Sometimes it seems like new healthcare technologies are changing the way we practice every day. We can diagnose, treat, and manage patients better than ever! Technology is always improving! It’s my favorite thing about the healthcare industry.
Still, there are some pieces of optometric equipment that I am completely dependent on, and I don’t know if I could ever live without!
1) The Phoropter
No, it might not have the glittering allure that a CLARUS 500 or LipiFlow might have. But I bet that most eyecare professionals, like me, use this critical piece of optometric equipment day in and day out! This is the workhorse of my practice, and the workhorse of my exam. Most patients undoubtedly expect for you to use the phoropter whenever they come to your practice.
Obviously, the phoropter generates the most revenue for my practice. It also tells me a lot about the ocular health status of my patients. I can uncover dry eye from fluctuating visual acuity, pathology from reduced best corrected visual acuity, or binocular vision conditions from unstable refraction.
Refraction is such an important element of my exam and often leads me towards diagnosing all kinds of ocular disease. I couldn’t imagine not having a phoropter in my office!
Learn how refraction can be a valuable tool in the detection of ocular disease.
2) The Biomicroscope
This is another piece of optometric equipment that I am sure many of us use on a daily basis in almost every encounter. Once again, it might not be the most glamorous toy in the office, but it serves such an important function.
I fit a lot of specialty contact lenses in the practice and manage a lot of dry eye disease, and quite frankly, could not do so without the use of the biomicroscope. Specialty contact lenses and dry eye disease make up a large component of revenue in the practice, so this piece of equipment is critical! I don’t need an anterior segment camera, just a basic, good ol’ slit lamp does the trick for me!
3) Ocular Coherence Tomography (OCT)
When I graduated from optometry school, I joined a practice that had a Cirrus by Zeiss, and I can’t begin to express just how valuable this was as I progressed through my career. I truly could not imagine managing ocular pathology (other than strictlyanterior segment pathology) without an OCT. I don’t even know how you could manage ocular disease without an OCT!
The OCT has allowed me to really expand the scope of what I can diagnose, treat and manage. This was so critical for me in the early stages of my career when I was trying to find my footing and get more comfortable managing disease on my own. The OCT is such a beneficial tool, not only for the wellbeing of my patients, but for my own educational benefit. It’s also enabled me to better understand when a referral is warranted as opposed to something I can manage comfortably and confidently in-house.
Check out this in-depth guide to using OCT in the diagnosis and management of ocular disease.
4) Visual Field
As a practice that manages a lot of ocular disease, including a challenging neuro case here and there, I could not practice without my visual field.
In addition to managing glaucoma, we have found ourselves receiving a lot of referrals for plaquenil evaluations due to our strong networking efforts with other healthcare professionals in our area. Our practice has been around for a long time, and consequently, we have a large geriatric demographic in our practice. This has undoubtedly led us also to performing visual field testing for those seeking blepharoplasty. As our practice excels in both routine and medical care, a visual field is something that is non-negotiable!
I debated between this piece of optometric equipment and the always reliable Binocular Indirect Ophthalmoscope, and ended up giving the edge to the Ultra-Widefield Retinal Camera.
Retinal photography has been around for a long time. It obviously has made incredible advances, and continues to improve in capabilities as seen with the CLARUS 500 and other imaging devices out there.
We perform Ultra-Widefield retinal imaging on all of our patients, without additional charge. Obviously, we know that in doing so, we are forfeiting a great source of revenue that can be integrated into the practice by charging for retinal screenings etc. We have found that the ability to examine patients in more detail, more efficiently, and more comfortably is well worth forfeiting the revenue.
I use my BIO on most patients despite us having an ultra-widefield retinal camera, but I can’t tell you how many times retinal photography has assisted me in examining and discovering pathology in patients who either refused dilation, or were not cooperative on examination. Seeing between 20-30 patients a day, many of whom have some sort of ocular pathology, this piece of optometric equipment is priceless for me!
Runner-up: The Autorefractor!
One surprise omission from this list might be the autorefractor. It was hard to leave this off the list as it improves workflow and efficiency, especially when examining patients without prior Rx’s, or those patients who might have had cataract surgery etc. However, I was always good at retinoscopy and could very easily rely on my retinoscope if I had to!
Thanks to modern technology, autorefractors are extremely accurate and efficient when it comes to . . . well, refraction! Obviously, we cannot rely on this as our final prescription, but it is a really good starting point if you have no refractive data. When patients bring their old prescription (or we have it on file), an autorefractor provides a quick comparison on what I can expect when discussing their visual status.
Many autorefractors have an autokeratometer function built in. This is extremely beneficial when it comes to contact lens fittings, since it allows me to mentally write a list of contacts for the patient.
The Forgotten Child: Good Computer!
You may think this is just me being fancy (possibly a millennial). However, when it comes to EHRs, digital refractive systems, and imaging systems, a fast and responsive computer goes a very long way in making your exam efficient and fluid. I have filled in at various practices and many have not invested in a good quality computer. How I know is when I am opening the retinal imaging file and then clicking “Next” on the EHR for the posterior segment screen, I am sitting there just waiting for BOTH to load. A good size monitor is a cherry on top because you are able to view multiple windows at one time, minimizing the need to scroll.
Having a fast computer and large monitor may not seem a priority for some, but in a busy practice where each second matters, it means the world. Don’t knock it till you try it! Think about the Touch ID on the iPhone and Samsung to unlock your phone. How frustrating is it when you have to unlock your phone via passcode when your fingers are dirty or wet?