Our Eye Imaging Technology

An eye exam is only as good as what you can see. For decades, optometrists relied on direct examination through a dilated pupil — a skilled approach, but limited to what’s visible to the human eye through a magnifying lens. The technology that’s arrived in the past 15 years has changed what an eye exam can do.

We’ve invested in the imaging technology that’s become the standard of care for serious eye disease detection. Most family-practice optometrists in the area don’t have this equipment in-house, which means they can’t offer the same depth of evaluation we do. Here’s what we use, and what each piece of technology actually does for you.

Optos ultra-widefield retinal imaging

Optos is a high-resolution camera that captures up to 200 degrees of your retina in a single image — far more than what a doctor can see through a dilated pupil with traditional examination. For comparison, the standard direct exam shows roughly 30-45 degrees of the retina at a time. Optos shows about 80% of the retina in one shot, including the far peripheral retina that’s notoriously hard to examine otherwise.

What it’s good for

• Catching peripheral retinal problems early. Retinal tears, lattice degeneration, peripheral retinal holes, and small melanomas can hide in areas that traditional exams reach with difficulty. Optos sees them.
• Documenting and tracking changes over time. A photograph is a permanent baseline. We can compare this year’s image to last year’s and identify changes that would be impossible to remember from exam to exam.
• Diabetic retinopathy screening. Standard of care for diabetic eye exams. The wider field captures more of the retina where diabetic changes happen.
• Monitoring conditions like macular degeneration, retinal detachments after treatment, and various pigmentary disorders.

What it’s like for you

You sit in front of the camera, place your eye against a soft cushion, and look at a small target inside. The camera takes the image in less than half a second. There’s a brief flash of light. There’s no contact with your eye and no discomfort. Dilating drops may still be needed depending on what we’re looking for and how clearly we can see your retina without dilation — we’ll discuss this at your visit. The imaging itself is done in a couple of minutes per eye.

Does Optos replace dilation?

For some patients, yes. For most, we still want to dilate — especially for new patients establishing a baseline, patients with diabetes or known retinal conditions, anyone over 60, or anyone with new symptoms that warrant a closer look at specific areas. Optos and dilation aren’t competing technologies; they’re complementary tools, and we use whichever combination makes sense for your visit.

OCT (Optical Coherence Tomography)

If Optos is the wide-angle camera, OCT is the ultrasound of the eye — except instead of sound waves, it uses safe, low-power light. OCT uses safe, low-power light to create cross-sectional images of the retina at near-microscopic resolution. We can see the individual layers of the retina, measure their thickness in microns, and detect fluid, swelling, or thinning that aren’t visible on any other test.

What it’s good for

• Glaucoma diagnosis and monitoring. OCT measures the nerve fiber layer around the optic nerve at a level of detail that catches structural damage years before vision loss is measurable on a visual field test. It’s the technology that has transformed early glaucoma detection.
• Macular degeneration evaluation. OCT shows the macula in cross-section, so we can detect drusen, fluid leakage (signaling wet AMD), thinning of the retinal layers, and the earliest changes that distinguish normal aging from disease.
• Diabetic macular edema. Fluid in the macula from diabetes is detectable on OCT before it causes vision loss. This is a major reason annual diabetic eye exams matter.
• Tracking changes over time. Year-over-year comparison of OCT scans tells us whether disease is stable or progressing — with measurable, objective data, not just impression.

What it’s like for you

Similar to Optos in terms of patient experience: you sit in front of the device, look at a target, and the scan takes a few seconds per eye. No drops, no contact, no discomfort. The resulting images are then reviewed and compared to your baseline.

How these tools change what an eye exam can do

Many of the most consequential eye diseases — glaucoma, macular degeneration, diabetic retinopathy — develop slowly and silently. Patients don’t notice until vision has been lost. That’s why screening matters.

Twenty years ago, screening relied almost entirely on what an experienced doctor could see through a dilated pupil. That was good, but limited. Now we have:

• Wide-field documentation of the entire retina that we can compare year over year
• Micron-level structural data on the optic nerve and macula that catches changes years before symptoms develop
• Objective measurements that don’t depend on memory or impression

That combination genuinely changes outcomes. Patients in our practice with early glaucoma, early macular degeneration, or pre-symptomatic diabetic retinopathy are caught at a stage where intervention can preserve their vision long-term. Twenty years ago, many of these patients would have been told everything looked fine until vision had already started slipping.

Insurance coverage for imaging

Both Optos and OCT are covered by:

• Medical insurance — when imaging is medically necessary (suspected glaucoma, diabetes, family history of macular degeneration, monitoring established disease, etc.). Apple Health, Medicare, and most major medical plans cover diagnostic imaging when there’s a medical reason.
• Some vision plans — some cover imaging as part of a routine exam upgrade; others don’t. Coverage varies.
• Self-pay — if your plan doesn’t cover imaging and you want it anyway, the out-of-pocket cost is reasonable. We’ll always discuss cost up-front before doing anything that affects what you owe.

Whether imaging is recommended for your specific visit depends on your situation — we don’t image every patient at every visit just because we have the equipment. We’ll explain why we’re recommending what we’re recommending, and what your options are.

If you haven’t had a comprehensive eye exam in a few years — or you want a more thorough evaluation than your last one — schedule with us. Call (360) 427-8324.