Special Testing

To provide diagnostic and therapeutic management of ocular disease and related systemic disease, UEC employs sophisticated diagnostic tools, state-of-the-art procedures and teams of health professionals with years of experience in the treatment of specific classes of complex eye and vision abnormalities. These interdisciplinary teams may include optometrists who have completed residency programs in ocular disease or hospital-based practice, attending ophthalmologists with clinical expertise in specialty areas, licensed nurse practitioners and social workers.

We Provide Care In:

: The Cataract Service provides total care of patients with cataracts including preoperative, surgical and postoperative management or we can provide shared (co-) management.

: The Cornea Service provides diagnostic and treatment options for patients with challenging conditions affecting the anterior part of the eye.

Dry Eye Clinic: This unit specializes in the diagnosis and management of ocular surface disease.  Extensive diagnostic tests are performed for patients with dry-eye disease and a variety of treatment options are made available.

: The Glaucoma Service, part of the Glaucoma Institute, provides complete diagnostic and treatment services for patients with glaucoma.

Hereditary Eye Disease Clinic: This unit specializes in the diagnosis and management of patients with hereditary retinal and optic-nerve diseases. The clinic provides the most state-of-the-art in diagnostic instrumentation and testing for patients with inherited eye diseases.

: The Neuro-Ocular Service provides management of conditions affecting the optic nerve and visual pathway. A board-certified neurologist is available for consultation.

: The Ocular-Plastic Service provides diagnostic and treatment services for conditions affecting the lids and orbit.

: The Retina Service provides complete diagnostic and treatment services for conditions of the vitreous and retina.

Electrodiagnostic Service
: The Electrodiagnostic Service provides VEP and ERG with the latest diagnostic equipment.

Imaging Service
: The Imaging Service provides diagnostic imaging for all types of ocular conditions with the latest imaging devices.

Outpatient Surgery
: The Outpatient Surgery Center is approved for the provision of surgical procedures requiring local anesthesia.

Our special tests in our Imaging Center include:

Structural Testing

: The Heidelberg Retinal Tomographer 3 uses confocal laser scanning technology to measure retinal contour, especially of the retinal nerve fiber layer (RNFL) as it converges at the optic nerve head. Changes in the optic nerve head and nerve fiber layer contour over time can be monitored.

: The GDx (Glaucoma Diagnosis) VCC (Variable Corneal Compensation) uses scanning laser polarimetry and the birefringent properties of the RFNL to assess RNFL thickness and check for changes (thinning or thickening) over time.

Stratus OCT 3
: Optical Coherence Tomography makes use of interferometry and optical reflectivity to assess and quantify the thickness and relative position of retinal tissue. The clinician is provided with a topographical map of the retinal tissue imaged. Commonly, macular edema and retinal nerve fiber layer thinning are quantified using this device.

Spectral Domain OCT
: While making use of the same principles as the Stratus OCT 3, the Spectral Domain OCT takes many more readings per second and provides the clinician with a 3-dimensional topographical view of the retinal tissue of concern at a much higher resolution than previous versions of OCT.

Optical Biometry IOL Master
: Using the principle of laser interferometry, this device records a patient’s axial length, anterior chamber depth, and corneal surface curvature. These measurements are then incorporated as variables into a program that calculates the correct intraocular lens power to be inserted after cataract extraction.

Corneal Topography (Orbscan)
: This device optically maps a patient’s entire corneal surface with respect to thickness, surface power and contour. The contour and eccentricity of a patient’s anterior and posterior corneal surfaces can be assessed with this device. Common indications include determining a patient’s eligibility for refractive surgery and aiding in the diagnosis and management of corneal diseases, such as keratoconus.

: A Pachymeter uses the principle of ultrasound to determine a patient’s corneal thickness. A common indication for this procedure is determining a patient’s central corneal thickness as part of a glaucoma evaluation.

Ultrasound Biomicroscopy
: The Ultrasound Biomicroscope (UBM) uses the principle of ultrasound to acoustically assess the characteristics and relative positions of the various structures of the anterior segment. In particular, the angle can be assessed as open, closed, or occludable.

A-and B-scan Ultrasonography
: A-Scan Ultrasonography uses the variable speed of sound through the different media of the eye to allow the clinician to assess the axial length. B-Scan Ultrasonography uses the same principles to allow the clinician to assess the various structures of the globe and posterior segment. Commonly, retinal detachments and lesions suspected to be elevated are assessed with this technique.

Fluorescein Angiography
: This procedure involves injecting a small bolus of fluorescein (a vegetable dye derivative) into a patient’s arm and photodocumenting, over time, the flow of the fluorescein through the choroidal and retinal vasculature. An exciter filter and a barrier filter are used to allow for the fluorescein to fluoresce and  block out all other wavelengths. Macular edema and vascular abnormalities, such as neovascularization, are commonly assessed by fluorescein angiography.

Digital Anterior and Posterior Photography
: Photodocumentation has become part of the standard of care for several ocular conditions. Diseases and abnormalities of the cornea, angle, lens, and retina are documented by means of photography throughout our clinics.

Functional Testing

Standard Automated Perimetry
: Automated perimetry involves systematically quantifying a patient’s visual field by showing to an illuminated target against a defined background and recording the patient’s response. The target is shown at different intensities and positions in order to plot the extent of the patient’s visual field, as well as to define the patient’s threshold at each test position. Ocular and neurological conditions which can affect the visual field are commonly assessed in this way.

Frequency Doubling Technology Perimetry (FDT)
: This technique for assessing a patient’s visual field involves the use of a target best described as a sine wave grating of a low spatial frequency that flickers at a high temporal frequency. This perimetric technique tests the magnocellular pathway because the target has a defined temporal frequency. This pathway may be damaged first in certain ocular and neurological conditions which affect the visual field.

: Visually Evoked Potentials are cortical responses to visual stimuli, usually flickering lights, which are measured by means of electroencephalography focused on the occipital cortex. Conditions having the capacity to affect these potentials, such as stroke and demyelinating disease, can be assessed in this way. Cortical function in non-communicating patients can also be assessed with this technique.

: Electroretinography is a technique used to assess the function of the neural cells of the retina, especially the photoreceptors, be means of quantifying their electric responses to visual stimuli. The procedure is done under photopic and scotopic conditions and is commonly used to aid in the diagnosis of and monitor for progression in many retinal degenerations and dystrophies, such as retinitis pigmentosa and cone dystrophies.

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