Our Equipment

 

Examining inside your eye-

Widefield Optos examination:

This machine will magnify any part of the photograph of the back of your eye (retina). Dr Dunlop will show you the important macula area, the blood vessels and the optic nerve. It is the magnification of any area that helps identify any haemorrhages in diabetes, drusen in age-related macular degeneration and changes in blood vessels eg blockages or emboli. The optic nerve may have changes related to glaucoma, or myopia, or even longstanding congenital developmental changes. Usually no dilating drops are needed for this examination.

 

 

Cataract Assessment –

IOL Master:

This is used to calculate the intraocular lens (implant) which replaces your own hazy lens (cataract) removed at your cataract operation. The laser safely measures the lens of your eye (axial length), the depth and the curvature of the cornea. Complex formulae give a range of options.

 

YAG laser:

This may be used after cataract surgery. At surgery the hazy cataract is sucked out of the bag and a clear intraocular lens (implant) is put into the bag. The bag can become hazy or crinkly. This is occurs in some adults and all children following cataract extraction. The YAG laser dissolves an opening in the bag so the view is clearer again.

 

OCT:

This is used to check your macula if there are any concerns before/after your cataract operation.

It is also used to check the optic nerve if you have had glaucoma or the intraocular (eye) pressure had been a concern before or after your cataract operation.

 

Humphrey Visual Field Test:

This is used to check the peripheral (side) vision if you have had glaucoma or the intraocular (eye) pressure has been a concern before or after your cataract operation

 

Intraocular Pressure Measurement:

Applanation tonometry – anaesthetic drop and blue light is used

Eyecare tonometry –no anaesthetic is needed and a disposable single use probe is used.

 

Glaucoma Assessment -

Intraocular Pressure Measurement:

Applanation tonometry – anaesthetic drop and blue light used. This is the gold standard and is used to confirm a measurement.

Eyecare tonometry –no anaesthetic is needed. This is useful in babies, children, apprehensive adults and especially when a false high eye pressure may be related to straining during testing.

Gonioscopy:

A small mirror is used to check the angle/drain of the eye. Anaesthetic drops are use before holding the eyelashes and eyelids with the gonioscopy lens. The intraocular (eye) pressure can be raised intermittently if the angle/drain is narrow. The result may suggest a different type of treatment eg laser

 

Humphrey Visual Field Test:

This is used to check the peripheral (side) vision. It is the gold standard of visual field tests. It is an international test with complex software. You need to keep your eye still and press a button when a light comes on in your side vision. It measures the function of the eye. It is helpful if you have a family history of glaucoma, your eye shows signs of possible glaucoma or the intraocular (eye) pressure has been a concern. Software is available to statistically compare if there has been a deterioration in the visual field. Subtle changes may be reversed with a change in your treatment.

 

FDT (frequency doubling technology test).

This is an Australian idea now commercialised. It tests a different part of the vision pathway to check for early glaucoma changes.

It tests the peripheral (side) vision with a grating rather than a dot of light. Sometimes this test is used when the Humphrey test is difficult to interpret.

 

 

OCT RNFL (Retinal Nerve Fibre Layer) Test:

This is a scanning laser. It is used to check the structure of your eye while you just look into the machine. It is helpful if you have suspicious changes in your eye that may be early glaucoma. It is also helpful if the intraocular (eye) pressure has been a concern.  It compares your measurements to the expected nerve thickness for your age group. Software is available to compare previous results,  checking if there has been any deterioration in the structure of the eye. A change in your treatment may be required.
 

OCT CCT (central corneal thickness) of the Cornea:

This is a measurement of the centre of the front (window) of the eye. Studies have shown if the cornea is thinner, then the optic nerve is more sensitive to eye pressure. This means the eye should be checked for glaucoma more frequently, and if there are early changes, treatment started or altered.


Pachymetry.

This is a handheld instrument to measure the corneal thickness.

 

Laser Treatment for Glaucoma.

SLT (selective laser trabeculotomy).

This laser is a bright light which helps the cells in the angle/drain of the eye to function better. It is useful to reduce the number of drops needed to control glaucoma. However more laser may be required over time. It is useful in open angle glaucoma.

PI (peripheral iridotomy).

This laser is a bright light which dissolves a small opening in the iris/coloured part of the eye. This allows more fluid to drain out in narrow angle glaucoma. It is designed to prevent total blockage of the angle and severe high pressure glaucoma.

Retinal Camera.

This is useful for documenting the optic nerve, macula, blood vessels and fundal features.

Fluorescein Angiography

Dr Anthony Dunlop investigates and treats retinal and macular diseases with this test.

 

Colour Vision Assessment.

Colour vision requires special lighting to accurately measure small differences in red, green and blue vision. Colour can be altered by optic nerve problems and drugs eg plaquenil. Boys, more than girls, may inherit red/green colour defects. We use,

Ishihara plates – basic red/green test

Pseudoisochromatic HRR plates – more detailed analysis of red, green and blue

 

Binocular Vision Tests.

Assessment of vision of each eye monocularly or both eyes binocularly depends on the age of the patient and how tired they are. We use many different strategies to confirm the measurements which vary during the day, at distance or near and in different lighting. We use,

Prism bars

Synoptophore

Hess chart test