Fundus imaging

#29 07-03-2007, 07:04 PM

In article <8p6dnYPcFtRn6BfbnZ2dnUVZ_u6rnZ2d[at]suscom.com> ,
"Rex Stomponato" <(-: [at] :-)> wrote:

- quote -

> "Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
> news:468927CC.90707[at]SpamMeSenseless.pergamos.net...

> > That's more or less what they were intending to do--make the optometrists
> > function more like pharmacists at the big mail-order places, i.e. much
> > lower on the food chain.

- quote -

> Sad for the pharmacists but they have little need to interact directly with
> the patients

In the US? My BIL (a very unreliable source) said that they eliminated
the middleman in Thailand, where he lived for a few years. If you need
pills, you see the pharmacist, not a doctor. He will listen to your
symptoms, and give you the medicine.

I think that there are pluses and minuses. I get my prescription drugs
by mail. There is no waiting, and I'm not charged for mailing. My
doctor prescribed three new drugs a couple of weeks ago, when I last saw
him. There was no written prescription. I could either pick them up
downstairs, or have them mailed. If I picked them up downstairs, I
would have to wait. I chose mail, and they arrived at my house in a
week. There is always a phone number on the pharmacy receipt to call
for a pharmacist consultation, but I've never called.

#28 07-03-2007, 04:14 PM

Sorry for the possible dual post...

Previous post was sent in error.

"Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
news:468927CC.90707[at]SpamMeSenseless.pergamos.net...
- quote -

> Rex Stomponato wrote:
> > "Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
> > news:4683E294.8060901[at]SpamMeSenseless.pergamos.net...

> That's more or less what they were intending to do--make the optometrists
> function more like pharmacists at the big mail-order places, i.e. much
> lower on the food chain.

Very successful approach as far as programmers or engineers are concerned,
optometrists I don't know yet.

Sad for the pharmacists but they have little need to interact directly with
the patients

- quote -

> The same thing happened to the weavers in the 18th Century--the spinning
> jenny made thread very cheap, so they made out like bandits until the
> flying shuttle turned weaving from a craft into a factory operation.

An oft repeated sad tale of the early industrial age.
Actually from what I understand the flying shuttle predated the spinning
jenny. But I am not a specialist of the history of weaving. :-(

- quote -

> But the correlation between usefulness and high incomes is very imperfect
> at best.

Who says there is one?

Optometry is a medico-scientific field like several others.
A para medical profession I you prefer.

- quote -

> It's okay with me for people to drive Mercedes if they like...but if I
> were a kid starting a career now, and even if I wanted money more than
> fun, I still wouldn't become an optometrist or a stockbroker. Those
> weavers would be in the back of my mind.

Mentioning optometrists and stockbrokers in the same sentence seems to me
a little strange.

I am not sure that the optometrists employed by Lens Crafters or Walmart
(the well known philanthropic organization) are actually receiving princely
salaries.

Maybe they do but the parallel with 18th century weavers is misplaced.

Optometrists are not going the way of the weavers any time soon, especially
with all the ongoing progress in diagnostic instrumentation and analytical
techniques.

And of course the current advances in treatment, not someting done so well
by remote control.

Except for strictly medical acts such as actual surgery, there is a great
overlap between ophthalmology and optometry at least in the US.

In fact these fields are now more and more complementary.

There is more to optometry than prescribing lenses/glasses/contacts and
checking how they fit on your nose or on your cornea.

In our corner of the woods the State University of NY has a College of
Optometry, in Manhattan, facing Bryant Park and next to the New York Public
Library.

You might take a few minutes to look over their site and its various pages.

http://www.sunyopt.edu/

http://www.sunyopt.edu/uoc/

and particularly this one:

http://www.sunyopt.edu/uoc/services/

Have a great day.

PS. Thanks for the stimulating exchange!

#27 07-03-2007, 03:35 PM

"Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
news:468927CC.90707[at]SpamMeSenseless.pergamos.net...

- quote -

> That's more or less what they were intending to do--make the optometrists
> function more like pharmacists at the big mail-order places, i.e. much
> lower on the food chain.

Very successful approach as far as programmers or engineers are concerned,
optometrists I don't know yet.

