[optimal] Re: Fundus Camera Woes

From: Steve Lusk <slusk@xxxxxxxxxxxxx>
To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
Date: Wed, 1 Aug 2018 12:31:42 +0000

I'm with you guys. I still have 5 Topcon 50EX's and I hope to work them until
they drop.

Steve Lusk, CRA
Vistar Eye Center Retina Consultants
phone (540)342-3400 ext. 4731
cell (540)420-2232
slusk@xxxxxxxxxxxxx
retina@xxxxxxxxxxxxx
________________________________
From: optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
Bennett, Timothy <tbennett1@xxxxxxxxxxxxxxxxxxxxxxx>
Sent: Wednesday, August 1, 2018 8:28:24 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Fundus Camera Woes

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You hit the nail on the head Jeremy. If it weren’t for clinical trials, I think
the traditional mydriatic fundus camera would be long gone by now. There just
isn’t much of a market for them these days unless you do study imaging. That’s
why a lot of places do everything they can to keep their old workhorse cameras
running for as long as they can. That’s also why there isn’t a device
comparison like Denice is looking for. If you want to purchase a new
traditional mydriatic fundus camera, there is only one choice in the US. Same
with many other modalities. There may be only one or two devices to choose from
once you decide on modality. The exception would be non-myds or myd/non-myd
hybrids where you have choices. Makes sense because there’s a market for
cameras that are perceived to be easier for the jack-of-all-trades tech to use.

I was consulting with a retina practice last week that was looking to replace
an older fundus camera because the techs there thought it was difficult to use.
The docs were satisfied with the images, so I advised them to keep it running
as long as possible and put that money into a modality they don’t already have.
They were surprised at that.

I’ve also had a difficult time convincing some docs that this is the time we
live in. Manufacturers have to make compromises. Sometimes they sacrifice
quality for reliability and ease of use. We have a doc who’s updating his
retinal atlas and complains constantly about the current state of image
quality. We had to replace an aging system last year and he hates the new
images. As he edits his book, he’s comparing the new images with the best of 15
years worth of images  from our old system. When we replaced it, we got the
best system possible. But he’s right, the images aren’t as good as we could get
in the past. I’ve explained the current state of technology to him, but he’s
not convinced. He’s skeptical saying that doesn’t make sense because every year
the camera in his iPhone keeps getting better, the same should be true of
fundus camera sensors. I keep pointing out to him there’s a market for better
smart phones, there isn’t for traditional fundus cameras/sensors. All the R&D
is going into newer technologies & modalities.

I could probably write a book on this topic, but I’ll stop here!

tim

From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On ;
Behalf Of Jeremy Pantell
Sent: Wednesday, August 01, 2018 6:49 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Fundus Camera Woes

Tim:

Thanx for writing.  I just can't imagine NOT having full MANUAL control when
dealing with a challenging patient, ie small pupil, poor fixation, cataract.  I
guess I was lucky enough to have a Classic Zeiss to use when I was called upon
to do stereo discs or seven fields studies.

regards, Jeremy p. pantell, cra retired

On Tuesday, July 31, 2018 4:53 PM, "Bennett, Timothy"
<tbennett1@xxxxxxxxxxxxxxxxxxxxxxx<mailto:tbennett1@xxxxxxxxxxxxxxxxxxxxxxx>>
wrote:

That’s correct Jeremy, the 450 is no longer made or sold. I believe Zeiss will
continue to support it for a few years. To my knowledge the Topcon 50DX is the
only mydriatic camera still being sold in the US. The emphasis is more towards
ultra-widefield and hybrid devices (combination non-myd/myd, etc).

From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Jeremy Pantell
Sent: Tuesday, July 31, 2018 4:45 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: Fundus Camera Woes

Tim: Was just reading your article.  The Zeiss 450 is no longer in production?
What about support?

Jeremy p. pantell, cra retired

On Tuesday, July 31, 2018 2:02 PM, "Bennett, Timothy"
<tbennett1@xxxxxxxxxxxxxxxxxxxxxxx<mailto:tbennett1@xxxxxxxxxxxxxxxxxxxxxxx>>
wrote:

This might not be specific enough for you, but this article from the current
issue of Ophthalmic Professional gives a current overview:

https://www.ophthalmicprofessional.com/issues/2018/july-august-2018/modes-of-retinal-imaging<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.ophthalmicprofessional.com_issues_2018_july-2Daugust-2D2018_modes-2Dof-2Dretinal-2Dimaging&d=DwMGaQ&c=JMssF5yGhxHtze4oObDCfw&r=WOF4CG_t9c7zovSXqCtnVwOQVKH4otvhDeNTwJizJCQ&m=AlwpUu14ElOUzWluChGwdAYOkKAZZ02vqBZsAL1Fc2U&s=OOqGX_1uP-kpQTJzN5UVeww05Tf0uDnJV2IHc5S5f6w&e=>

If I had to replace a traditional fundus camera right now, I have no idea what
I’d get….

Good luck,

tim

From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Barsness, Denice
Sent: Tuesday, July 31, 2018 1:30 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Fundus Camera Woes

Try as I might, I do not find a comprehensive overview of current fundus
systems, non myd or otherwise, where I can do a quick at a glance comparison of
features

If it’s out there, and I missed, it, someone please enlighten me

If I had a budget of 50-60K, to purchase a camera, what would my tribe
recommend?

Full disclosure, I’ve been a dedicated Topcon 50 series/ OIS Winstation kinda
gal for the past two decades

Open to new ideas….

D.

Denice Barsness, CRA, COMT, CDOS, FOPS

CPMC Dept of Ophthalmology/ The Eye Institute

Ophthalmic Diagnostic Services

711 Van Ness Avenue Suite 250

San Francisco CA 94109

415-600-5781

FAX 415-558-7011

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Follow-Ups:
- [optimal] Re: Fundus Camera Woes
  - From: Dennis West

References:
- [optimal] Re: Fundus Camera Woes
  - From: Jeremy Pantell
- [optimal] Re: Fundus Camera Woes
  - From: Bennett, Timothy

[optimal] Re: Fundus Camera Woes

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