About two years ago, optometrist Thomas R. Benthien bought a digital fundus camera for his Chicago practice. It has come in very handy--it may even have saved his patient's life.

When Dr. Benthien first got the camera, he used it on all his patients. One year later, a 33-year-old white female patient returned, and her photos were retaken. "When viewing the photos from the previous year, we could see there was some slight swelling of the nerve heads, which I had missed with direct ophthalmoscopy," he says. "I immediately thought of pseudotumor cerebri, but she had had no significant weight loss recently."

Dr. Benthien eventually made sure she saw a neuro-ophthalmologist, who found a space-occupying brain tumor in the calcarine area of her occipital lobe.

"She was operated on and is doing very well today," Dr. Benthien says. "Needless to say, she was very happy with us."

This patient's story exemplifies one key statistic: Four out of five optometrists (80%) say that the most important factor for buying new diagnostic technology is to improve patient care.

Sure, new technology can increase revenue--8% of respondents say that's their primary reason for buying new equipment. And, new technology can improve office efficiency (5%) and increase a practice's marketability (1%). But, improving patient care is what makes that investment in new technology really mean something.

These are the results of our annual Diagnostic Technology Survey, based on the responses of 417 O.D.s to an e-mail questionnaire.


What's Hot Right Now

What is the number one piece of equipment that O.D.s are buying or want to buy? More than half (53%) say a digital fundus camera.

What is Your Most Important Reason for Buying New Technology?
Among the other most wanted items: electronic medical record systems/practice management program (42%), corneal topographer (32%), automated refraction system (31%), digital anterior segment camera (28%), perimeter/visual field analyzer (27%) and ocular coherence tomographer (25%).

Digital fundus camera. Respondents to this survey could not say enough about the advantages of using a digital fundus camera.

Optometrist Larry Cusma, of Schenectady, N.Y., upgraded his fundus photography from Polaroid to digital. "We get a lot of diabetic referrals from area physicians, and we always send a complete diabetic report plus retinal photos on each and every diabetic patient. We also go over the photos with the patient, explaining the possible retinal changes that can occur with diabetes. The patients appreciate the extra time and detailed explanation," Dr. Cusma says. "No O.D. practice that practices primary care optometry should be without a digital retinal camera."

Has This New Technology Increased Your Profitability?
Tim Kirk, O.D., has a Canon digital fundus camera with computer access in all the exam rooms of his suburban Detroit practice. "It sets our practice apart in our area for quality and high-tech eye care. But, more importantly, it allows us to see subtle retinal changes or disease that we might otherwise miss," Dr. Kirk says. "Even with the slow economy we continue to grow with this approach to high-tech eye care."

Electronic medical record (EMR)/practice management system. Briana Shelton, O.D., of Marion, N.C., bought an EMR system to improve office efficiency and eliminate paper charts. "Now, with e-prescribing, there are PQRI bonuses I can qualify for as well."

Corneal topographer. "[A new] topographer has allowed me to be the contact lens specialty fitter that I have held myself out to be," says optometrist Vanessa Loo Chang, O.D., of McAllen, Texas. "I've been able to receive more comanagement fees for LASIK, begun orthokeratology fittings, fit keratoconus patients with more confidence, and manage superficial punctate keratitis more effectively."

For Patients With Eye Diseases Such As Glaucoma or Diabetes, How Often Do You Perform a Dilated Fundus Examination?
Automated refraction system. Optometrist Jerry Ferrell, of Marion, Ohio, says the purchase of a Marco Epic freed up clinician time and increased volume by two more patients a day. "We now discuss findings much more and spend much less time doing a refraction."

Dave Boeckman, O.D., of Conroe, Texas, bought a Topcon CV-5000 to improve patient flow and make his refractive tasks more ergonomic. "After 28 years, I figured out I was too tall to be an optometrist."

Digital anterior segment camera. For her practice in Piggott, Ark., optometrist Angela Howell added a digital imaging system that captures both anterior and posterior segment images. "It has allowed me to document conditions and follow them with confidence," she says. "It really has a "wow factor" for patients and their families when you can show digital photos of conditions as you are communicating their plan of care."

Keith Kajioka, O.D., of Modesto, Calif., echoes that sentiment. "[Digital photography] is so vital for early detection of any changes to pathology. I dont know how I did without it," he says. "This technology has increased my service profit on exams by 40%."

Do You Currently Use an EMR System?
Ocular coherence tomographer. Before Darin R. Cummings, O.D., bought an OCT for his practice in Ephraim, Utah, he was constantly sending patients to a retinal specialist for the scans. "Now, I've been able keep patients in my office, run the tests myself, and continue giving excellent care," he says. "The OCT paid for itself in less than eight months."

Optometrist Jeff Yunker says, "My OCT has been a boon to my medical optometric practice in Grand Forks, N.D. I can now diagnose, with near certainty, early macular and nerve fiber layer changes. In fact, our regional retinal specialist refers his patients to our office for OCT when he is in town at his satellite clinic."

Nerve fiber analyzer. Terry Steckman, O.D., of Bend, Ore., says his new Marco RTA 5 "not only gives me the capability of retinal imaging, but allows me to detect, diagnose and follow more subtle retinal pathology. I dont have to refer as many patients out for additional testing," he says. "Also, the return on investment for has been very good for our bottom line."

Since optometrist Diane Forecki purchased a Zeiss GDx in August 2008 for her Schaumburg, Ill., practice, "it's been an unbelievable asset. It has helped me diagnose at least five or six children under 16 with glaucoma. Also, when the screening comes up as outside normal and the nerves dont look that bad, it helps in determining a plan of action," she says. "Reimbursement is good too."

Wide-field scanning laser ophthalmoscope. "I lease the [Optos] Optomap to increase patient flow and to decrease the number of patient dilations," says Brian VanDerPloeg, O.D., of Louisville, Ky. "It has saved us in this unforgiving economy."


What New Technology Are You Considering Purchasing (Or Have Purchased in the Last Three Years)?

Other Results

This years technology survey also produced other interesting results:

-Just two out of five optometrists (39%) currently use an electronic medical records system.

-More than 70% of O.D.s have an instrument to measure corneal thickness, such as a pachymeter. (That means nearly 30% do not.)

-Between leasing and buying, 70% of O.D.s say they will buy their next major piece of equipment while 27% say they will lease.

-Regarding new vs. used equipment, 84% of respondents say they will buy or lease their next major equipment purchase, 15% say they will buy used or refurbished equipment, and 2% say they will repair existing equipment.

-About 14% of O.D.s share equipment with another doctors practice.


How Much Will You Be Spending on Instruments and Equipment This Year?

"Even in the current economic climate, optometrists find that investing in new technology is well worth it. I have found that the more I invest in my practice with new equipment, the more patients invest in me as their primary eye care physician," says Dr. Cummings. "New technology pays dividends!"