Having worked in optometry for over 30 years, I have been, and continue to be, amazed, impressed and excited by the introduction and evolution of technological support in the profession.
Whilst I have worked with many machines and aids, it was five years ago at Portsmouth independent opticians, Anne Gill Eyecare, when I found an instant rapport, understanding and ease working with the Cobra – a non-mydriatic, digital fundus camera – and it is still currently my favourite piece of equipment for eye examinations.
I know that this might seem an unusual feature to mention first, but I am often working with the elderly, the vulnerable and people who can be nervous about eye examinations for a variety of reasons, from fear of the unknown to concerns about deterioration.
The modern, smooth orb design of the Cobra HD fundus camera is sleek and very non-threatening – I have had patients comment on how attractive it looks, and that helps put them at ease.
As technology develops and more tools enter the marketplace, you can tell the companies that have given thought to people receiving an examination, as well as those conducting it, and I believe that is an important element to a truly successful product.
The Cobra’s compact design also makes it really easy to use. Use the joystick to move position, the focusing knob to adjust and then press a button to take a picture from the live image on screen – it’s that simple.
"The modern, smooth orb design of the camera is sleek and very non-threatening – and is still my favourite piece of equipment for eye examinations"
As a fundus camera
With the Cobra, there is no need to dilate pupils before the examination and it is easy to direct a patient’s gaze in order to photograph different parts of the retina. I have also found the Cobra lessens discomfort when light sensitive patients have ophthalmoscopy done.
I am often asked by patients to explain what I see when I look inside their eye, so this is a lovely way to show them and help explain if there are any issues. I like to get at least one full set of photos for a patient, especially if it’s the first time I’ve seen them, because this can be used as a reference point for the future.
Other benefits of taking the photos I have found include explaining patchy vision from macular degeneration or holes to family members; using them rather than memory when writing referrals; and printing or emailing images to patients or consultants. On follow-up visits, I have the previous image on the screen during ophthalmoscopy so any changes are instantly recognisable.
The Phoenix computer software that accompanies the Cobra allows you to compare previous photos side-by-side, so you can show patients consistency or any change. Various filters also enable you to view images in different ways. The photos can be overlaid to establish any change in a choroidal naevus or confirm no change at all. Photos taken in different directions can be put together using the ‘mosaic’ function for a much wider view of the retina.
"I am hugely supportive of technology that can not only provide effective examinations and diagnoses, but be understood by patients themselves"
As a meibographer
The meibographer function is great for dry eye examinations, allowing me to show patients where and how their meibomian glands function. The software allows you to draw good areas in green, loss areas in red and it calculates the percentage of gland loss, making it easier for the patient to understand.
I am hugely supportive of technology that can not only provide effective examinations and diagnoses, but be understood by patients themselves. As our knowledge and ability increases, successful implementation depends on being approachable and understood by the public.
I always feel that I have added value to the service that I provide when a patient takes an interest in their eye examination. In the current climate, where we want patients to take responsibility and be proactive in their healthcare, I believe we need to make the initial move and reach out to them. That is why I work for patient-orientated opticians, such as Anne Gill Eyecare, which have equipment such as the Cobra that help me do just that.