As we say in my household "Embrace the Chaos!!" 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 Peterson John C Sent: Wednesday, August 13, 2014 12:40 PM To: 'optimal@xxxxxxxxxxxxx' Subject: [optimal] Re: question about OCT-C Certification Agreed! Denice, for your part, you've come up with a great name for a band: "The Chaos of Normal" -jcp ******** John C. Peterson, MBA-ITM Senior Ophthalmic Photographer UW Health Eye Clinic 2880 University Ave., Rm. 246 Madison, WI 53705 (608) 263-7163 From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of CPMC Ophthalmic Diagnostic Center Sent: Wednesday, August 13, 2014 2:37 PM To: 'optimal@xxxxxxxxxxxxx' Subject: [optimal] Re: question about OCT-C Certification Tim, one of the clearest, most rational explanations of the chaos of "normal' I have heard in a long long time. Thank you 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> [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Steffens, Timothy Sent: Wednesday, August 13, 2014 12:27 PM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Normative databases are interesting. Personally, I don't care for them. Everybody wants them but they only mean something on the first visit. I want to see change over time. We are born and die with a certain number of nerve fibers. For every decade of life a "normal" person loses 1 micron of nerve fiber, no matter their age, race or gender. So if you live to be 100 you'll loss 10 microns of nerve fiber. Gary....that explains only the slight change. When reviewing RNFL scans, physicians want to see where the patient falls in the "normal" range on the first visit. After that, they are looking for change over time. Someone can be in the normal range and stay there their entire life but still have glaucoma. If the graph is trending down (RNFL loss) only a few extra microns over decades and there is evidence of VF loss, and high pressures or other factors they can potentially stay in the normal range even though they have glaucoma. Especially if it's managed well. So in the Spectralis it's important to do a Posterior Pole (P.Pole) scan and Asymmetry report for glaucoma and a GPA report on the Cirrus. You will need three scans to on interments to see real change. I hope this helps and make sense. Tim From: "<Miller CRA>", <OCT-C>, PA <GMILLER@xxxxxxxxxxxxx<mailto:GMILLER@xxxxxxxxxxxxx>> Reply-To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>> Date: Wednesday, August 13, 2014 at 1:53 PM To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>> Subject: [optimal] Re: question about OCT-C Certification Well, I did a 'quick and dirty' experiment on our Cirrus. I had one of my coworkers do RNFL measurements on my eye. We compared my scans by changing the DOB to 1928 and then to 1995. (neither of which is my real birthday!) To my surprise, there was only a slight difference when comparing my RNFL between the two 'normaltive' database readings. I did get into the yellow readings in a few quadrants in the one scan, but was all green in the other. For what it's worth... Gary ________________________________ From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf of Steffens, Timothy [tjsteffe@xxxxxxxxxxxxx<mailto:tjsteffe@xxxxxxxxxxxxx>] Sent: Wednesday, August 13, 2014 1:22 PM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Any instrument that has an age matched normative database, Cirrus, Stratus and Heidelberg. I'm not sure about Optovue and Topcon. Thanks, Tim From: "<Miller CRA>", <OCT-C>, PA <GMILLER@xxxxxxxxxxxxx<mailto:GMILLER@xxxxxxxxxxxxx>> Reply-To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>> Date: Wednesday, August 13, 2014 at 1:17 PM To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>> Subject: [optimal] Re: question about OCT-C Certification I know it could matter on the Cirrus. An incorrect birth date could throw of what would be 'normal' to someone of that age. y that, I suspect comparing a scan from a 30 year old against the normative database of a 60 year old could be an issue... and visa versa. But now that my curiosity is peeked, I will have to run a little test and see. Gary ________________________________ From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf of Tom Steele [tsteele@xxxxxxxxxxxxxx<mailto:tsteele@xxxxxxxxxxxxxx>] Sent: Wednesday, August 13, 2014 1:14 PM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Steven, Which devices would this still be an issue. Thank You, Tom Steele, CRA Midwest Eye Institute 200 West 103rd Street Indianapolis, Indiana 46290 317.817.1018 tsteele@xxxxxxxxxxxxxx<mailto:tsteele@xxxxxxxxxxxxxx> CONFIDENTIALITY NOTICE: This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is confidential and/or privileged. