View Annual Report - Jules Stein Eye Institute

Ophthalmic Photography
Clinical Laboratory
The Ophthalmic Photography Clinical Laboratory, under
the direction of Dr. Tara A. McCannel, provides a wide
array of photographic techniques important in patient
care, research, and teaching. The primary purpose of
ophthalmic photography in patient care is to record the
present state of the eye, and in cases of abnormality, to
establish a baseline and monitor the patient’s condition
over time. Patient care services include photographic
documentation of anterior segment diseases involving
corneal problems like growths, infection, and trauma;
photographs of ocular motility to record abnormalities
in eye movement; fundus photography, which captures
pictures of the retina; and diagnostic testing using
fluorescein and indocyanine green angiography, which
records the dynamics of blood flow in the eye. The
Laboratory also supports the research and teaching
activities of the Jules Stein Eye Institute by preparing
and duplicating graphic materials for presentation
and publication.
Ophthalmic Ultrasonography
Clinical Laboratory
The Ophthalmic Ultrasonography Clinical Laboratory,
directed by Dr. Steven D. Schwartz, performs clinical
examinations that are useful in diagnosing both ocular
and orbital eye diseases. Diagnostic examinations
include standardized A-scan, B-scan, and biomicroscopy.
Standardized A-scan is useful in tissue differentiation
and is commonly employed to diagnose ocular and
orbital tumors, including choroidal melanoma. B-scan
provides location and contour information and is par-
ticularly useful in differentiating vitreous membranes
from retinal detachment. Ultrasound biomicroscopy
provides exquisitely detailed, high-resolution views of
the anterior segment of the eye and is a critical tool for
the evaluation of ocular pathology, especially in opaque
corneas. Biometry and intraocular lens calculations are
also performed in the Laboratory, under the direction of
Dr. Ralph Levinson. Biometry measures the axial eye
length, anterior chamber depth, and lens thickness;
intraocular lens calculations are performed to determine
the power of the lens implant for cataract patients.
Perimetry Laboratory
The Perimetry Laboratory, under the direction of
Dr. Joseph Caprioli, performs visual field examinations
that determine the sensitivity of central and peripheral
vision. Examinations are conducted with advanced
Humphrey automated perimetry equipment. Testing
detects visual field deficits associated with certain kinds
of eye diseases such as glaucoma, retinal disorders,
and neuro-ophthalmic conditions. Utilizing pinpoints
of light around a perimetry bowl, the test evaluates
different areas of the field of vision. Test results are
computerized and compared to a range of normal
values by age group. Patterns of diminished fields of
vision are related to specific eye diseases. Perimetry
testing is employed for diagnostic purposes and to
monitor visual field sensitivity over time, especially for
glaucoma patients. Both standard and shortwave auto-
mated techniques are available, in addition to frequencydoubling
perimetry and motion-detection perimetry.
Visual Physiology Clinical Laboratory
The Visual Physiology Clinical Laboratory, under
the direction of Drs. Michael B. Gorin and Steven
Nusinowitz, quantitatively evaluates the function of
the retina and visual pathways. Patients are referred
for functional testing to confirm a specific diagnosis
or, in cases where the etiology is unknown, to rule out
alternative diagnostic possibilities. Electrophysiological
tests, including both the full-field and multifocal electroretinograms
(ERG and mfERG), the electro-oculogram
(EOG), and visually evoked cortical potentials (VECP),
record electrical signals from different layers of the
visual system to identify the site responsible for visual
symptoms. Psychophysical tests require the participation
of the patient in specific tasks to evaluate visual
functions like color blindness, contrast sensitivity, and
visual acuity. In many cases, both electrophysical and
psychophysical tests are performed together to obtain
the optimum amount of information for diagnosis.
Programs | Clinical Laboratories 85