By Nicholas Altuneg
Optometrist
Kincumber, NSW

When considering any new equipment purchase the first questions that enter my mind are:

1. Will the new equipment cause me to better diagnose or manage my patients’ needs?
2. How many patients a week would benefit from the new procedure?
3. If this is a significant number, will these patients value and respect the additional service?
4. Would patients be prepared to pay a reasonable fee for this additional service, which will help subsidize my lease repayments on this equipment?
5. Will this new procedure save me or cost me time in consultation?

Weighing all of these factors together, I felt I could answer yes to most of the questions with regards to the purchase of a Slit Lamp Camera (SLC). Even if I couldn’t recover all of the lease repayments, I would still have acquired improved ability to diagnose and monitor anterior eye changes over time as well as a tool to provide an educational benefit to my patients. I would also have a new toy – its always fun to play with new toys (a lot more fun then saying “better 1 or 2’ all day long) – not to mention the “wow” which invariably leads to better patient retention and positive referrals.

I talked to Lee Pepper at Optical Manufacturers and he organized delivery of a Topcon DC-3 Slit Lamp Camera and I upgraded my Slit Lamp to a Topcon SL-D4 to house the unit. My initial thoughts were that I would use the SLC mainly for contact lens aftercare appointments where I observed keratitis or contact lens changes such as protein deposition, irregular contact lens edges, etc. Over time I have realized that this vision was too limited.

I have used this technology increasingly over time with anterior eye pathology. Consequently, I feel much more confident with the accuracy of my diagnosis of anterior eye changes occurring over time in such conditions as pterygium, iris naevi, blepharitis, uveitis and eyelid lumps and bumps – such as chalazion, sebaceous cyst or papilloma. I have also been showing patients what has happened to their eye when they have ingrown eyelashes or corneal damage from a fingernail, foreign body or contact lenses. The camera also allows you to document and allay fears related to subconjunctival haemorrhages.

There are more conditions that I haven’t even touched on here where the SLC can be used – don’t be afraid to think outside the box!

The SLC has been well received by my patients. I am finding that they are impressed by the technology and are happy to have an explanation of anterior eye disease that they can understand and relate to. The procedure only takes a few minutes and I find I spend more time talking to the patient than doing the test. The consultation becomes more interactive as people start asking more questions, and this is great for rapport building and patient loyalty. The better the patients understanding of their condition, the better I find their compliance with disease management recommendations and the better their compliance with recommended follow up visits.

I have found Optical Manufacturers to be very helpful with any questions that I have had in terms of hardware and software setup and registration. They have also been great with instruction in the use of the Topcon equipment and with troubleshooting ways to better perform the procedure.

I had some doubts initially about purchasing a Slit Lamp Camera but now that I have been using it so successfully I am very satisfied with my decision.