Ah, the elusive "Gray zone" of the sulcus, sclera spur and beyond. UBM works great, to a point. AS-OCT has it's shining moments. Gonio can make pretty pictures. We're all looking for the Holy Grail- easy, high resolution images of the iris and beyond. Something that can slice through pigment, yet penetrate deep enough for the Glaucoma guys. Sometimes, it's having the confidence to know that it's the technology failing you, not your skills. Just as you get to the Angle and beyond, things start to fall apart. UBM or at least 20MHz US works pretty well for the lens, at least anteriorly, but depending on the eye, the depth of the AC, yadayadayada, really getting enough information deep enough into the anterior posterior chamber is tricky.... Don't even get me started about reproducible metrics! D. Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS Ophthalmic Diagnostic Center CPMC Department of Ophthalmology 2100 Webster Street Suite 212 San Francisco CA 94115 (415) 600-3937 FAX (415) 600-6563 From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of John Head Sent: Friday, July 19, 2013 7:04 AM To: optimal@xxxxxxxxxxxxx Subject: [optimal] anterior heidelberg, viewing thru hazy cornea We have a new anterior lens and module for the Hedelberg Spectralis at a second site, but not much experience using it. As a photographer familiar with the other Heidelberg functions, how much differnet is the anterior scanning methodology? trying it a couple times, it seems that fixation can be an issue? are there any optimal scan settings, ie ART levels, HS or HR? basically I'm looking for some pointers, because an MD wishes to see the angle for possible peripheral anterior synchiae, or a "mass blocking" which may be causing a "malpositioned ACIOL in the chamber." the trouble is, I don't know enough about the machines capability, especially when the MD says she cannot see the angle due to a "hazy cornea." any suggestions or comments would be appreciated. Thanks, John Head, CRA