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Diabetes is an increasingly common health issue, affecting over 38 million Americans, according to the American Diabetes Association. Diabetes can raise the risk of other health concerns, including diabetic retinopathy.
Diabetic retinopathy occurs when excess sugar in the bloodstream damages the blood vessels in the retina. This can lead to vessels swelling, rupturing, and leaking fluid into the surrounding tissue. Vessels may close completely, reducing circulation and creating a risk of scarring. New vessels may develop, but with abnormalities that lead to retinal damage that can cause vision loss.
Anyone who has diabetes may develop diabetic retinopathy, and the risk increases over time. Doctors should check patients with diabetes for signs of diabetic retinopathy every year. If signs appear, they may need more monitoring.
Eye care providers and other health care professionals can offer diabetic retinopathy screenings using various tools. Dilated pupil exams, retinal imaging, and optical coherence tomography are all accurate methods of diagnosing diabetic retinopathy.
Understanding Diabetic Retinopathy Screening Machines
Screening for diabetic retinopathy means looking inside the eye. It checks the retina for signs of blood vessel damage.
Traditional methods, such as dilating pupils and using a slit lamp or ophthalmic microscope, can accomplish this. New methods can take detailed pictures of the retina. These methods include digital retinal imaging and optical coherence tomography. They help in examining the retina closely.
Types of Machines
Several types of machines capture retinal images. They are all reliable tools for identifying signs of diabetic retinopathy and other eye conditions. You can use them in coordination with other vision screening techniques.
Fundus Camera
A fundus camera is a tool that takes a digital picture of the retina and sends it to a computer for review. Eye care providers can choose between tabletop camera models and handheld, portable fundus cameras.
Fundus photography is simple and noninvasive. Patients like that it can be done without dilating the pupils. It takes only a few seconds. The patient looks straight into the fundus camera and holds still for the image capture.
Most fundus cameras have wireless connectivity and send images directly to the patient’s electronic health record. Primary care providers can use fundus cameras to take pictures, which they can then send to telehealth services. Eye care professionals can then evaluate the images.
Optical Coherence Tomography
Optical Coherence Tomography (OCT) is another type of digital retinal imaging. OCT devices are tabletop models that use infrared light to create a cross-sectional eye image. The resulting images present the eye in layers, which allows eye care providers to examine the retina in detail.
OCT screenings typically require pupil dilation, which increases appointment time and decreases patients’ convenience. Once the pupils are dilated, the patient sits in front of the device. They focus on a single point while the machine scans their eyes, which takes only a few seconds.
The OCT device wirelessly transmits images to the patient’s electronic health record for the provider to examine.
Ophthalmic Microscope
Ophthalmic microscopy, colloquially called a slit lamp, is a traditional method of examining the inner structures of the eye. The process requires eye dilation, and there is no image capture of the eye. Instead, the eye care provider has the patient rest their chin on the microscopy device. The provider looks through the other side to gain a magnified view of the eyes to perform real-time examination.
You can perform slit lamp exams in combination with retinal imaging. The physical exam allows the provider to evaluate the eyes and receive patient feedback.
The images provide more information about the eyes and create a record of eye health, which helps providers track changes over time.
The Importance of Image Resolution
Retinal images must be sharp and clear to be valid as a clinical tool. Resolution informs how well providers can identify signs of eye disease or injury from the image. Poor-resolution images that don’t clearly show details, such as blood vessel structure, aren’t useful for identifying eye disease.
Fundus cameras and optical coherence tomography devices effectively capture quality images when users operate them properly. Providers should invest in good equipment and receive training to ensure they take high-resolution images.
Training can be vital for primary care providers offering retinal imaging for teleretinal evaluation. Primary care providers may be unable to do slit-lamp exams, making the images more important. Proper equipment operation ensures higher-resolution images, which makes the screening more effective for the patient.
Consider Ease of Use When Choosing A Screening Machine
When selecting the best diabetic retinopathy screening device, you should consider daily use and quality. Your patients will use the device, and they must understand what is expected of them during the screening.
Tabletop devices have supports for the chin and forehead. These help patients sit comfortably and reach the right position during the screening.
Handheld devices require that a patient sit independently and look at the camera. As counterintuitive as this sounds, handheld devices can benefit individuals with disabilities.
The device can be carried to them and will work in the most comfortable position. You don’t need to ensure that the path to the device is fully wheelchair-accessible, and the patient’s height is not as important.
In addition to being easy for patients to use, the device should be something your staff is comfortable operating. The more efficiently staff can move patients through screening, the less time the next patients will have to wait for the device.
A customer service plan can help when a device has a problem. It guides staff in troubleshooting issues.
Other Features To Consider
You should also consider what features are necessary for your practice’s nature. For example, an eye care specialist with a permanent office may want to buy strong tabletop equipment, which will help screen many patients each day.
A primary or mobile health care provider may want to provide retinal screenings. This could be their only eye care service. A handheld fundus camera is excellent for screening patients. It helps those who may not have access to diabetic retinopathy screening.
Other factors to consider include:
Portability
Home health care providers and providers who work out of multiple sites need equipment that can go with them. In addition to size and weight, you should consider functions like power supply and wireless connectivity. Devices charging via USB ports may be best for charging in a vehicle. WiFi connectivity can be useful for transmitting images to a telehealth platform or linked electronic health record system.
