Advanced Technology

Refraction

A basic eye exam is where it all begins and, with the help of the Nidek RT-3100 Intelligent Refraction unit, gone are the days of clicking between “1”  and “2”.  Instead, the lens selection is smooth and quick, resulting in quicker, less fatiguing and therefore, a more accurate eye exam.

The unit is linked to a digital chart which provides more chart options to prevent memorising. It also caters for all ages and literacy levels.

refraction

Comparing between your old specs is now possible as the lens movement is smooth and almost instantaneous, so you can appreciate the change in your lens prescription, if any at all.

Fundus Photography

The back of the eye or the fundus is the only part of the body where we can “look inside” in a non-invasive manner. This gives us valuable information, not only about the health of the eye, but systemic diseases like diabetes, MS, hypertension, and many other can show clues of their presence here.

The area visible with the fundus camera is restricted by the pupil size, so we can only see an area roughly 10 mm in diameter. In this picture, the two most important structures are the macula (where it all happens), and the optic nerve which is like the body’s optic fibre cable to send the visual information to the brain. The optic nerve is roughly 2 mm in diameter, and lies approximately 3.5 mm from the macula.

Fundus
F1

A healthy fundus. The large yellowish dot is the optic nerve head. The dark cherry
coloured spot is the macula.

F2

Another healthy fundus pic.

F3

Diabetic Retinopathy. The yellow deposits are called exudates and a hallmark sign.

F4

Notice the pale optic nerve found in glaucoma which is the 2nd leading
cause of blindness.

F5

Retinitis Pigmentosa (RP)

F6

Age related macular degeneration (ARMD).

Corneal Topography

Corneal1
Corneal2

Corneal Topography creates a 3D map of the cornea in order to:

  • Assess its shape
  • Diagnose certain conditions
  • Design contact lenses, The information is fed into software which designs a virtual contact lens. This is then made up and tested on the actual patient’s eye.  The advantage is that we can do many virtual fits before we actually make up the lens and, in this way, save time and material costs, while achieving more accurate fits.
C1

A Topography of a healthy cornea.

C2

The same Topography image in 3D.

C3

A Topography of a cornea with Keratoconus.

C4

The same Topography image in 3D.

C5

A Topography of a corneal graft.

C6

A Topography of a corneal injury.

There are many cases where patients have not been able to improve their vision with spectacles, and the Topographer has shown why, detecting surface abnormalities on the cornea from dry eye to ulcers. As a diagnostic tool it also can detect the meibomian gland dysfunction-one of the main causes of a dry eye.

Slit-lamp Biomicroscopy

As the fundus camera captures images of the inside (back) part of the eye, the slit lamp does it on the front part. This is a staple of any eye care clinic as it gives a magnified image of the anterior structures of the eye. It is with this instrument that we diagnose dry eyes, foreign body injuries, red eyes, lid conditions and many others. The slit lamp is also used to assess a contact lens fit, the video of the hard contact lens in the services section is taken with this instrument.

Slit1
Slit2

A Slit Lamp Biomicroscope image of a Scleral Contact Lens on a Keratoconus Eye.

Slit3

A Slit Lamp Biomicroscope image of a Scleral Contact Lens on a Corneal Graft Eye.

Note the Graft isn’t central, but located up & in towards the nose side.

Slit4

A Slit Lamp Biomicroscope image of a Pterygium, often mistakenly called a “Cataract”.

OCT

Ocular Coherence Tomography or OCT is similar to a CAT scan. The image captured is viewed in profile and greatly magnified. In ophthalmology, OCTs are used to detect diseases, like Glaucoma (the second leading cause of blindness), and Macular Degeneration, far earlier than other instruments.

At our practice, the main function of the OCT is in assessing the fit of our custom-designed scleral lenses. The profile, magnified view in each section of the lens allows for better troubleshooting and better results.

Oct1

An OCT image of a Scleral Contact Lens on an eye which has had a corneal graft.  Note how the lens closely follows the contours of the eye.

Oct2

An OCT image of a Corneal Graft, showing the junction between the donor & host corneas.

Note the Scleral Lens lying on top, with the tear layer forming a gap between the lens and the eye.

Oct3

An OCT image of a Corneal Graft, showing the junction between the donor & host corneas.

Note the Scleral Lens lying on top, with the tear layer forming a gap between the lens and the eye.

Oct4

Another OCT of a graft, this time the tear layer between the lens and eye is greater, and caused by the thinning of the host cornea in that area.

Oct5

An OCT image of the retina (back part of the eye), with the green arrow pointing to what Macular Degeneration looks like.  Also called Age Related Macular Degeneration (ARMD), it is one of the leading causes of central vision loss in the world with family history and smoking increasing its incidence. 

Oct6

An OCT image showing the cornea, sclera (the white part of the eye), and iris (the eye’s colour), all in one image.  There is also a Scleral contact lens in place.

Oct7

This OCT image is to detect risk factors leading up to Glaucoma.  As mentioned previously. Glaucoma is the 2nd leading cause of blindness in the world, with an incidence of between 1-4 in every 100 people.  This test can detect risk factors long before any existing technology.  The above case is safe BTW.