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Optos
Optos
Clinical Pearls
An Optos is a high- definition image of the entire retina (OCTs take an image of very small areas). It is a literal photograph that will reach in all the hard to see peripheral areas of the retina.
Properly positioning the patient's head is everything when using this machine!! In order to get the patient's eye close enough into the hole for an image, their head must be turned to either the right or the left. Never have them put their head straight into the machine, they will never be able to get close enough for a good image.
To do OD, have the patient turn their head to the left so their nose is to the left side of the opening, and then put their right eye into the center of the opening. Explain to them it is like looking into the peephole of a door (they usually understand after you explain it like this). Have them turn their head opposite to get OS
Don't be afraid to gently move a patients head manually to get them into the correct position, just please ask their permission before touching them with your hands (some patients will get angry!)
Image of OD
The white disc in the image is the optic nerve
Remember, the optic nerve is ALWAYS closer to the nose when looking into the eye
The macula is the darker area to the left of the optic nerve
Another image of OD
Or is it????
We usually also take Optos images on the autofluorescence setting (AKA: FAF, AF, or simply called black and white photos)
The AF images highlight lots of things that we would not be able to see clearly on the color photos, such as fluid accumulation (edema)
Check the diagnostic slip to see if the provider wants this as well (ST always just wants only the color)
This is what panretinal photocoagulation (PRP) looks like in a patient with proliferative diabetic retinopathy
PRP uses an Argon laser to seal bleeding vessels shut.
This is a detached retina!
This is a gas bubble from a Pneumatic Retinopexy (surgery for a detached retina)
This is a fluorescein angiography
We inject fluorescein dye into a patient's veins and see if it leaks out of the vessels
Under normal circumstances, the dye should stay within the retinal vessels
This is Wet AMD
Notice the accumulation of the dye outside of the vessels
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