Lees & Henschell Optometrists, Brisbane QLD
Optomap 200DX Ultra-Wide Digital Retinal Scan
We have a well-established full-scope practice in the inner western suburbs of Brisbane, incorporating three fully-equipped rooms serviced by four optometrists. We have always been keen to embrace new technologies but have resisted change for the sake of change—the technology must enhance the quality or scope of the service we offer our patients.
We are extremely conscious that providing exemplary service to our adult patients is critical to the short- and long-term viability of the practice. Because of our local demographic and the good relationships we have with local GPs, many of our adult patients present specifically for diabetic assessment or ‘a check of that macular thing I see them talk about on TV.’
When we were introduced to the Optomap scanning laser ophthalmoscope, we were immediately impressed by the field of view and detail of the retinal image and were convinced it would be an enormous benefit to our practice, provided it could at least pay for itself.
The pay-as-you-use rental option was perfect for us but we need not have worried, the instrument has been cash flow positive from day one. We charge $45 per scan (pensioners $35) and offer it to our patients as an optional procedure. We are up-front that it is a non-Medicare fee, but when the benefits are explained we have experienced almost universal take-up.
In the two years we have had the Optomap retinal scanner, it has exceeded our expectations and made detection of early stage pathology much easier. We have found it particularly effective in the detection of retinal holes and tears, subtle hypertensive vessel changes, isolated micro-haemorrhages and early macular changes.
I learned the value of performing a wide-angle scan in the first week of operation. An asymptomatic university student agreed to my offer to ‘practice’ on him with a no-charge scan. To my surprise, a small peripheral retinal hole was clearly visible (Figure above). It was subsequently lasered by a retinal surgeon who, I learned, now owns an Optomap too.
As a show-and-tell instrument, it is excellent and gives the patient a much better understanding of their condition. I must admit to occasionally using a graphic image from the stored library to demonstrate what could happen if a diabetic patient is resisting adherence to medical treatment.
The only occasional limitation to its effectiveness is when the patient has very deep-set eyes or a protruding brow, in which case the scanned area is reduced. Nevertheless, the Optomap 200DX Ultra-Wide Digital Retinal Scan has proved to be a wise investment for our practice and, as with our mobile phones, we wonder how we ever survived without it.