New Eye Care Instruments
Eye care specialists are in constant pursuit of ways to administer better care to patients. Developing more accurate and efficient diagnostic tools is an important component to this search. The UIC Eye Center prides itself in its constant development and implementation of new eye-care instruments and techniques. This issue of “Eye Facts” discusses four new instruments that have greatly improved eye care and treatment of common eye conditions.
New Equipment will Aid Diagnosis of Retinal Diseases: Optical Coherence Tomographer Model 3000 (OCT3)
The UIC Eye Center has acquired an Optical Coherence Tomographer Model 3000 (OCT3), an extremely powerful tool for ophthalmologists to use in the diagnosis and treatment of glaucoma and other retinal diseases. The acquisition was made possible by a generous gift from Mr. Gerhard Cless, founder and president of the Karl Cless Foundation and co-founder of Zebra Technologies Corporation, the world’s leading provider of bar code printers.
The OCT3 is considered state-of- the-art technology for cross-sectional imaging of the retinal tissue in living human eyes. This latest advancement in imaging technology dramatically improves visualization of disease-related abnormalities in the retinal structures. UIC Eye Center clinicians and researchers can now visualize retinal abnormalities in patients who are suspected of having macular hole. In addition, they will be able to image choroidal neovascularization in patients with age-related macular degeneration. The OCT3 will also be used to measure retinal nerve fiber layer in patients with diagnosed or suspected glaucoma. The OCT3 will help ophthalmologists better evaluate the progression of these diseases in the early stages and monitor treatment.
Core Imaging Facility: State of the Art Imaging
The NIH-supported Core Imaging Facility provides department investigators with state-of-the-art instrumentation for digital image acquisition, processing and analysis. Investigators use the facility extensively to enhance their research capabilities and documentation.
The facility’s latest acquisition is a Leica TCS SP2 AOBS (acousto-optical beam splitter) spectral confocal multiphoton microscope which combines spectrophotometric detection with confocal microscopy. The resulting multi-channel confocal imaging spectrophotometer significantly increases the flexibility and efficiency of the detection system. The equipment housed in the facility includes an imaging station comprised of an inverted Zeiss microscope cooled high-resolution digital camera and a workstation with deconvolution and calcium ratio software.
The RetCam 120: Advanced Technology in Ophthalmology
With joint funding from the UIC Eye Center, the UIC Medical Center recently purchased the RetCam 120, a digital imaging technology, which has been hailed as a revolutionary tool in the diagnosis and management of pediatric retinal diseases. Developed by Massie Research Laboratories of Dublin, CA, the RetCam120 allows systematic photographic imaging of pediatric retinal diseases affecting the equator and periphery revealing new details about their natural history and response to treatment. Since its acquisition, ophthalmologists from the department have imaged many rare medical conditions including meduloepithelioma, pre-term retinoblastoma, atypical retinopathy of prematurity, juvenile retinoschesis, posterior persistent fetal vasculature, and juvenile Coats’ disease. This tool is particularly helpful since it allows direct comparison of the pretreatment and post treatment for retinoblastoma and as well as monitoring the course of this large variety of maladies. As an unexpected benefit, the RetCam 120 has increased the parents’ understanding and engagement since they can visualize their child’s problem. Finally, physicians can also share clinical information in meetings and over the Internet increasing the access to information about these rare diseases.
The ability to see the contour of the cornea, the transparent portion of the outer coat of the eyeball is an important tool in the identification of corneal disorders. The contour of the cornea has been traditionally measured by a keratometer, which has been around for more than 100 years. The keratometer offers a limited evaluation of the cornea and is greatly enhanced by the corneal topography unit. The UIC Eye Center acquired a corneal topography unit several years ago. However, a new, upgraded version has recently been obtained that is on the cutting edge of this new technology. The corneal topography unit projects a series of light rings onto the surface of the cornea. The separation between the rings is measured at many points by a computer and a color-coded map of the surface of the cornea is presented.
This new technology permits earlier diagnosis of many corneal diseases, provides vital information to eye surgeons for preoperative and post-operative decision making and provides helpful information for the fitting of contact lenses.
Home Tonometer (Portable Eye Pressure Monitor)
Glaucoma is an eye disease that causes damage to the optic nerve and may result in blindness. High intraocular pressure (IOP) is a dominant risk factor in the development of glaucoma. Eye doctors must keep a constant record of their glaucoma patients’ IOP to insure that they receive the most effective treatment. However, an accurate assessment of a glaucoma patient’s eye pressure is difficult to establish because eye pressure may fluctuate during the day and go undetected. A patient with presumably normal eye pressure during a doctor visit, may have periods of increased eye pressure at other times during the day. To combat this problem, a portable instrument called the Home Tonometer has been developed at the UIC Eye Center. The Home Tonometer allows the patient to monitor eye pressure at home or work. With the eye close to the instrument, the patient pushes a lever and the eye pressure measurement is taken comfortably and easily in about two seconds.
Monitoring of IOP provides the eye specialist with important information to determine proper treatment and prevent further loss of vision.
We are sorry, but the home tonometer is not for sale. Engineers at the UIC Eye Center have developed two prototypes that are used in our clinic, but they have never been picked up by a major medical equipment company and developed for sale.
Retinal thickness analyzer
Macular edema (thickening of the retina) is a major contributor to 5000 new cases of diabetes-related blindness yearly in the U.S. This condition is caused by leakage of fluid from the blood vessels into the retina, the light-sensitive layer of the eye. The accumulation of fluid causes retinal thickening and deterioration of vision. This condition can often be treated with laser treatment. A new technique has been developed at the UIC Eye Center to assess and document the degree of retinal thickening. The procedure takes less than 30 minutes and is similar to an eye exam. A weak, harmless laser beam is projected on the retina while the patient is asked to look in different directions. An image of the retina is recorded on photographic film or video tape. A computer then processes and analyzes the images to determine the degree of thickening. Measurements are obtained at various locations on the retina to generate a thickness map for each eye.
This new technique of measuring retinal thickening sensitively monitors the degree of thickening for evaluating progression and treatment of macular edema.
Driving assessment system
How do eye care specialists determine whether or not an individual with limited vision is capable of safely operating a vehicle? Certain eye conditions can cause severe peripheral, or side-vision loss. Whether one should continue driving with visual field loss has been a difficult decision for clinicians, patients and their families. This question becomes even more difficult in some older patients who may additionally have reflexes that have naturally slowed with age. The driving assessment system, currently being tested at the UIC Eye Center, objectively measures a number of driving skills using a three-screen, interactive driving simulator. A patient’s driving ability is assessed through the recording of a patient’s responses during an eight-minute session on a simulated driving test course. The driving session tests patients on crossing lane boundaries, braking response and the rate of deceleration. Head and eye movements made during driving are also measured. Additionally, the driver is presented with a number of challenges on the simulator to test hand-eye coordination and response time. Studies show that performance on the simulator is highly representative of real-world performance. Upon completion of the driving test, patients and their physicians are given a “driving performance profile”, which is a report of how the patient performed. Is this patient able to see well enough to drive safely? The driving assessment system helps eye care specialists make this difficult decision.
As new technologies are developed, the ability to diagnose and treat eye conditions will continue to improve, as will the overall quality of eye care.