What is Retinal Photography?

Retinal photos are images taken with a retinal camera that capture the patient’s optic nerve, macula, and a portion of the retina which can be used to diagnose and manage a variety of diseases including diabetic retinopathy, macular degeneration, and glaucoma. Retinal photos are attempted on most patients 5+ years of age depending on their mobility and ability to fixate.

How to Complete Retinal Photography

Photos can be completed dilated or undilated; however, sometimes, especially if the patient’s pupil size is small, it is difficult to obtain clear, unshadowed images undilated. It is preferable to take the photos without CL's in, however, if they already have their CL’s in, it can be done with them in; however, if the photo is blurred after taking it then you will need to have the patient take their CL's out). Wipe off equipment prior to testing.

1. Have the patient remove their glasses (see note about CL's above)

2. Enter patient information into MVC. Search for the patient name; if they have had photos previously they will be in the computer. Ensure that you are pulling up the correct patient by verifying their birth date. Once you find the correct patient click on the patient name, then click Patient images. Select Capture New, which will set up new photos to be taken. If it is a patient that is new or has not had photos done then you click Add patient and enter patient information; PVC account number goes in record number; Last name, First name; DOB goes in comments then click save and close. Click Patient images and then capture new.

3. Have the patient place their chin on the chin rest and adjust the height of the table and chin rest as necessary. The following is a script of what the test will entail: "You will see an orange light first, I need you to focus on the orange light, shortly after you will see a green light, remain focused there, shortly after the green light you will see a flash"

4. Start with the right eye first; move the machine to the left. Once they are focused on the target there will be three dots lined up in a triangle on the pupil and two circles (with the smaller circle inside the bigger circle) Line the smaller circle up with the three dots where they sit within the circle; make sure the pupil is a perfect circle and not split in half. Use the joystick to move in and out and the knob on the joystick to move the circles up and down. Turning the knob to the right will move it down and moving the knob to the left will move it up.

5. Then push the square button by the joystick. This changes the screen. There will be two dots parallel to one another, you want to make sure that the dots are in focus and are in the center of the half boxes off to the right and left sides centrally; make sure the dots are in the center of the half boxes to the best of your ability. (this ensures that the photo will be in focus..this is very important) There will also be a faint line in the center that you need to ensure is lined up properly. The line has to be a complete line and not separated from one another. In order to adjust this, there is a knob on the side of the camera machine that you turn to get the line to come together as a complete line and in focus. This is important for the focus of the photos as well.

6. Once you complete that then there is a button on top of the joystick, press that button to flash the camera and take the photo; Make sure the patient does not blink, by directing them to not blink or watch for the blink on the screen.

7. Move the machine to the right and complete steps 4-6.

8. Once complete you can ask the patient to sit back, and the images will appear on the computer. Click on each photo, assigning it as a right eye or left eye, the x out of screen.

9. When you seat the patient for dfe, pull up the photos in the room, to do so pull up MVC if it is not already and select the patient name on the left hand side and click on patient images and then captured images. This will bring of the history of photos taken of the patient.

How to Record Retinal photography in the Chart

Retinal Photos are recorded in the testing table on the testing tab in the patient’s chart. To add an entry to the chart, click on the three dot ellipsis in the upper left corner of the testing table and select “Add”.

This will open up a separate window where you will enter the type of photos (screening or fundus); B under Eye (standing for both eyes); the date the photos were taken in the ordered, performed, and reviewed boxes in the lower left corner; the initials of the doctor who ordered and reviewed the photos, and the initials of the OA or eyewear stylist who took the photos. After all the information is put into the record, click save in the upper right corner.

This will add the entry into the testing table.

Fundus photo entries will be the exact same except that you will also use the Diagnosis subtable to select the diagnosis which is the reason why the photos were ordered.

Here’s a video on how to add a photo entry

Please complete the Checkpoint Quiz