-Level Medical Eyecare
When I refer to a retinal specialist or surgeon, they routinely comment back to patients that we have “the best toys,” meaning that we are well equipped compared to many optometric practices they work with, allowing us to provide high-level care with advanced technology. These positive reinforcements elevate our stature with patients and result in more patients sending their friends and family to us. New patients often tell us, “I was told to come to you because I heard you have the best.”
When we first invested in ZEISS CIRRUS OCT, in 2007, we were a newer practice with only a small amount of medical eyecare. Now, 65 percent of what we do is medical eyecare and our CIRRUS is indispensable. If you look at an instrument like ZEISS CIRRUS OCT as a long-term investment it will allow you to grow a wide-ranging medical eyecare practice, and the profitability will blow you away because this is technology that really sets you apart, and allows for exponential growth.
Aaron Lech, OD, FAAO, is the owner of ClearVue Eye Care in Roseville, Calif. To contact him: Aaron.Lech@clearvue.org