EyePACS Learning Community October 24, 2011 Photographers’ Corner:New Approaches to Old Problems Harry Green, OD, PhD Nancy Nguyen, OD Jorge Cuadros, OD, PhD Barbara Shayesteh UCB Digital Health at 510-642-5456
Items to discuss Changes to the photography certification process New Compact Flash adapters Optimizing External Photos Review of retinal landmarks Small Pupil Artifacts – avoiding the dreaded shadow Photograph quality before and after the decision to dilate Awards
Photography Certification New certification website: http://photographer.eyepacs.com Separate from the main www.eyepacs.org site where actual patient cases are uploaded Two parts: Practice Case Module Test Questions Module To start a new photographer certification: Accounts to the certification site are by email invitation Email email@example.com with photographer’s full name and email address
Practice Case Module Capture retinal photos of non-patients (i.e., other clinic staff) and upload photos on a case by case basis onto the EyePACS photographer certification website Cases are graded for: Good focus No artifacts Correct view for all 8 photos (fixation target is moved appropriately) Start by submitting 3-5 full cases These will be evaluated and feedback provided If not of sufficient quality, more test cases will be requested If of good, consistent quality, can then proceed to Test Questions
Test Questions Module Consists of 10 multiple choice questions that cover the basics of effective Digital Retinal Imaging To pass the test, candidates must correctly answer all questions. If a candidate fails the test, he or she is advised to review the Test Review page that provides the correct answer and explanation for each question the candidate missed. The candidate will then be given the option of retaking the test.
Compact Flash to MicroSD Adapters The Why Bending the pins in the compact flash reader inside the camera back
Compact Flash to MicroSD Adapters The Why Bending the pins in the compact flash reader inside the camera back The How MicroSD to Compact Flash adapter MicroSD card very small
Compact Flash to MicroSD Adapters The Why Bending the pins in the compact flash reader inside the camera back The How MicroSD to Compact Flash adapter MicroSD card very small The When Ready to ship
Tips for External Photos What is important for the external photo: Pupil margin in sharp focus Iris details in sharp focus The eye should take up 2/3 of the screen as pictured Bright red reflex to helps indicate presence of cataracts CR-Dgi: pull tab all the way “out” for “out”side photos CR-1: pull tab “down and out” for “out”side photos
Retinal Landmarks To Look For Vessels Optic Nerve Macula
Alignment and Gaze DirectionInternal Field 1 Internal Field 2 Internal Field 3
“The Shadow” – Small Pupil Artifacts3 MUST HAVE elements 1. Optic Nerve visible and in adequate focus 2. 50% of the retinal area visible and in adequate focus 3. MACULA
“The Shadow” – Small Pupil Artifacts External Internal 1 Internal 2 Internal 3
The Shadow – Small Pupil ArtifactsSolutions: Make sure the room is completely dark Wait longer between photos (30-60sec) Small pupil “s.p.” knob Ask patient to wiggle their toes Increase flash 911 Dilation Shadow Overall dark + shadow
September 2011 WinnersVolume East Valley Community HC 198 Golden Valley HC - Modesto 100 Golden Valley HC - Merced 92Growth compared to August 2011 Lifelong Medical Care showed the highest increase over July’s screenings.