Returning Patient Independence Registration Form

The Optomap Retinal Exam, an ultra-widefield retinal examination, is a revolutionary diagnostic tool that allows clinicians to view a majority of the retina. The Optomap Retinal Exam is a non-dilating camera that captures a digital image of the retina. The Optomap allows the doctor to capture a 200° high-resolution image of the retina in a single shot-- without dilation -- in a quarter of a second. It is easy for the patient, takes just a few minutes to perform, and is immediately available for review with the patient in the exam room.

Dilation, the traditional method, requires eye drops that enlarge the pupil area and blurs vision for approximately 4 to 6 hours. The drops require 30 minutes to take affect and then another 10 to 15 minutes of evaluation with a bright light source and a magnifying lens. The resulting clinical evaluation is like the Optomap, if the clinician is experienced, patient is cooperative and pupil dilation is maximized. A comprehensive dilation is achieved through 8 to 10 individual inverted views of each retina that is documented on the exam form.

• It allows for an enlarged image to see a more detailed view of the retina
• It takes just a few minutes start-to-finish, rather than approximately 45 minutes with dilation
• You leave the office with vision intact, rather than with light-sensitivity and blur
• Creates a permanent record
• Allows for future comparisons--we can compare this year’s image to next year’s image—side by side
• Can be reviewed by other doctors, if necessary