Routine Fundus Photos
July 22, 2009DrHovanesian No Comments »Routine Fundus Photos for Healthy Patients
How often do we wish we had a photo of what a patient’s fundus looked like five 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 two years offered fundus photography to routine patients who see our doctors us 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 two 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 an 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.
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