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Posted on 08-09-2016

Often I will begin a blog article with a question that patients frequently ask me, but this time I have a question for you.  Should I continue to offer patients beneficial technologies like baseline digital retinal photography or ocular coherence tomography (OCT) - the latter is like an MRI of the deeper layers of the retina - even though these tests are not yet covered by one's vision benefits (e.g. VSP, Eyemed, MESC, Davis Vision, Medicare, etc.).

Let's look at retinal photography.  First, no, IT DOES NOT TAKE THE PLACE OF A THOROUGH DILATED RETINAL EXAM.  I have read about some doctors who tell patients that they won't need their eyes dilated if photographs are taken... this is simply not true.  However, two very important benefits of retinal photography are the following.  (1) Occasionally, while reviewing a sharp, detailed photograph of the retina, the doctor may see subtle signs of early anomalies or disease that might otherwise go undetected during a "well vision" retinal exam.  (2) If and/or when something remarkable (out of the ordinary) is detected, it can be beneficial to have a "baseline photograph" to refer back to for comparison.

To explain further... if or when a doctor sees signs of diseases like macular degeneration, glaucoma, diabetic retinopathy, hypertensive retinopathy, or some other anomaly, retinal photography can be a significantly valuable tool in monitoring changes in the status of the disease.  It can also be extremely important in determining if treatment is working as expected, or if on-going treatment needs to be altered.

There are a good number of major medical insurance plans that cover the cost of these tests when they are ordered in connection with a disease that has an insurance code. However, a "baseline" retinal photograph in the absence of remarkable findings is, unfortunately, not a covered procedure.  So... it's a good idea to have the test done, it's not cost prohibitive, and the question is - should it be offered to every patient?

Sometimes I wonder how we got along before we had retinal photography.  It is almost like wondering how we got along before photocopy machines, computers (instead of typewriters), fax machines or cell phones!  When I am asked, "How did you do eye exams before having all this technologically advanced equipment?"  My answer is simple, "Not as well."

The next time you visit my office and you are told about retinal photography, I hope you will understand that it's not a MUST for you to have, but it really is in your best interest.  If you say, "No thanks," no one will badger you - promise.  It is your choice.  It is important for you to be an integral part of your health care team.

As usual, I am interested in your comments.  Please write to me at info@drcharm.com. If you'd prefer, I wouldn't mind learning how to become more proficient using Facebook and/or the Anaheim Hills Buzz.  We could give those a try too.

Be well,
Dr. Harry J. Charm, Optometrist

Anaheim Hills Family Optometry
6200 E. Canyon Rim. Rd., Suite 101
Anaheim Hills, CA 92807
(714) 998-2020

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