1) Please describe what the OCT is used for and give a basic sense of how it works. An Optical Coherence Tomographer (OCT) uses advanced laser and camera technology, computer software and hardware to provide high resolution colour, and cross-sectional, images of the retina, the light-sensitive lining on the back of the eye where light rays focus to produce vision.
2) What components, or how much of the retina, does the OCT look at and give imaging for? This specialized technology allows us to document very fine details in your retinal, vascular, and optic nerve tissues. It can image the entire thickness of the retina, including each of its 10 distinct cellular layers. The OCT can also take detailed scans of other structures of the eyes, including the cornea, anterior chamber, iris, and crystalline lens.
3) What types of eye diseases and disorders can be discovered? Comparing OCT scans over time allows us to more easily identify small changes caused by ocular and systemic diseases such as diabetes, high blood pressure, glaucoma, and macular degeneration. In all of these conditions, your retinal vasculature, optic nerve head and/or macula can vary subtly, indicating insidious progression of a disease, even in the absence of any visual symptoms. Early detection of ocular diseases with OCT imaging allows us to begin necessary treatment and/or management plans earlier, which in turns leads to improved outcomes.
4) What is it about this particular technology that you find most exciting; the component that made you feel you need to invest in this for your practice? We believe in providing the best healthcare possible, and this is only possible by using the latest ocular imaging technology. Without an OCT, we would quite simply be falling short in our vision. We actively manage a lot of diabetic retinopathy, glaucoma, macular degeneration, hypertensive retinopathy, and many other retinal diseases that require constant retinal
monitoring. Having an OCT has lead to a sharp decline in necessary referrals that end up delaying important diagnoses and treatment. This alone is worth the investment.
5) Can you describe the patient experience when using the OCT? The process is very quick and easy. The patient places his/her chin on a chinrest and the OCT is lined up to the correct height. A green target light appears on a screen to maintain steady fixation. A series of 128 cross-sectional scans takes place within two to three seconds, and then a bright flash follows for a final retinal picture. After a few seconds of processing, both the surface picture and the series of scans can be viewed on a large screen next to the OCT.
6) Do the patients that walk through your doors day in and day out, appreciate the upgrade in technology? Absolutely. Many of our patients comment on the impressive display of technology as we show them their scans and assess the results in front of them. Even having been exposed to the technology for several years now, the amount of detail provided in each scan still amazes me. Speaking as a health care consumer as well, people like to know that their doctors have (and are using) the best technology available.
7) How does this technology improve comprehensive eye exams compared to the days when we did not have an OCT in the optometric office? Not only does the OCT save time for our patients by allowing us to acquire high resolution imaging of various retinal structures within a few seconds, but it delivers crucial information regarding the internal health of the eyes and gives us the ability to spot very minute changes in the retinal tissue over time. Many ocular diseases present with very gradually changes to the structure of the retinas over months or years, so having a sequence of annual or biennial retinal scans can aid us in earlier diagnosis and treatment, before a disease affects your vision. The earliest possible diagnosis is absolutely crucial in many ocular diseases because once vision loss occurs, it can be permanent.
8) To what patients do you recommend using the OCT? In short, all of them. I cannot think of a single case where having a patient’s OCT scans (or better yet, a series of consecutive annual scans) in front of me would not be preferable. Whether it’s identifying a very small, yet significant, change to their optic nerves indicating a risk factor for glaucoma, managing an active condition, or just adding that extra confidence that the retinas are indeed still stable and in good health.
9) Can you share a particular story in which, by using the OCT, you were able to detect and treat a disease that would have otherwise gone undetected? A case that immediately comes to mind involves a patient with mild dry macular degeneration (an early form of the disease) and cataracts, who suddenly advanced into very early stage wet macular degeneration in one eye. This change involves the formation of a neovascular membrane, or small blood vessel growth and leakage within the retina. If caught early, treatment can stabilize vision and slow or stop significant vision loss, but once vision loss begins it is often permanent even with our best efforts. Fortunately, with prompt referral for ocular injections we were able to largely spare the patient’s vision.