The Cost-Benefit Ratio Applied to Instrumentation

The Cost-Benefit Ratio Applied to Instrumentation


By Joshua Lahiff, OD

When evaluating new instrumentation for your practice, it’s important to begin with the end in mind’the ultimate benefit to you and your patients. Instrumentation can be expensive on the front end, but can pay huge dividends through patient referrals and retention, in addition to billing for the actual test.

Fundus Photography

Speaking from my clinical experience, the best investment we’ve made in instrumentation is our retinal imaging system. The clinical advantages of fundus photography are obvious, but offering patients the ability to see the back of their eye is a huge benefit. When you involve patients in their care, they feel more engaged in their treatment and are more likely to follow your recommendations. In addition, retina-imaging systems can, in some instances, eliminate the need for dilation, which saves time and increases efficiency. This technology has been the best referral source for our practice. I’ve had countless patients say, “I’m sending my husband in tomorrow. I can’t believe you can tell I have diabetes just by looking in my eye”

Flat Screen TV for Acuity and Imaging

LED technology is both inexpensive and impressive. When used with a VGA cord, a flat screen LED television can interface with most computers, allowing you to use it as a second monitor. Intranet within your office can then send fundus photos, visual field results from OCT and educational software onto the big screen in the lane. This will wow your patient and provide him with an enhanced practice experience. There are several acuity systems that will also interface with this technology, allowing you to use your LED television for refraction and visual acuity, thus eliminating the need for equipment you would have to buy and set up. Flat screen TVs are also great entertainment options for patients in the waiting room, such as the bored dilating adult. Powerpoint presentations can be converted into TIFF format and run as internal marketing presentations while patients wait. Remember, it’s small touches like these that can set your practice apart and help improve patient retention.


A must for any clinical setting, an autorefractor saves time and increases efficiency. Most new models provide topography and even wavefront-guided refractions. With wavefront analysis, you can determine if your patients need a different prescription at various times of the day or discover a more accurate fi nding when completing their refraction. It can be a great marketing advantage to advertise that your practice offers wavefront-guided refractions.

Visual Field Analyzer

Having a visual field analyzer is essential for treating glaucoma; matrix versions are smaller and cheaper and still allow you to interface with EHR systems and run threshold visual fields. Combining a visual field analyzer with the rest of your technology allows you to manage most patients, eliminating the need to refer to another OD.


EHR should be at the hub of any modern practice. Federal government incentives are still available to help offset the cost of EHR implementation if they are “meaningfully used.” EHR will also be a springboard for the future of intercommunication between providers in different offices and the patient's primary care physicians. We’re able to electronically print prescriptions and send all of our findings to the optical center, which helps reduce costly errors.


Reimbursement for OCT has decreased, but it’s still an essential instrument for treating macular disease and glaucoma and it amazes patients. Not only does OCT demonstrate how high tech your practice is, it also interfaces with most EHR software. Additionally, OCT scans can be viewed on the TV screens in your exam lane.

Why Buy?

Technology can highlight your practice and set you apart from others in the area. In fact, other optometrists, ophthalmologists and primary care providers refer patients to our Laramie location for “special testing” because they recognize the value of the cutting edge technology we use. Our up-front costs to establish this type of practice will benefit us for years to come. nOD

Dr. Lahiff is a partner at the Cheyenne Vision Clinic, an associate professor at the Illinois College of Optometry and Western University and a clinical instructor for the University of Wyoming family practice residency in Cheyenne. He can be reached at (307) 638-6610.