City Eye Centre is equipped with the latest state-of-the art ophthalmic technology to provide you with the most up-to-date diagnosis and treatment. These instruments and testings include Optical Coherence Tomography (OCT) scanning, ultra wide-field fluorescein angiography, fundus photography, ultrasonography, corneal topography, endothelial mapping, and anterior segment imaging. In particular, our OCT instrument provides ultra-high resolution cross-sectional images through the retina to assist in diagnosis of retinal diseases such as macular degeneration. It is also used to monitor treatment efficacy of intra-vitreal injections such as Eylea, Lucentis or Avastin. Ultra-wide field fundus photography allows 200º of the retina to be imaged in a single capture, and this enables the doctors to diagnose, document and monitor the peripheral retinal conditions in an unprecedented way.

These are some of the diagnostic tests and procedures performed at City Eye Centre:

What is OPTICAL COHERENCE TOMOGRAPHY (OCT)?

Optical Coherence Tomography (OCT) is a new imaging technique used to provide unprecedented high resolution and cross-sectional images of the eye. The OCT scan allows microstructures of the eye to be imaged and shows different colour-coded layers of the retina. It is particularly useful in the diagnosis and management of age-related macular degeneration, diabetic macular oedema, macular hole, epiretinal membrane, vitreo-macular traction syndrome and glaucoma. It has also become a gold standard in monitoring the efficacy of intravitreal anti-VEGF injections (Eylea, Lucentis or Avastin) for age-related macular degeneration and tailoring treatment regime.

An OCT scan is very quick to perform and it is completely painless and non-invasive. Results are available instantaneously and it is a great way for patients to gain a better understanding of their eye condition.

What is OPTOS ULTRA WIDE-FIELD FLUORESCEIN ANGIOGRAPHY?

A Fluorescein Angiogram is a photographic test performed to examine the retina at the back of your eyes using a special camera and taking multiple photographs, coupled with a small injection of a special dye into a vein in your arm. This test provides your Doctor with necessary information about the retina and nearby tissues and is used to diagnose certain eye conditions, determine if treatment is possible, and plan or guide your treatment.

Most patients who undergo a fluorescein angiogram do not experience significant side effects. About one patient in twenty patients may feel a little nauseous or light-headed for about 20 seconds as the dye circulates. The nausea is very rarely enough to cause vomiting. In all cases, the dye eventually gets excreted through the kidneys, so you will pass bright orange/yellow urine during the next 24 hours or more.

Very rarely patients develop a transient itchy rash, which usually lasts for about an hour. If this occurs when you get home, an antihistamine drug will help. If you are concerned about this or have any problems, please contact City Eye Centre or your GP. Severe allergic reactions such as asthma and anaphylaxis are very rare.

Heavy use of the injected arm should be avoided for a few hours following the angiogram. Your vision will be blurry from the flash for about 10 minutes and from the drops for several hours but should clear progressively.

What is VISANTE ANTERIOR SEGMENT OCT?

This latest technology combines the power of optical coherence tomography (OCT) with Placido disk images to enable analysis and imaging of the cornea and anterior segment in an unprecedented fashion. The information gained is extremely valuable in assessing the cornea prior to and after surgery, particularly for lamellar corneal grafting as well as insights into the angle and iris, aiding the diagnosis and management of complex glaucoma. Conditions benefiting from this advanced equipment include keratoconus, corneal scarring, narrow-angle glaucoma, plateau iris syndrome and anterior segment dysgenesis.

 

What is SPECULAR MICROSCOPY?

The endothelium is a single layer of cells on the inner surface of the cornea. It specifically functions to maintain the clarity of the cornea. Diseases of the endothelium causes swelling of the cornea resulting in opacity, loss of vision and breakdown of the eye surface resulting in ulceration and scarring.

A way of monitoring the structure of the endothelium is the specular microscope. This specialised piece of equipment is able to assess the size, shape and density of the cells as well as identifying any abnormal structures. Important diseases of the endothelium include Fuch’s endothelial dystrophy, iridocorneal endothelial syndrome (ICE), contact lenses, posterior polymorphous dystrophy and loss due to previous surgery or trauma. It is also an important monitoring tool post corneal transplantation.

 

Normal specular microscopy readout.

What is INDOCYANINE GREEN (ICG) ANGIOGRAPHY?

Indocyanine green angiography (ICG) is a similar procedure to fluorescein angiography. It however involves a different diagnostic dye that circulates through the deeper ocular circulation and allows the choroid layer of the eye to be imaged. ICG angiography is often used in conjunction with fluorescein angiography and is particularly useful for patients with polypoidal choroidopathy (a variant of macular degeneration)

Similar to fluorescein angiography, ICG angiography involves a small injection of a special diagnostic dye. Photographs of the retina and the blood vessels are then taken as the dye circulates through the blood stream. This test allows a detailed evaluation of any blockage, leakage of dye, or areas of ischaemia (poor circulation) in the retina and is important for the Doctors to diagnose or monitor your eye condition.

The procedure usually takes about half an hour to complete. The retina is photographed with a specialized digital camera as the dye travels through the retinal circulation. Bright flashes of light from the camera will be experienced. After having a ICG angiogram, we advise that you do not drive home yourself home after the appointment and you are accompanied by a family member or friend.

The risks associated with injection of ICG are low and most patients do not experience any significant side-effects. In rare cases, ICG can cause nausea and allergic reactions. As ICG dye contains iodine, this procedure is contraindicated in individuals with an allergy to iodine, shellfish, or cough mixture, betadine or other iodine contrast agents. Please inform the Doctors of any allergies you have and in particular any known or suspected iodine allergy.

What is FUNDUS PHOTOGRAPHY?

A special camera is used to take photos of the front or the back of the eye. We also use the latest Optos ultra wide-field camera to take 200º image of the retina. Fundus photography is a useful way of documenting the appearance of your eye condition at the time of your consultation and keeping a permanent record. It is also an effective method of monitoring any changes in the condition at future follow-up visits.

The procedure only takes a few minutes and is completely painless and non-invasive. Bright flashes of light will be experienced as the pictures are being taken.

The Optos camera we use to take photos of your eyes is a new technological innovation. It allows 80% of your retina to be imaged in one single capture, allowing Doctors to better diagnose and monitor your condition.

What is A-SCAN ULTRASOUND/IOL MASTER?

An A-scan ultrasound or an IOL Master is used to provide accurate measurement of intraocular lens implant for cataract surgery. Ultrasonic waves are used to measure dimensions of the eye and calculate the required.lens power to help you achieve clear vision after your surgery.

What is B-SCAN ULTRASOUND?

B-scan ultrasonography is commonly used to provide a cross-sectional image of the internal structures of the eye. It is often used to measure tumours, or to detect retinal or choroidal detachment. It is also used when the view of the retina is obscured and can not be examined clearly, such as in cases of vitreous haemorrhage, dense cataract, or in trauma patients. The technique is very quick to perform, non-invasive, and completely safe.