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to us at the above email address From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [mailto:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] On Behalf Of Stephen Travers Sent: Wednesday, August 13, 2014 1:02 PM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Hi Steve Regarding the naming convention for entering the patients birthday into the OCT unit, remember that some OCT units use the patients birthday to assist in determining if that patients OCT results fall within the "Normal" range expected from the OCT normative database . If you do not enter the correct birthday this may result in a false positive or negative when compared with the Normative values of the specific database . Hope this helps Stephen Stephen Travers Manager Clinical Affairs Heidelberg Engineering,Inc 1808 Aston Ave | Suite 130 | Carlsbad, CA | 92008 Tel: 760-536-7000 | 800-931-2230 Fax: 760-536-7100 Mobile: 817-716-2699 Email: stravers@xxxxxxxxxxxxxxxxxxxxxxxxx<mailto:stravers@xxxxxxxxxxxxxxxxxxxxxxxxx> From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Steve Lusk Sent: Wednesday, August 13, 2014 9:53 AM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Great thanks for the info. I do have one other question. I know there is the exam fee for OPS, do we have to pay an additional fee to the company who comes to our locality to administer the written exam? Steve Lusk, CRA Vistar Eye Center Retina Consultants 5296 Peters Creek Road Roanoke, VA 24019 Phone: (540) 342-3400 ext. 4731 Fax: (540) 362-1155 slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx> www.vistareye.com<http://www.vistareye.com/> The information contained in this email may contain confidential health information that is privileged and legally protected from disclosure by federal law, the Health Insurance Portability and Accountability Act (HIPAA). This information is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are herby notified that reading, disseminating, disclosing, distributing, copying, acting upon or otherwise using the information contained in this facsimile is strictly prohibited. If you have received this information in error, please notify the sender immediately. Thank you. ________________________________ From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on behalf of Miller CRA, OCT-C, Gary E. Sent: Wed 8/13/2014 10:05 AM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Great! You are welcome, Steve. By the way, I am not sure if you or others out there are aware, but the OPS Board of Certification has just launched their new, updated OCT-C exam which now includes Spectral Domain technology. Also, the cost of the exam has been dropped to $200 for those taking the exam before September 28, 2014!! The only thing to be aware of is the scores for those taking the exam during this special pricing period will be held until mid October. So you would need to wait until then to hear if you passed. Let me know if you have any other questions, Steve... Gary ________________________________ From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> [optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf of Steve Lusk [slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>] Sent: Wednesday, August 13, 2014 9:24 AM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Excellent. That is what I was looking for. Thanks! Steve Lusk, CRA Vistar Eye Center Retina Consultants 5296 Peters Creek Road Roanoke, VA 24019 Phone: (540) 342-3400 ext. 4731 Fax: (540) 362-1155 slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx> www.vistareye.com<http://www.vistareye.com/> The information contained in this email may contain confidential health information that is privileged and legally protected from disclosure by federal law, the Health Insurance Portability and Accountability Act (HIPAA). This information is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are herby notified that reading, disseminating, disclosing, distributing, copying, acting upon or otherwise using the information contained in this facsimile is strictly prohibited. If you have received this information in error, please notify the sender immediately. Thank you. ________________________________ From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on behalf of Cornelia Beyer Sent: Wed 8/13/2014 2:36 AM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: question about OCT-C Certification Agee with Gary , we only use 1/1/1990 for OCT-Portfolio and Clinical Trial purposes On Tue, Aug 12, 2014 at 1:51 PM, Steve Lusk <slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>> wrote: I have quite a mundane question that as a group, we are split on. Under the naming convention for OCT, do we enter the applicants birthday or is 1-1-1900 simply used as a signifier to satisfy the software requirements. Thanks Steve Lusk, CRA Vistar Eye Center Retina Consultants 5296 Peters Creek Road Roanoke, VA 24019 Phone: (540) 342-3400 ext. 