This article is more than 5 years old. Information may no longer be current.
Routine fundus photos for healthy patients
Click Here to Manage Email Alerts
How often do we wish we had a photo of what a patient's fundus looked like 5 or more years ago? In my own practice, this question comes up quite frequently as I look at a little RPE irregularity in the macula or perhaps an optic disc whose neuroretinal rim looks a little thin. Is this the beginning of a progressive disease state or an old finding that just isn't part of the patient's known history?
To avoid this situation in the future, my practice at Harvard Eye Associates in southern California (www.harvardeye.com) has for 2 years offered fundus photography to routine patients who see our doctors for primary care in the office. We provide each patient a form that explains the potential future value of these photos and offer to take them for a nominal fee that covers our costs; neither medical nor vision insurance carriers cover the cost of fundus photography in the absence of a qualifying diagnosis and medical necessity. As a courtesy, we print an extra copy of the photos for patients to keep in their own records in the event that they move out of state or change doctors.
In the 2 years since we have offered this service, it has helped us identify a small number of changes in a few patients' optic nerve appearance. In future years, we expect these "old photos" will be instrumental in early detection of glaucomatous optic atrophy and perhaps macular degeneration as well. In many, many cases it has already served as meaningful reassurance to patients (and doctors) that all is well and unchanged from their previous exam.
Readers are invited to comment on whether your practice offers a similar service and how you have (or haven't) found it to be useful ancillary information.
Get more expert perspective from Dr. Hovanesian live at Hawaiian Eye 2010, to be held January 17-22, 2010 at the Grand Hyatt Kauai. Learn more at OSNHawaiianEye.com.