At Premier Eye Care, we utilize advanced technology in addition to expert medical skills and knowledge to help provide you with excellent eye care.
When your eyes are examined, you may notice the use of numerous technological devices that improve our ability to care for you.
- When checking your vision, an auto-refractor is a machine that measures your glasses prescription based on how light is focused by your eye. This measurement is then refined by the doctor in the exam room.
- The visual field machine helps provide an accurate understanding of visual field loss in diseases such as glaucoma, Plaquenil toxicity, and other diseases such as brain injuries or tumors.
- Optical coherence tomography or OCT is an advanced technology that provides a cross sectional view of the retina and optic nerve head. This technology is useful in the evaluation of patients with diseases such as macular degeneration, glaucoma, and numerous other diseases of the eye.
For patients undergoing cataract surgery, we use the most advanced machine available, the Lenstar optical biometer by Haag-Streit, to measure the eye. Using advanced lens formulas, these measurements are used to predict which lens we will implant into the patient's eye once their cataract has been removed.
We primarily use Alcon Acrysof lenses during cataract surgery. These advanced technology lenses have aspheric optics, filter ultraviolet and near-ultraviolet light, and provide consistently superior results. For patients with astigmatism, this lens is available with astigmatism correcting technology. Some patients prefer a multifocal version of this lens that can reduce your need for reading glasses.
It is not uncommon for the physicians of Premier Eye Care to order diagnostic testing for a patient. Here is a list of the most frequently used state of the art testing equipment and the purpose of each particular machine.
A-scan and Optical Coherence Biometry
An A-scan is a test that is used to help the physician determine the power of intraocular lens that will be implanted during cataract surgery. This is achieved by using a mild infrared laser beam to measure the length of the eye and the curvature of the cornea. This is a non-contact measurement. In the event that your cataract is very dense and the laser beam cannot measure through it, a contact ultrasound is used to measure the length of your eye. Your eye is anesthetized with a numbing drop and a small probe which uses sound waves to measure, is placed on your cornea to record the measurements. Multiple measurements will be taken. Those measurements are then calculated to determine the lens power. You do not need to be dilated for this test. This test takes approximately 5-10 minutes.
Pachymetry measures the thickness of the cornea. This is an important measurement for calculating a more accurate eye pressure measurement for patients with glaucoma. Using a type of laser known as interferometry, several measurements of the thickness of the corneal are performed. Multiple readings are taken for each eye to get an accurate average. This test usually takes 5-10 minutes.
B-scan/ Diagnostic Ultrasound
A small probe is placed on the eye that is able to see through opaque media. Ultrasound uses sound waves that make a picture of the internal structure of the eye. The doctor can see the presence of retinal detachment, retinal holes, tears, foreign material, hemorrhages, and malignant melanomas. The B-scan helps determine the difference in tissue, i.e. malignant melanoma as opposed to metastatic tumors or a benign nevus. This procedure takes about 5-10 minutes, while seated in a comfortable chair.
The Ishihara Color Vision Test is a diagnostic test used to detect deficiencies in color vision. The patient is seated at a table and asked to identify the number they see on 24 different color plates. Color vision tests generally take 3-7 minutes to complete.
Humphrey Visual Field (HVF)
A visual field test is a method of measuring an individual's entire scope of vision, that is their central and peripheral (side) vision. Visual field testing actually maps the visual fields of each eye individually. The visual field test is a subjective examination, and is most frequently used to detect any signs of glaucoma damage to the optic nerve. In addition, visual field tests are useful for detection of central or peripheral retinal disease, optic nerve disease, and diseases affecting the visual pathways within the brain. Spokane Eye Clinic's advanced instruments used to conduct this test take approximately 5-10 minutes per eye to complete. No dilation is required for this test, and can take 30-45 minutes total for instruction and testing.
Optical Coherence Tomography (OCT)
A mild beam of laser scans through the layers of the retina, making a picture. This helps your doctor see what is going on in the back of your eye from macular swelling, macular holes, macular degeneration, macular puckers and optic nerve swelling. These are just some of the conditions that the OCT can help diagnose, which helps the doctor to treat and follow the progress of ongoing treatment. The procedure takes about 10 minutes to complete.
Slit Lamp Photography
Slit lamp biomicroscopy photography, is documenting the structures of the eye. This type of testing is usually anteriorly, taken with a camera mounted to a microscope. Corneal disease, pterygiums, corneal scars, cataracts, pigmented areas, or perhaps trauma are all reasons to take slit lamp photos. No special preparation to the patient is needed, including dilation or the need for a driver.
Ultra-Wide Field (UWF) Fluorescein Angiography (FA)
Fluorescein Angiography is a special type of diagnostic photography to document the circulation of the retina. This helps the retinal specialist with treatment and diagnosis of the retina. Most often this test is ordered for macular degeneration, diabetes, or occlusion of the retina. Your physician will review this test to help determine if there is leakage, swelling, or blockage in the retina. Fluorescein Sodium dye is injected into a vein of the arm, forearm or hand. At the same time a rapid sequence of photographs with a special filter is taken, to document the appearance of the dye in the retina. Most people will bring a driver for this procedure since they are dilated, and can experience a rosy hue or colors of vision from the flash of the camera, after the photography session for a few minutes. Our Optos California Camera allows us to visualize the far peripheral retina– allowing for better diagnosis and treatment (some diseases are only present in the periphery) of a variety of retinal diseases. This procedure usually takes approximately 20 minutes.
UWF Fundus Autofluorescence (FAF)
Autofluorescence is a type of fundus photography that uses a filter to highlight the natural bioluminescence of the retinal tissue. Unlike regular color fundus photography, the image is monochromatic, and will show areas of deposits from cell dysfunction. This test usually takes around 1-2 minutes. Unless a dilated exam is needed, our Optos California camera can perform this without dilation.
UWF Fundus Photography
Fundus photography documents the back of eye (retina), and can be performed with colored filters or specialized dyes. They are visual records that document the current ophthalmoscopic appearance of a person's retina. Fundus photos are routinely ordered in a wide variety of eye conditions, including glaucoma, diabetes, and macular degeneration. Our Optos camera can take the photos without dilation. This test takes usually around 1-2 minutes.
UWF Indocyanine Green Angiography (ICG)
Indocyanine green is a type of photography that images the very outer level of the retina called the choroid. It uses a special green type of dye that is injected into the vein, and is imaged by the camera with a red filter. This procedure can last up to an hour when combined with an FA, and often will require an IV to be placed while imaging. The entire process can take between 20 and 60 minutes.
We also use several advanced lasers to treat a variety of disease:
Is used to treat a variety of retinal diseases including - Diabetic Retinopathy, Retinal Vascular Diseases including Retinal Vein and Arterial Occlusions, Choroidal Neovascular Membranes, Age Related Macular Degeneration, Diabetic Macular Edema, Central Serous Retinopathy, Retinal Breaks/Detachments, Tumors, Eale’s Disease, Coats Disease, Retinopathy of Prematurity, and Peripheral Retinal Lesions.
Selective Laser Trabeculoplasty (SLT)
Is used to lower the intraocular pressure in patients with glaucoma who don’t respond well or are intolerant of topical medications or who have too high of pressure and are poor candidates for glaucoma surgery.
Is used to treat opacification of the lens capsule which sometimes occurs following cataract surgery as well as perform a laser iridotomy in closed angle glaucoma.
Is used to perform cyclophotocoagulation on glaucoma patients who don’t respond to prior therapies.