• Scanning Laser Optical Coherence Tomography (OCT)- this is a diagnostic tool that allows for more detailed viewing of certain tissues in the eye. This is a type of scan that is similar to ultrasound that takes a picture of the eye and scans the deeper layers resulting in images previously only viewed through more invasive techniques. The OCT also gives a report with statistical data that can be monitored through repeat testing over time allowing the doctor to catch damage and progression much earlier than previously possible.
    • Anterior Segment OCT- this is a scan of the cornea and the angle (the part of the eye responsible for draining aqueous fluid out of the eye).
      • Cornea scanning may be ordered when monitoring corneal edema (swelling), certain types of corneal dystrophies and degenerations, and as part of the testing required for glaucoma care.
      • Angle evaluation is necessary for glaucoma management. The angle can be viewed during a test called Gonioscopy. The angle can also be imaged in an anterior segment OCT.
    • Optic Nerve OCT- scanning the optic nerve has drastically improved glaucoma management and allowed eye doctors to diagnose glaucoma earlier and manage glaucoma more accurately. The optic nerve can also be affected by conditions that cause swelling, elevation, and atrophy. These conditions can occur at any age and can be viewed during a routine vision exam. However, a medical examination and OCT scan is necessary to accurately diagnose and treat/monitor these conditions. The OCT report gives an average retinal nerve fiber layer value and compares the nerve to "normal" nerves. Follow up scans will compare previous scans and provide a "progression analysis" which assists the doctor in managing the disease.
    • Macula OCT- scanning the macula allows for viewing of the deeper layers of the macula and observing the severity of macular degeneration, dystrophies, and edema (swelling). Macular degeneration has treatments available for certain stages if diagnosed early enough. The macula OCT allows doctors to diagnose and treat certain conditions of the macula that previously could not be treated.
    • Visual Field Testing- Automated perimetry is a detailed measurement of the entire field of vision (central and peripheral). This allows doctors to determine if glaucoma has affected vision yet. This also assists doctors in determining if a stroke, brain tumor, aneurysm, or brain injury has affected vision. There are many conditions that can cause visual field loss and certain defects aid doctors in determining the cause. For example, a pituitary tumor can be diagnosed from a visual field test based on the type of vision loss and specific location of field loss.
    • Pachymetry- this is the measurement of the thickness of the cornea. This test is important for managing corneal edema, glaucoma, and determining if a patient is a candidate for LASIK.
    • Topography- this is a map of the cornea. This test allows the doctor to view the curvature of the front surface of the eye (cornea) and diagnose conditions such as keratoconus, keratoglobus, and other causes of irregular corneas. Topography also assists doctors during the fitting of specialty contact lenses.
    • Lipi-view/Lipi-flow- The Lipi-view images the meibomian (oil) glands of the eyelids. These glands are necessary for maintaining healthy tear film and quality vision. The Lipi-flow is a treatment to the eyelids that improves functioning of the meibomian glands. A less expensive procedure is manual expression of the meibomian glands that the doctor can perform in the office.
    • Anterior Segment Photography- photos of the cornea, eyelids, and conjunctiva may be necessary to monitor certain conditions. Photography can be done while viewing the eye in the slit lamp biomicroscope with a camera.
    • Fundus Photography- a clear photo of the retina, optic nerve, and macula may be ordered for patients with certain conditions affecting those structures. For example, a choroidal nevus is a "freckle" in the choroid (the layer behind the retina) that must be monitored for any changes that could signal cancer. Drusen are little white deposits in the retina that may be a normal finding or may be a sign of some diseases in the eye. Retinal drusen should be photographed and monitored closely for any changes.

At Total Vision Care, we have access to all of the above equipment and techniques to manage most conditions of the eye. Some eye diseases may require specialty eye care. Similar to your Primary Care Physician referring you to a Cardiologist or Rheumatologist, Dr. Mayes will refer a patient to a Retina Specialist, Cornea Specialist, Glaucoma Specialist, Cataract Surgeon, Neuro-ophthalmologist, Oculo-plastic Surgeon, Vision Therapy Specialist, or Low Vision Specialist if needed. When Dr. Mayes diagnosis a medical problem with the eyes, she will discuss these findings, order any testing necessary, and discuss treatment options. Treatment options may include a referral to a specialist for a second opinion or surgical intervention.