Perhaps I can help. I’m an optometrist in Tennessee. I own my own practice, and we use the Optomap for our patients in two ways.

The first way is for diagnosis and treatment of disease, such as glaucoma, macular degeneration, and diabetic retinopathy. Second, for patients without these diseases, we still offer the Optomap as an adjunct to a complete eye exam. I say an adjunct, because we still use dilating drops on every patient. I think it is the best way to get the most complete examination of the retinas.

Personally, I would not trust the Optomap alone to give me a full clinical picture of the inside of a patient’s eyes, as it only images 270 degrees. With dilation, I can see much more, but in less detail. It is the detail that makes the Optomap so valuable to me. And, I will admit that the detail it provides has allowed me to catch disease that I would not have detected with dilation alone (note that there have also been diseases that I have found with dilation that did not show up on a patient’s Optomap). Additionally, the Optomap image is stored for future use and reference. So, both techniques complement each other.

As for insurance, it should be remembered that large insurance companies are about the bottom line. Whether the bottom line is what’s best for patients is another story. We have a variety of value-added services (those that are not covered by vision insurance) that we feel make a complete exam, and we offer them to our patients with the understanding that we are going above and beyond the standard of care and therefore there will be an additional out of pocket expense.

We do not use scare tactics. In over 15 years of dilating patients, I have never caused an acute angle-closure glaucoma attack. As I said, we prefer to dilate all patients.

A similar thing happens in our eyewear gallery: when a patient with VSP wants a nicer pair of eyewear than the plan covers, they pay the additional expense, because VSP will not. We do not limit a patient’s choice to what VSP covers. We offer the patient what is best for their visual needs, and then allow them to decide what they want.

So the question is this: how well do you want to take care of your eyes? My suggestion (and I would opt for this myself even if I were outside this business) would be to have the Optomap performed, and insist upon dilation as well. If you are told that this would be redundant, find an optometrist who agrees with your point of view.

Finally, I agree with you, although perhaps not for the same reason since we are on different sides of the exam equipment, so to speak: the system needs fixing. But remember, by your own admission, you don’t even have to pay for most of your care. By any standard, you are most fortunate indeed.

Thanks for your time. I hope I have helped.

Feel free to email me if you like, and have a great day,

Andy

Andrew W. Howard, O.D.
LaFollette Eye Clinic
LaFollette, Tennessee