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Optomap helps doctors see the back of the eye
By CHRISTINA TISCHNER
Article published on Thursday, March 29, 2007 |
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![[Image]](/content_images/032907_lle-05.jpg) |
| The Optomap retinal scanner |
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LARGO – Necessity is the mother of invention, often inspiring people to do great things.
Five-year-old Leif Anderson inspired his father to action in a rather unorthodox way. He went blind in one eye.
At the time, Leif’s father, Douglas Anderson, was the head of a design and engineering firm in Scotland. He is the creator of the Optomap retinal scanner, a machine that helps eye doctors examine the back of the eye without the need for dilation.
In 1990, Anderson took Leif to the eye doctor, where the child was diagnosed with a retinal detachment: the innermost layer of the back of his eye pulled away from the supporting tissues. Even though he received regular eye exams every year, the detachment was caught too late. Leif went blind from a problem that was hiding in plain sight.
Leif’s doctor told Anderson it was very challenging to give Leif the complete checkup he needed because it was difficult for the child to sit for the exam and point his eye in the right direction. Anderson became motivated to design an exam he felt would be more comprehensive and easier to perform. He wanted to help prevent other children from meeting Leif’s fate.
Anderson took the idea to his engineering firm, where his team designed what is now the Optomap. The machine uses a laser to scan the retina and produce an image. The test takes a quarter of a second and does not require dilation drops. The images can be reviewed right away by a physician.
The test scans more than half of the eye, including the side areas, where abnormalities are often missed. This range of view is larger in size than the view typically offered by a dilated fundus exam, or DFE, and offers the doctor a panoramic viewpoint of the nerves, blood vessels and other aspects of the eye.
For a DFE, the doctor dilates the eyes and requires his patient to just sit very still while the back of the eye is examined. Typically, a DFE offers a brief glimpse of a small portion of the retina and requires the use of a small lens to reflect light onto the retina, temporarily causing discomfort in some patients.
The purpose for this type of exam is to diagnose, treat and prevent serious, sometimes fatal diseases from robbing patients of their sight.
One of those diseases is melanoma, a deadly form of cancer. While it is found frequently on the skin, it can be found in the eyes as well.
According to the Collaborative Ocular Melanoma Study, melanoma of the eye is often asymptomatic, meaning patients do not know they have it until the growth becomes so large it obstructs vision or causes retinal detachment or hemorrhage. If left untreated, melanoma can cause blindness. At worst, it can spread to other portions of the body, killing the patient.
Melanoma can start out as a small freckle in the back of the eye and is capable of growing rapidly. The study recommends regular comprehensive eye exams for early detection. The Optomap enhances early detection by offering a wider view of the retina as well as a photographic comparison from year to year to help detect subtler changes in the eye.
Dr. Jeffrey LaPlume of Lenscrafters in Largo Mall was the first doctor in the Tampa Bay area to utilize the Optomap. He said the test is more helpful than a DFE with regard to melanoma because it uses two lasers to scan the retina, allowing a more in-depth look at the eye. It helps in detecting “changes in color, shape, border and size in relation to the optic nerve,” he said. The multiple lasers help provide multiple images and can help in determining if a freckle is cancerous.
In addition to melanoma, another deadly form of cancer often found by eye exams is retinoblastoma. According to Harvard University’s Digital Journal of Ophthalmology, retinoblastoma (RB) is a rare cancer found in children and is the third most common cancer to affect children. Children with RB have cancerous tumors growing on the back of the eye. According to the journal, 90 percent of the cases are diagnosed in children under 5. If left untreated, the disease is almost always fatal, so early detection is crucial to saving lives.
The Optomap provides images that are beneficial to diagnosis by illustrating any changes that may have occurred from year to year.
Cancer is not the only disease diagnosable by an Optomap exam. More common diseases such as diabetes and hypertension can be discovered during an eye exam. LaPlume recalled an incident when he discovered a patient’s bout with hypertension.
A gentleman came into the doctor’s office for an eye exam and elected to have the Optomap imaging done. By viewing the Optomap images of the blood vessels in each eye, LaPlume was able to determine the patient was suffering from a significant bout of high blood pressure. He then proceeded to take the man’s blood pressure reading and discovered the patient’s pressure was 240/180, a dangerously high level (normal readings run about 120/80 or lower). LaPlume promptly sent the patient to the hospital for treatment. If it weren’t for the doctor’s diagnosis based on the images, the condition could have gone undetected, and the patient could have suffered a heart attack or stroke as a result.
Still another disease is diabetes which can cause blindness if left untreated. Its effects are often asymptomatic as well. According to Prevent Blindness America, approximately 16 million Americans have diabetes. Individuals who do not seek treatment for the disease are 25 times more likely to go blind than the general population. This is because diabetes can weaken the small blood vessels in the retina, leading to bleeding inside the eye. Regular eye exams are especially important for diabetics because the doctor can determine if any damage has occurred.
The Optomap allows doctors to follow the progression of a patient’s diabetes from year to year. Doctors can save images of the retina from previous exams and compare them to the latest images.
LaPlume uses the Optomap to get his patients actively involved in their eye care.
LaPlume said the thing that sold him is the same thing that gets his patients excited.
“It’s the ‘wow’ factor,” he said. “Patients like being able to see their own eyes and to see what we are looking for.”
“It’s fast, it’s simple and I like seeing what the doctor is seeing,” said one female patient. “It gives me peace of mind,” she said.
LaPlume knows there is more to the Optomap than impressing patients. The new technology helps him and other doctors with early detection of diseases.
The Optomap was first introduced to the public in 2000 in the United Kingdom and the United States. It received approval from the Food and Drug Administration the previous year.
At this time, the Optomap is not covered by most insurance companies, so there is often an additional fee. Patients who utilize this technology don’t seem to mind, however. As of February 2007, 10 million Optomap exams had been performed worldwide.
80 percent of blindness is avoidable: 60 percent is treatable and 20 percent is preventable.
Blindness is the No. 1 complication of people with diabetes.
Diabetes is the leading cause of blindness among most adults.
Every five seconds, someone in the world goes blind. One child goes blind every minute.
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Article published on Thursday, March 29, 2007
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