Is it just us, or have you noticed that more technology has come out in the last five years than in the previous 20 combined? It seems like we need individual special instruments for every disease that we see and manage. Not sure whether it is the same for you, but our offices seem to be getting pretty full of equipment; we seem to be running out of outlets and space. For this reason, we ask: “Are combination instruments, particularly topographers, the new normal in our practices?”

There is a good chance that not everyone reading this owns a topographer; if that applies to you, now is a good time to consider one. Topography maps have long been seen as the contact lens fitters’ best friend. Ours have been. From diagnosing disease to helping us better fit a lens, we use our topographers every day. But as our older technologies start needing to be replaced, as practice owners, the two of us always ask: “Is there something better to replace what we have?”

How Newer Is Better

In the case of topographers, our answer is yes. Topographers use light to gather information about the cornea. Most topographers capture an image of discs reflected upon the corneal surface and then calculate the distance between those rings to provide the curvature changes throughout the cornea.

Newer instruments are coming out that allow other measurements to be taken. One example is the measurement of axial length. There are several devices that can do this, each also offering other add-ons. Measuring axial length is beneficial for myopia management and for cataract lens replacement calculations. In a heavy contact lens practice that does much myopia management, this can be a great addition.

Most practices focus on primary care. But by and large, primary care practices are augmented by a specialty of some sort. Many practices have multiple specialties in areas such as dry eye, binocular vision, specialty contact lenses, low vision, glaucoma, retinal disease, and/or myopia management. When it comes time to replace equipment, our suggestion is to get the biggest bang for your buck by purchasing equipment that can be used multiple times a day on a variety of patients.

One such instrument type that has gained popularity is a topographer combined with a dry eye suite. I (Dr. Kading) have two versions of this type of instrument, and they have become an invaluable part of my everyday practice. As contact lens specialists, we have grown into dry eye practitioners. We see patients, image their meibomian glands, monitor their tear quality, measure their corneal shape, and assess their tear volume, all with one instrument. With several manufacturers to choose from, this addition to the practice can save space, increase revenue, and, most importantly, bring about better patient care.

The Verdict

If you are looking to replace or add topography to your practice, we believe that the new normal is to purchase a combination unit that brings more to the practice. CLS