Clinical Skills Certificate Course:

Fundus Photography and Fluorescein Angiography

Course level:

This course is intended for ophthalmic assistants, technicians and technologists.

Course structure:

This course consists of short, illustrated reading segments. There is a quiz at the end of the course. Upon passing the quiz, the user will receive a certificate of completion.

Estimated time to complete:

Two hours.

Short Course Description:

The course on fundus photography includes discussion of instrumentation, procedures, troubleshooting, and image defects and artifacts. The course on fluorescein angiography includes discussion of preparation, the injection, the angiogram, descriptive terminology, common abnormalities, and other considerations. Fundus autofluorescence, RGB channel separation, and iris angiography are also discussed.

For the Detailed Course Description, see below

The course can be purchased via Paypal (you don't need a Paypal account) by using the button below, $10 for 2 months of access. More than one course can be purchased at the same time by going to the course catalog. Courses can also be purchased via Authorize.net from the course catalog.

After purchase, the course can be accessed immediately by using the "courses" tab on the top menu bar to link to your "my courses" page.

Detailed Course Description

Fundus Photography

Instrumentation

   The Camera Body and Headrest
   The Control Panel
   Computerized Capture Systems
   35 mm Camera Backs
   Maintenance

Procedure

   Patient identification
   Mount the correct camera back if applicable
   Make sure the camera and camera back are operational
   Set the eyepiece
   Record patient information
   Pre-set the camera for retinal photography
   Instruct the patient
   Position the patient
   Align the eye
   Align the image
   Capture the image
   Handling the difficult patient
   Photography in the periphery

Troubleshooting (including image defects and artifacts)

Problems

   Illumination lamp does not light
   Flash lamp does not flash
   35 mm camera back does not work
   Digital imaging: the flash works but there is no image on the screen
   The flash works but the secondary camera does not work
   Operator cannot see an image of the patient's eye through the eyepiece
   Good focus is not possible

Image defects and artifacts

   The periphery of the image is dark
   The center of the image is dark
   Image flare or washed out image (over-exposure)
   The eyepiece image or the captured image is too dark (under-exposure)
   White spots on the image
   Your color slide film comes back black, without an image on it
   Your image has what seems to be a white curtain coming down over it, or it is totally white
   Your image has a crescent at the edge of the frame
   Your color slide film has some overlapping images
   Your color slide film has some frames that have only partial images and some images that look like they did not develop properly
   Your color slide film has some images that seem to be cut in half

Fluorescein Angiography

Preparation

   Characteristics of fluorescein dye
   Adverse reactions
   Preparation for the fluorescein angiogram
      dye preparation
      patient preparation
      the consent form
      setting the camera up

The Checklist

The Injection

Setting up and administering the injection
   Procedure
   Extravasation
   Avoiding an arterial injection
   What if I can't get a vein?
   Oral administration of fluorescein

The Angiogram

Starting the angiogram

Early, Mid, and Late Phase Photos
   The choroidal flush and the arterial phase
   The venous phases
   Universal Precaution Reminders
   Late phase photos

Other Considerations
   Phototoxicity
   What parts of the retina do I photograph?
   What magnification (angle) should I use?
   Document the pathology
   The doctor-patient-photographer relationship
   Documentation (printing, etc.)

Descriptive Terminology and Common Abnormalities

Descriptive Terminology

   Pseudo-fluorescence and auto-fluorescence
   Hyperfluorescence
   transmission
   leakage
   pooling
   staining
   Hypofluorescence
   blocked fluorescence
   non-perfusion

Some Common Abnormalities

   Age Related Macular Degeneration
   Diabetic Retinopathy
   Central Serous Choroidopathy
   Artery and Vein Occlusions

Retinal Cameras: The Next Generation

  The Topcom 50Dx and the Zeiss Clarus are compared
    Auto-focus, auto-exposure, alignment assist
  Auto-fluorescence
  RGB channel separation
  Iris angiography