• A wide-angle, “bird’s eye” view of around 200 degrees or over 80 percent of the retina in most patients. “The whole is greater than the sum of the parts.” With UWF you don’t get the retina in piecemeal; you get the whole bolt of cloth.
I view my Optos as an extension and enhancement (not a replacement) of indirect ophthalmoscopy. Sometimes when I view a patient’s image prior to the fundus exam, I’m better able to target my ophthalmoscopy toward areas of interest.
• Better penetration of media opacities with Optos’s laser scanning than with the white light of typical fundus photography, even through small pupils. Plus, with poor dilators and uncooperative and/or photophobic patients, it’s very common to get a better view of the retina than with BIO or precorneal lenses.
• I see more choroidal nevi with Optos. I have a hard time with this because I’m deuteranomalous, and I think the bright light of the slit lamp and BIO washes out the contrast so that I have a harder time picking up the subtle gray of nevi.
• Red and green filters allow separate viewing of the choroidal and retinal layers. Fundus autofluorescence (FAF) highlights lipofuscin and subtle AMD-associated pigment changes that may be difficult to appreciate with traditional ophthalmoscopy.
UWF is an excellent way to screen for diabetic retinopathy, and when combined with fluorescein angiography, it can highlight peripheral diabetic lesions which might go unnoticed with traditional ophthalmoscopy.1
• The “Fly-Through” feature is just plain cool. Turning it this way and that makes me feel like Tom Cruise manipulating his gestural interface in Minority Report (see video).