Ophthalmic imaging has long played an important role as an adjunct to ophthalmic examination. With the recent advent of new technology and treatment options for many ocular conditions, imaging has become a critical component of the comprehensive ophthalmic examination in some practice settings. Fundus photography, optical coherence tomography and fundus autofluorescence results are frequently used as a foundation for treatment plans in glaucoma, diabetic retinopathy and macular degeneration. Utilization of these procedures is on the rise. In the US, over ten million ophthalmic imaging procedures were billed to Medicare in 2011. That number continues to go up with each passing year.
The increased utilization of imaging in ophthalmology has created new opportunities for ophthalmic medical personnel to play a more valuable role on the eye care team. Whether you are looking to take on a new position as a dedicated imager, or to add a few new skills to your repertoire as an ophthalmic assistant, the challenge is often how to get started.
Build a foundation,
There is very little formal training available in this highly specialized field. People usually enter the profession from a related field. Some begin as a photographer and then learn the ophthalmology side of the job. More often, imagers start as ophthalmic assistants or technicians and learn the necessary photography skills. If you are already working as an ophthalmic technician, you can build on that foundation to get started in imaging. Chances are you already possess good patient management skills and a working knowledge of ocular anatomy and common clinical findings. From there you will need to add technical imaging skills and hands-on experience to build on that foundation.
There are a number of educational resources that can help you get started. These include instrument manuals, textbooks, journal articles, webinars, online tutorials and educational seminars. The most comprehensive and practical learning opportunities can be found at educational programs offered by the Ophthalmic Photographers’ Society, Inc. (OPS), the Association of Technical Personnel in Ophthalmology (ATPO) and the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). These non-profit organizations support education and certification of ophthalmic medical personnel. They offer excellent national and regional educational programs that include a variety of lectures and hands-on workshops in ophthalmic imaging. These programs also offer continuing education credits necessary for certification or recertification.
One particularly good course for beginning imagers or technicians looking to expand their skill set is the Ophthalmic Imaging Crash Course offered by the OPS. This six hour course provides an introduction to fundus photography, fluorescein angiography and OCT with an opportunity to try various imaging devices.
Practice and experience
Lectures, books, instrument manuals, tutorials, webinars only go so far. You’ll need hands-on experience to build on the technical foundation provided by educational resources. Some skills can only be acquired or refined through experience. This is especially true when faced with challenging patients or a difficult view of the eye. Practice also helps you become more confident and efficient. There is often a point of diminishing return during an imaging session when the patient becomes fatigued and can no longer cooperate. In these cases moving quickly and efficiently usually results in the best image quality. With experience, you’ll learn to recognize anatomical landmarks or unexpected findings or know exactly where to align the instrument and prioritize the most important views.
Get some feedback
Constructive feedback is also an important component of building your skills. If possible, try to find a mentor to help guide you as you learn. A mentor can be a coworker, physician, or an experienced ophthalmic imager. A mentor can suggest resources, review images with you, provide feedback on image quality, help you troubleshoot problems, or suggest strategies for challenging patients. Ophthalmic imagers are often willing to share their experience and expertise with both beginners and peers, so don’t be afraid to ask for advice. You can also reach out to the doctors you work for. Time spent with a physician reviewing images of interesting cases or unusual findings can be incredibly valuable. You can get an understanding of what the physicians look for in images and how they support diagnostic decisions.
Networking with peers can also be helpful and can take on many forms. Membership in ATPO or OPS is a good place to start. These groups provide additional resources such as the Journal of Ophthalmic Photography, discounts for educational programs, online message forums, blogs and other peer networking opportunities. Social media sites such as the OPS and JCAHPO/ATPO Facebook pages provide a free informal networking opportunity to share images, news related to the profession, and educational opportunities. Optimal is a free interactive email discussion list dedicated to ophthalmic imaging. This established group is very helpful and enjoys answering questions from both beginners and experts alike.
Take it to the next level
If your goal is to transition into a full-time imaging position, you might want to progress gradually, starting first with OCT, then adding fundus photography, and eventually angiography, anterior segment imaging, and ultrasound. This progression allows you to confidently add new skills and build on the foundation you’ve already established.
The exam content outlines for the certification programs offered by OPS or JCAHPO can help you design a program for self-study. These outlines include the most commonly performed tasks and skills in ophthalmic imaging. JCAHPO offers three levels of technician certification (COA, COT, COMT) that include ophthalmic imaging skills, while the OPS offers two advanced imaging certification programs (CRA and OCT-C) with extensive lists of requisite skills in imaging. Using these outlines for self-study not only builds skills, but also helps prepare you for certification. Getting certified is formal recognition that you have the skills needed for the job.
Ophthalmic imaging plays a vital role in eye care and offers a challenging and rewarding career. Getting started may be easier than you think.
Ophthalmic Imaging Career Resources
Ophthalmic Photographers’ Society, Inc. (OPS): www.opsweb.org
The Association of Technical Personnel in Ophthalmology (ATPO): www.atpo.org
The Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO): www.jcahpo.org
EyeCareCE online education site: http://eyecarece.jcahpo.org/
OPS Facebook page: https://www.facebook.com/theopsociety?fref=ts
JCAHPO & ATPO Facebook page: https://www.facebook.com/jcahpo?fref=ts
Optimal email discussion list: http://freelists.org/list/optimal
OPS Career Pathways Resources: http://www.opsweb.org/?page=CareerPathways
Discover Eye Careers: http://discovereyecareers.org/
Some of the major instrument manufacturers provide online educational resources that are specific to the devices they produce.
Heidelberg Engineering: http://www.heidelbergengineering.com/us/academy-education/
Optovue Inc: http://optovue.com/videos/