Device-to-device connectivity is also a consideration. Bluetooth lets the device send images to a nearby laptop or phone without needing cellular data or WiFi. This can be particularly important if you treat patients in their homes, which may or may not have WiFi service.
Automation:
OCT devices need to align the scanner with the position of the patient’s eyes. Automating eye tracking ensures that the device captures the necessary images without tedious adjustments and calibrations.
Some retinal imaging devices can use AI to automate image evaluation. The FDA has approved AI tools that can autonomously detect signs of diabetic retinopathy from handheld fundus camera images. However, these tools may not work with all devices.
Integration With Other Systems:
One critical factor in any imaging device is the ease with which images can be transferred to the patient’s electronic health record. Ensure your EHR system works with the imaging device to add images to records easily.
Check for device limitations to send images to a telehealth platform. The administration can provide a list of compatible fundus cameras to ensure easy connectivity.
Which Machine is Right for You?
Consider the comprehensive perspective when deciding which retinal imaging machine is right for your patients and your practice:
- Cost: Tabletop cameras tend to be more costly than portable fundus cameras. However, they can be a smart choice for an eye care practice, mainly if it performs many screenings and needs a durable device.
Handheld fundus cameras cost less. This is great for practices that offer diabetic retinopathy screening in primary care.
- Image quality: Tabletop fundus cameras offer higher resolution images than handheld cameras. This can help clinics that check patients for diabetic retinopathy and other eye problems, like glaucoma and macular degeneration.
Handheld cameras create images good enough for first-line screening. However, patients might need more imaging if needed. OCT devices provide clear images of different layers of the eye, making them an excellent choice for doctors. They can diagnose eye diseases in their offices, so sending patients elsewhere is unnecessary.
- Patient needs: Your equipment should serve the needs of your patient population. Ensure your retinal screening device is set up so patients feel comfortable using it. They should easily understand what to do.
Devices should be easy for staff to use. This way, the process respects patients’ time, and patients won’t have long wait times caused by a backup of screening equipment.
Conclusion
If you are looking for the best retinal imaging equipment for your practice, Nava Ophthalmic is here to help. We have a wide selection of fundus cameras and other vision care equipment. Contact our staff to help you find the right product for your practice!
FAQs
What is the cost of retinal imaging equipment?
The cost of retinal imaging devices depends on what type of equipment you choose. OCT equipment has a higher price point because of the technology involved. Tabletop high-resolution fundus cameras cost more than handheld cameras.
Extra features, such as wide-field retinal imaging and exams not requiring pupil dilation, can raise the device’s cost.
What is the role of AI in retinal imaging?
AI tools are playing a growing role in medicine. AI can be useful for enhancing retinal images for easier evaluation.
The FDA has approved new AI tools that can independently detect signs of diabetic retinopathy. These tools can work with retinal imaging cameras to identify signs of eye disease in retinal images. They use machine learning to analyze images in real-time. If AI detects a possible problem, providers can use that information to refer a patient for further testing.
Does my practice need a fundus camera, an OTC device, or both?
Having both standard and OTC retinal imaging capabilities can benefit your patients. Having different types of imaging helps eye care providers diagnose patients faster. They can do this without sending patients to other offices.
You should have slit-lamp biomicroscopy along with retinal imaging devices. Slit-lamp exams are a key part of complete eye exams.
How can primary care providers and other health services offer diabetic retinopathy screening?
Primary care providers and other health services can use portable eye screening devices. They can also use telehealth platforms to diagnose diabetic retinopathy using AI.
Providers can use a camera to take pictures of the retina and send them to a cloud-based platform.
Eye care professionals will then evaluate the images. If abnormal findings are found, they can recommend additional screening. These services can help low-income or rural communities where patients cannot access eye care specialists.
John Berdahl, MD
Meet Dr. Berdahl
Dr. Berdahl is most motivated by the trust his patients place in him during their moments of vulnerability.
That patient trust has, first and foremost, driven him to become an accomplished surgeon. However, as he meets patient needs and learns more about the problems they face, he’s had several opportunities to stretch his skills as an inventor and problem-solver. He co-invented the MKO melt, an innovation used in our Sioux Falls clinic that provides sedation during cataract surgery without the use of an IV or opioids, and developed Interfeen, a rare disease drug that helps with ocular conditions. He created astigmatismfix.com, a resource that has helped tens of thousands of surgeons eliminate residual astigmatism after cataract surgery, and he co-founded ExpertOpinion.MD, a site where patients can request medical opinions from authentic world experts. He also is the founder of Balance Ophthalmics, the first non-surgical, non-pharmacologic way to lower eye pressure for glaucoma treatment, which was FDA approved in 2024.
Interests & Added Expertise
Dr. Berdahl is equipped to employ the most innovative and tested techniques available to effectively treat most diseases of the anterior segment (front part of the eye). He is exceptionally skilled at diagnosing the best treatment for varying stages of glaucoma, corneal diseases, and cataracts. He is also a meticulous refractive surgeon.
To advance the technologies available to our patients, Dr. Berdahl collaborates with numerous ophthalmology companies as a consultant. However, to minimize potential bias, all consulting fees are donated to charity.
Education
- Hills-Beaver Creek High School, Hills, MN
- Augustana College, Sioux Falls, SD
- Mayo Medical School, Rochester, MN
- Mayo Clinic Internship, Scottsdale, AZ
- Duke University, Durham, NC
- Minnesota Eye Consultants Fellowship (Minneapolis, MN)