Article Date: 12/1/2012

Street Smarts
Street Smarts

Tis the Season: Ophthalmic Toys

Better patient care and increased revenue are nice but new equipment can also revitalize your staff and boost your enthusiasm.


Dr. Beck, who highly recommends enjoying new toys, is a 1993 graduate of the Pennsylvania College of Optometry. E-mail him at

By Dan Beck, OD Leland, N.C.

WITH SO MANY ophthalmic devices available, deciding which ones best fit your practice needs can be nerve-racking. Sales reps go to great lengths to convince you that their product will increase revenue, which sounds great until you hear the price. That said, some purchases are worth the investment, and while generating income from new technology is a great reason to make a purchase, don’t forget that new toys are just plain fun.

Optomap Readings

I’d seen many Optos images in journals and at CE conferences over the years, but the wow factor always wore off quickly because they weren't images of MY patients’ retinas. This year, our practice acquired an Optos 200Dx. The ability to show my patients the ultrawidefield view of the backs of their eyes is truly a professional thrill.

In one case, I had an 8-year-old female patient with no visual complaints. A standard retinal photo showed no signs of disease, but because she didn’t cooperate during the dilated fundus exam, I asked our tech to acquire Optos images. Just beyond the nasal limits of the standard retinal photo, we saw a large, 4-disc diameter tumor.

When she returned from the prestigious eye institution we’d referred her to, she and her mother were smiling from ear to ear. The tumor was benign and didn’t require surgery. Seeing them so happy and relieved was satisfying for me.

Optical Coherence Tomography

Without a doubt, the instruments that provide the coolest bells and whistles are OCT machines. The ability to acquire and manipulate microscopic images of the retinal layers and nerve fiber layer seemed like science fiction 20 years ago. Today, OCT is priceless in many practices. Admittedly, this advanced technology is more difficult to explain to patients. But once they get it, I’d argue there’s no other machine that impresses like an OCT.


I’m sure many readers are thinking that most new toys are too cost-prohibitive for their practices. While it’s true that a certain level of income must be generated to justify the purchase of most instruments, starting small can be fun and profitable, too.

Adding a pachymeter, for example, immediately raises the level of care for your glaucoma patients and suspects, and most pachymeters can be had for a few thousand dollars.

I once had a patient who’d been prescribed glaucoma medication for several years by another doctor. His cupping was .2OV/.20H OU. Visual fields, gonioscopy and OCT findings were normal. His IOPs were 15 OU but his pachymetry results were 642 and 639. I told him to stop taking the glaucoma meds and return in a month. At his 1-month follow-up, his IOPs were 21 OU but taking his very thick corneas into account, his true pressures were around 16. It was rewarding when I explained that he didn’t have glaucoma, and he was thrilled about not needing the drops anymore, though we continue to monitor him.

Sage Advice

When I was about to enter college, my father gave me some great advice. He said, “nothing in life is worse than going to a job every day that you hate. Study for a career you’ll really love and don’t be afraid of change.” We’re all frustrated and worn out at times, but keeping things fresh is one of the best ways to make work fun. And adding new equipment is one way to keep your job fresh and fun, and hopefully add to your bottom line as well. nOD

Optometric Management, Issue: December 2012