This thread is a reinforcement that nothing is guaranteed in ophthalmic
imaging. Each of our experiences are unique.
Many years ago (1984), we had an Dept of Neurology "in house" IRB approved
clinical trial for an anti-seizure medication that required FP/FA. I had only
been an employee of the university for one week and had a patient seize early
in the required FA. (Zeiss FF3 fundus camera). Argh. Unhappily, but I admit
quietly relieving to me, the other photographer had 2 other patients have
seizures during the same FA protocol in the next few weeks. After the third
incident our Retina Chair went beyond just reporting an adverse reaction and
immediately stopped our participation in the protocol until the situation was
thoroughly examined. After review, the trial was closed with no further
explanation that I was privy to. I never pursued finding out any more about
the trial or the drug. Was it a failure of the drug to suppress seizures?
Light intensity? Frequency? Not sure, but this was in the olden days of film
based angiography when you had to "pace" your images for a 36 exposure roll.
In the ensuing 34 years, I had only one other patient have a seizure during an
FA. That patient had significant retinal ischemia and was experiencing
frequent unrelenting seizures.
Sounds like my experience is the exception, but it made a significant
impression on me and I always double checked with the requesting physician
before proceeding with any flashing light imaging in a patient with a
documented seizure disorder - especially if that physician was a resident. I
have had neuro-ophthalmologists tell me they have avoided flash photography for
some of their seizure prone patients.
My .02,
p
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [optimal-bounce@xxxxxxxxxxxxx] on behalf of
Darrin Landry [darrin@xxxxxxxxxxxxxxxx]
Sent: Tuesday, February 13, 2018 11:35 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Photosensitive Epilepsy
Coming up on 30 years in ophthalmology- never had a problem with this. The
flash recycling time on most fundus cameras are probably not fast enough to
trigger an attack. You can click as fast as you want- the flash isn’t going to
keep up with you.
Darrin A. Landry, CRA, OCT-C
Ophthalmic Consutant
Bryson Taylor, Inc.
www.brysontaylor.com<http://www.brysontaylor.com>
207-838-0961
On Feb 13, 2018, at 12:17 PM, George Henry, CRA, PBT
<ghenry@xxxxxxxxxxxxxx<mailto:ghenry@xxxxxxxxxxxxxx>> wrote:
Also, since the flash frequencies most likely to provoke a seizure are in the
15 – 25 Hz range, fundus photography and fluorescein angiography are probably
not going to cause a problem.
Unless you have a VERY fast trigger finger…
<image002.jpg>
George E. Henry, CRA, PBT (ASCP)
Wheaton Eye Clinic, Ltd.
2015 N. Main St.
Wheaton, IL 60187
630.588.3615
________________________________
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of heather carmello
Sent: Tuesday, February 13, 2018 11:05 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: Photosensitive Epilepsy
Thanks for confirming my suspicions george.
Heather Carmello,CRA,OCT-C,COA
Vice Chair, Board of Education
Ophthalmic Photographer's Society
www.opsweb.org<http://www.opsweb.org/>
412-295-8563
On Feb 13, 2018 12:04 PM, "George Henry, CRA, PBT"
<ghenry@xxxxxxxxxxxxxx<mailto:ghenry@xxxxxxxxxxxxxx>> wrote:
It is a documented risk in electroretinography. We do not perform ERG on
patients with a history of seizure disorders.
<image003.jpg>
George E. Henry, CRA, PBT (ASCP)
Wheaton Eye Clinic, Ltd.
2015 N. Main St.
Wheaton, IL 60187
630.588.3615<tel:(630)%20588-3615>
________________________________
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] On
Behalf Of Paul Kelly
Sent: Tuesday, February 13, 2018 10:58 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Photosensitive Epilepsy
Hi
Has anyone experience of any incidence of photo-triggered seizure being
triggered by ophthalmic devices or diagnostic procedures.
Thanks
Paul Kelly
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