1. 1. EyePACS Learning CommunityOctober 24, 2011Photographers 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
2. 2. Items to discuss Changes to the photography certificationprocess New Compact Flash adapters Optimizing External Photos Review of retinal landmarks Small Pupil Artifacts avoiding the dreadedshadow Photograph quality before and after the decisionto dilate Awards
3. 3. 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 ucb.digital.health@berkeley.edu with photographers full name and email address
4. 4. Practice Case Module Capture retinal photos of non-patients (i.e., other clinicstaff) and upload photos on a case by case basis ontothe 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
5. 5. Test Questions Module Consists of 10 multiple choice questions that cover thebasics of effective Digital Retinal Imaging To pass the test, candidates must correctly answer allquestions. If a candidate fails the test, he or she is advised toreview the Test Review page that provides the correctanswer and explanation for each question thecandidate missed. The candidate will then be given the option of retakingthe test.
6. 6. Compact Flash to MicroSD Adapters The WhyBending the pins in the compact flash reader inside the camera back
7. 7. Compact Flash to MicroSD Adapters The WhyBending the pins in the compact flash reader inside the camera back The HowMicroSD to Compact Flash adapterMicroSD card very small
8. 8. Compact Flash to MicroSD Adapters
9. 9. Compact Flash to MicroSD Adapters The WhyBending the pins in the compact flash reader inside the camera back The HowMicroSD to Compact Flash adapterMicroSD card very small The WhenReady to ship
10. 10. 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 2/3of the screen as pictured Bright red reflex to helps indicate presence of cataracts CR-Dgi: pull tab all the way out for outside photos CR-1: pull tab down and out for outside photos
11. 11. Retinal Landmarks To Look For Vessels Optic NerveMacula
12. 12. Alignment and Gaze DirectionInternal Field 1 Internal Field 2 Internal Field 3
13. 13. The Shadow Small Pupil Artifacts
14. 14. 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 adequatefocus 3. MACULA
15. 15. The Shadow Small Pupil ArtifactsExternalInternal 1 Internal 2 Internal 3
16. 16. The Shadow Small Pupil ArtifactsSolutions:Make sure the room is completely darkWait longer between photos (30-60sec)Small pupil s.p. knobAsk patient to wiggle their toesIncrease flash911DilationShadow Overall dark + shadow
17. 17. Benefits of Dilation
18. 18. September 2011 WinnersVolume East Valley Community HC198 Golden Valley HC - Modesto100 Golden Valley HC - Merced92Growth compared to August 2011 Lifelong Medical Care showed thehighest increase over Julys screenings.