the contact lens exam
Lights, Camera ... Time to Invest in Photodocumentation
BY PETER D. BERGENSKE, OD, FAAO

We've never had a better, or at least a cheaper, time to consider adding photodocumentation to our contact lens practices. High-quality digital cameras continue to drop in price, and the cost of of dedicating a computer to slit-lamp photography is well within reason. Consider these tips if you're ready to make the leap.

Easier than You Think

You can use any slit lamp to capture digital images -- you just need to decide how convenient you want to make it and what quality you're after. The great sensitivity of digital cameras have made the need for an auxiliary flash unit virtually obsolete, with a few exceptions. You can also more easily become adept at setting the right illumination because the camera immediately displays images that you take.

Ophthalmic photography (and especially slit lamp photography) isn't an art that you'll master overnight, but with the immediate feedback of a digital camera, you'll learn swiftly and you won't waste a small fortune on developing bad photos.

No Purchase Necessary

If you already own a digital camera, then you can start using it with your slit lamp right now. Simply hold the camera up to one of the eye pieces, optimize the image on the view screen and snap away. You can obtain reasonable photos this way with normal slit lamp illumination.

This is obviously awkward and not too impressive to the patient. Keep in mind that one advantage of adding digital photography to your practice is the "wow" factor for the patient. When's the last time you said "wow" to the tiny image on the back of a digital camera?

Taking a Step Up

A second relatively inexpensive alternative is to purchase an eyepiece mount for your slit lamp. You can purchase these from most manufacturers, and they provide a more stable and professional-looking setup.

You'll need to make sure the mount is compatible with the camera, of course. Such a system is suitable for a slit lamp dedicated to photography, but it's a bit unwieldy if you intend to frequently mount and dismount the camera (you're also more likely to damage the camera from all the handling).

Time to Split

A beam splitter is the ultimate solution in most instances, and adapters are available for most current, and many older, slit lamp models. The catch is that the beam splitter may be the most expensive part of the purchase. Ideally, the beam splitter will include a diaphragm that allows you to adjust the light going to the camera, but this isn't essential.

Final Considerations

In addition to considering how to mount the camera on the slit lamp, it's worthwhile to make certain that the camera can attach to an AC power source. Digital cameras require much energy, and you can lose your data if the power in the camera goes down. Most digital cameras can attach directly to a computer for downloading and viewing images on the monitor. It's a much more impressive display for your patients, and you can more easily see if you captured what you intended.

Most digital camera systems come with software that allows you to archive photos on your computer. Note that photo files take up a fair amount of computer disk storage space, so you'll want a CD burner on the computer to free up space on your hard drive if you intend to store a lot of photos.

Dr. Bergenske, a past chair of the American Academy of Optometry's Section on Cornea and Contact Lenses, has practiced for more than 20 years in Wisconsin and now is on the faculty at Pacific University College of Optometry. E-mail him at: berg1101@pacificu.edu.