Chapter 9: Ocular Imaging

INTRODUCTION

9.1 INTRODUCTION TO OCULAR IMAGING

Ocular imaging technology has become an integral part of eye care and revolutionized our approach to disease identification, diagnosis, and management. The high sensitivity of various ocular instruments with their superior imaging capabilities can provide detailed information on ocular structures, aiding in deeper understanding of disease pathophysiology and progression, thus laying the groundwork for a more objective, image-driven diagnostic approach to common and rare ocular diseases. This chapter provides the foundation for a procedural approach when using these tools in clinical care.

As technology continues to evolve, newer and more specialized instruments are introduced to increase the quality of patient care. The focus in this chapter will be on the most common ocular imaging technologies used by primary eye care providers today for a variety of ocular conditions ranging from corneal dystrophies to optic nerve abnormalities. While ocular imaging has become an integral part of managing certain ocular conditions such as in diabetic retinopathy, it is important to note that imaging does not replace the dilated exam and is meant to be supplemental. The provider is responsible for carefully and critically reviewing all ocular imaging acquired for their patient in addition to providing the standard of care for each condition they manage.

While proper analysis of the image acquired for any of the procedures listed in this chapter is essential for proper patient care, it is beyond the scope of this text to provide a comprehensive review of every possible anomalous result that may manifest on each of these instruments. Instead, proper recording is outlined in order to provide the examiner with the framework to apply the information when clinically relevant according to their expertise.

Many of the devices used for ocular imaging store patient information for proper review and therefore must be secure and password protected (see Procedure 1.2). Furthermore, all acquired images should be securely stored and archived as part of the patient record or file to safeguard protected health information.

9.2 OCULAR PHOTOGRAPHY

Purpose

The aim of this procedure is to image anterior and posterior segment ocular structures for the purpose of photo-documentation and diagnosis and management of ocular disease. A variety of filters and imaging modalities can be used for fundus photography highlighting structures and pathologies otherwise not visible on ophthalmoscopy alone.

Equipment

• Slit lamp camera (anterior segment imaging)

• Fundus camera (posterior segment imaging)

  Note: The examiner should review the instructions provided by the manufacturer for the specific model and fundus camera configuration. Various posterior segment cameras offer a variable angle of view ranging from 30° to ...