4731<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx> Fax: (540) 362-1155<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx> slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx> www.vistareye.com<http://www.vistareye.com/> The information contained in this email may contain confidential health information that is privileged and legally protected from disclosure by federal law, the Health Insurance Portability and Accountability Act (HIPAA). This information is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are hereby notified that reading, disseminating, disclosing, distributing, copying, acting upon or otherwise using the information contained in this facsimile is strictly prohibited. If you have received this information in error, please notify the sender immediately. Thank you. -----Original Message----- From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on behalf of aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx> Sent: Sun 8/10/2014 10:00 AM To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx> Subject: [optimal] Re: Photographing techniques using a Zeiss 2x magnification lens James, I figured that. I'm going to try everyone's suggestions this week and hopefully my eyes will cooperate. A.D. sent by iPhone > On Aug 10, 2014, at 9:00 AM, JamesStrong > <jamesdstrong@xxxxxxxxx<mailto:jamesdstrong@xxxxxxxxx>> wrote: > > FWIW - changing settings on the camera body will have no affect on > focus/parfocality - it's an optics issues. > > j- > > >> On Sat, Aug 9, 2014 at 11:22 AM, Eric Kegley >> <ekegley@xxxxxxxxxxxxxxxxx<mailto:ekegley@xxxxxxxxxxxxxxxxx>> wrote: >> Because the mag is higher, it is very important that your image is as sharp >> as possible trough the eyepiece. Also, you said something about the diopter >> compensation wheel being as plus as possible. You shouldn't have to change >> that unless your subject is very hyperopic. My advice would be to make sure >> your reticle is very well focused and then focus carefully on the center of >> the frame. >> >> Thanks, >> EK >> >> Eric Kegley, CRA, COA >> Director of Ophthalmic Imaging >> 6560 Fannin St., Suite 750 >> Houston, TX 77030 >> Main 713 524-3434<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx> >> >> Sent from my iPhone >> >>> On Aug 9, 2014, at 9:31 AM, Marshall Tyler >>> <marshalletyler@xxxxxxxxx<mailto:marshalletyler@xxxxxxxxx>> wrote: >>> >>> Are the eyepiece sharp at the same time as the image is sharp? >>> Try a test target of a ruler or sm as 'll printed text which you tilt >>> relative to the plane of focus. It should be sharp in the center. If sharp >>> closer or further away you have a focusing problem. If is not sharp >>> anywhere you may have a lens/system problem. >>> >>> Thank you, >>> Marshall >>> Marshall E Tyler >>> >>>> On Aug 8, 2014 11:09 PM, <aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx>> >>>> wrote: >>>> Thanks Jeremy for the eye opener. I hope it's not a waste $ for the lens. >>>> >>>> I've changed the compensation lens to the highest plus mag on the FF4 and >>>> turn the dial all the way. The image looked clearer but no cigar. I'm >>>> going to try and change the setting on the 6D itself to macro, not sure >>>> what will happen and if it will even let me change the setting while it's >>>> connected to the PC. >>>> >>>> I would like more input on my thoughts if possible. >>>> >>>> Aissa >>>> >>>> A.D. sent by iPhone >>>> >>>> >>>>> On Aug 8, 2014, at 10:16 PM, Jeremy Pantell >>>>> <jpantell@xxxxxxxxxxxxx<mailto:jpantell@xxxxxxxxxxxxx>> wrote: >>>>> >>>>> HI AISSA! I guess the question is whether the Canon 6D/Zeiss 2X adapter >>>>> will "parfocal" with the Zeiss eyepiece. I would focus off your monitor >>>>> while trying to come up with a better solution. When using the 2X with a >>>>> film setup there was no particular magic about it. Just focus very >>>>> carefully and compose within the viewfinder grid. Good patients would >>>>> yield very nice results. >>>>> >>>>> sincerely, jeremy p. pantell bfa cra >>>>> >>>>> >>>>> On Friday, August 8, 2014 4:06 PM, Aissa Dirawatun >>>>> <aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx>> wrote: >>>>> >>>>> >>>>> Hello everyone, >>>>> >>>>> Our practice purchased a Zeiss 2x lens adapter for our FF4 (w/ Canon 6D) >>>>> camera to use for ONH pictures. I'm having trouble focusing the image. I >>>>> need your advice. >>>>> >>>>> Thank you! >>>>> >>>>> Aissa Dirawatun, COA >>>>> Ophthalmic Photographer/Technician >>>>> Virginia Retina Center >>>>> 20 Rock Pointe Lane Suite 20 >>>>> Warrenton, VA 20155 >>>>> >>>>> -- >>>>> "Reading makes immigrants of us all. It takes us away from home, but more >>>>> important, it finds homes for us everywhere." ~ Jean Rhys 1890-1979 > ________________________________ IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. 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