Diagnostics

At Fromer Eye Centers, we utilize the latest technology to help diagnose and manage your ocular conditions. The following are some, but not all, of the instruments we have in our offices.

Visual Field

The Humphrey visual field is a diagnostic test to measure visual fields, or perimetry. The Humphrey visual field test measures the entire area of peripheral vision that can be seen while the eye is focused on a central point. During this test, lights of varying intensities appear in different parts of the visual field while the patient's eye is focused on a certain spot. The perception of these lights is charted and then compared to results of a healthy eye at the same age of the patient to determine if any damage has occurred. This procedure is performed in about 20 minutes and is effective in diagnosing and monitoring glaucoma. Patients with glaucoma will undergo this test on a regular basis to determine the progress of the disease. The Humphrey visual field test can also be used to detect conditions within the optic nerve of the eye, and certain neurological conditions as well.

Ultrasound Biomicroscopy (UBM)

UBM is a technique primarily used for imaging of the anterior segment of the eye to obtain cross-sections of the eye at microscopic resolution. UBM can be used for imaging much of the anatomy of the anterior segment, as well as associated pathologies, including angle closure glaucoma, ciliary body cysts, neoplasms, and angle trauma. Additionally, UBM can be used for imaging of the cornea. Pathologies that can be identified include keratoconus, corneal dystrophies, edema, and scars.

Optical Coherence Tomography (OCT)

Optical coherence tomography (OCT) is an advanced technology used to produce cross-sectional images of ocular structures. These images can help with the detection and treatment of serious eye conditions such as corneal dystrophy, macular holes, macular swelling and optic nerve damage. The technology is most commonly used to image the front part of the eye (cornea) and back part of the eye (retina). Its non-invasive objective measurements can help diagnose and manage the progression of ocular conditions, such as glaucoma, diabetes and corneal dystrophies. The OCT uses technology that is similar to CT (computerized tomography) or CAT (computerized axial tomography) scans of internal organs by using scattered light to rapidly scan the eye and capture a multitude of cross-sectional images to create an overall image. Unlike other imaging techniques, the OCT uses light to produce high resolution images, rather than sound or radio frequency waves.

Fluorescein Angiography

Fluorescein angiography is the practice of taking photographs of blood vessels inside the eye (an angiogram) with the help of a contrast dye (fluorescein dye). These pictures help doctors evaluate, diagnose and manage retinal problems, such as diabetic retinopathy, macular degeneration, abnormal vessel growth, swelling, leaking, cancer or tumors. The diagnostic examination is done in the office. First, the patient's pupils are dilated with eye drops. Then, a few photographs are taken with a special ophthalmic camera. Next, the contrast dye is injected into the patient's arm. The dye travels through the blood vessels from the arm into the eye within a few seconds and "lights up" the blood vessels for the camera. Several photos will be taken at different time intervals for comparison.

A-scan Ultrasound Biometry

Amplitude scan commonly referred to as A-scan is routine type of diagnostic test used in optometry or ophthalmology. The A-scan provides data on the length of the eye, which is a major determinant in common sight disorders. The most common use of the A-scan is to determine eye length for calculation of intraocular lens power. When a cataract is removed, the lens is replaced by an artificial lens implant. By measuring both the length of the eye (A-scan) and the power of the cornea. The other major use of the A-scan is to determine the size and ultrasound characteristics of masses in the eye, in order to determine the type of mass.

B-scan Ultrasonography

B-scan is a high-frequency ocular ultrasound that produces a cross-sectional image of the eye and the space behind the eye. The B-scan is also known as; echography - eye orbit, ultrasound - eye orbit, ocular ultrasonography or orbital ultrasonography. The B-scan enables eye care professionals to accurately diagnose and evaluate a wide range of eye conditions including: cataracts, retinal detachment, tissue damage, inflammation, vitreous hemorrhage, tumor, suspected foreign body, eye trauma and lens dislocation.

IOLMaster Optical Biometer

IoLMaster determines the power of the intraocular lens (IOL) implant for cataract or lens replacement surgery. It allows for fast, accurate measurements of multiple areas of the eye, such as eye length and surface curvature, which are necessary for cataract surgery. IOLMaster is a non-contact and non-invasive method of measuring the axis length, corneal radii and anterior-chamber depth of the eye, nothing touches the eye and no drops are needed.

Ocular Response Analyzer (ORA)

Ocular Response Analyzer (ORA) is the only tonometer that measures Corneal Hysteresis (CH), a superior predictor of glaucoma progression. Corneal Hysteresis is an indication of the biomechanical properties of the cornea differing from thickness or topography, which are geometrical attributes. CH measurements are significantly associated with risk of glaucoma progression. Eyes with lower CH had faster rates of visual field loss than those with higher CH.

Pachymeter

Pachymeters are devices that display the thickness of the cornea, usually in micrometers, when the ultrasonic transducer touches the cornea. Corneal pachymetry is an important test for laser vision correction patients and in the early detection of glaucoma.

Transcranial Doppler (TCD)

A Transcranial Doppler (TCD) is a 15 minute non-invasive, painless and safe ultra sound, looking at all of the major arteries and vessels of the Circle of Willis (multiple paths for oxygenated blood to supply the brain). This test allows for the assessment of a patients risk of stroke/ocular stroke by measuring the Ophthalmic Artery and Cerebral Vascular blood flow. Common symptoms and conditions that may qualify for the Transcranial Doppler Test: migraine, ocular migraine, sudden vision loss, visual field defect or disturbance, history of stroke, blurred vision, double vision, glaucoma, cardiovascular system complications and carotid Artery Disease.

Cell Count CellChek

CellChek device is a non-contact, auto-alignment, auto-focus, auto-capture, auto cell count. The endothelial cell count (ECC) is the most accurate way of measuring the number of cells per square millimeter and their size/shape. It is used to help in the diagnosis of certain eye conditions, and also prior to surgery to assess the safety of the procedure given the health of the cornea.

Corneal Topography

The Corneal Topographer is a diagnostic tool that provides your doctor with information about the surface power, thickness, front and back shape of the cornea. By providing information about the posterior of the cornea, indications of certain corneal diseases or abnormalities are diagnosed earlier. With the Corneal Topographer your doctor is able to identify whether or not you are a candidate for refractive surgery and which procedure would provide you with optimal vision correction. Over 9,000 different points of data on the cornea are measured in just seconds, providing your doctor with immediate results.

Fundus Camera

A fundus photograph is a specialized form of medical imaging. Using a customized camera with high-powered lenses that are mounted to a microscope, photographs are taken of the back of the eye by focusing light through the cornea, pupil and lens. Fundus photographs are used to identify or monitor a wide variety of ophthalmic conditions. To begin the process, the pupil is dilated with eye drops. The patient will be asked to stare at a fixed device, keeping the eyes focused and still. There will be a series of flashes of light. The process usually takes no more than 10 minutes. Some of the ophthalmic conditions fundus photography is used for include: glaucoma, diabetic retinopathy, macular edema, micro aneurysm and optic nerve. Fundus photography has also been used to interpret the results of a fluorescein angiogram.

TearLab

TearLab testing is used for early and accurate detection of dry eye disease. Because it provides a means of quantitatively monitoring the severity and possible progression of dry eye, TearLab testing is invaluable for ophthalmologists in customizing treatments for their patients. TearLab testing measures tears' osmolarity (salt concentration), which is an indicator of whether dry eye disease is present. The greater the osmolarity, the more severe the problem. Osmolarity in both eyes is measured, and the higher of the two numbers is used for the diagnosis.

Handheld Slit Lamp Microscope

Portable slit lamp allows the user to examine patients who cannot comfortably sit at a larger slit lamp, including pediatric, wheelchair-bound, or bed-ridden patients. It can be easily reassembled for more traditional joystick/headrest operation. Whichever method is used, the portability does not diminish the quality of the examination.

Icare/Tono-pen Tonometers

Tonometry is the procedure eye care professionals perform to determine the intraocular pressure (IOP), the fluid pressure inside the eye. It is an important test in the evaluation of patients at risk from glaucoma.

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