Sad for the pharmacists but they have little need to interact directly with
the patients

- quote -

> The same thing happened to the weavers in the 18th Century--the spinning
> jenny made thread very cheap, so they made out like bandits until the
> flying shuttle turned weaving from a craft into a factory operation.

An oft repeated tale of the early industrial age.
Actually from what I understand the flying shuttle predated the spinning
jenny.
But I am not a specialist of the history of weaving. :-(

- quote -

> But the correlation between usefulness and high incomes is very imperfect
> at best.

Who says there is one?

Optometry is a medico-scientific field like several others.
A para medical profession I you prefer.

- quote -

> It's okay with me for people to drive Mercedes if they like...but if I
> were a kid starting a career now, and even if I wanted money more than
> fun, I still wouldn't become an optometrist or a stockbroker. Those
> weavers would be in the back of my mind.

Mentioning optometrists and stockbrokers in the same sentence seems to me
a little strange.

I am not sure that the optometrists employed by Lens Crafters or Walmart
(the well known philanthropic organization) are actually receiving princely
salaries.

Maybe they do but the parallel with 18th century weavers is misplaced.

Optometrists are not going the way of the weavers any time soon, especially
with all the
ongoing progress in diagnostic instrumentation and analytical techniques.

And of course the current advances in treatment, not someting done so well
by remote control.

Except for strictly medical acts such as actual surgery, there is a great
overlap
between ophthalmology and optometry at least in the US.

In fact these fields are now more and more complementary.

There is more to optometry than prescribing lenses/glasses/contacts and
checking how
they fit on your nose or on your cornea.

In our corner of the woods the State University of NY has a College of
Optometry,
in Manhattan, facing Bryant Park and next to the New York Public Library.

You might take a few minutes to look over their site and its various pages.

http://www.sunyopt.edu/

http://www.sunyopt.edu/uoc/

and particularly this one:

http://www.sunyopt.edu/uoc/services/

Have a great day.

#26 07-02-2007, 04:29 PM

Rex Stomponato wrote:
- quote -

> "Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
> news:4683E294.8060901[at]SpamMeSenseless.pergamos.net...
> > Sounds like a project I managed to wiggle out of, about a dozen years
> > ago...a contact lens company wanted to put automated eye exam kiosks in
> > malls, so that they could get past the dominant position of optometrists
> > and sell disposable contact lenses by mail, direct to consumers. Not a
> > truly terrible idea, but the development cost would have been fairly
> > staggering--mostly in the interpretation rather than the optics. We
> > managed to help them with an improved business model rather than a kiosk,
> > so everybody went away happy. So far, optometrists still drive Mercedes.
> You blew it big time.
> Once the optics would have been designed (perhaps not as easy a task as
> you imply), the data should have been sent immediately to a real optometrist
> in India for interpretation and prescription.
> Et voila! :-)

That's more or less what they were intending to do--make the
optometrists function more like pharmacists at the big mail-order
places, i.e. much lower on the food chain. The same thing happened to
the weavers in the 18th Century--the spinning jenny made thread very
cheap, so they made out like bandits until the flying shuttle turned
weaving from a craft into a factory operation.

The reason I wanted to duck it was that I was a consultant to the
consultant...i.e. downstairs tenant in the outhouse. They weren't bad
people--I really quite liked them all, and one of them turned out to be
a long-lost cousin--but the production pressures in that job were not
going to be fun, and the available rewards would be small, since none of
my management cared much about it.

Besides, they weren't going to be able to make any money at it for some
years, and that wasn't on their agenda. As I said, the consultant and I
managed to fix them up with an improved business model instead, which
they adopted most of.

- quote -

> As an optical engineer and having worked with optometrists and
> ophthalmologists (*) I have found out that optometrists know their
> optics while ophthalmologists are for the most quite hazy about it.

> Therefore while optometrists (allegedly) enjoy their "dominant position" and
> as you put it "drive Mercedes" they still perform a useful function.
But the correlation between usefulness and high incomes is very

imperfect at best. It's okay with me for people to drive Mercedes if
they like...but if I were a kid starting a career now, and even if I
wanted money more than fun, I still wouldn't become an optometrist or a
stockbroker. Those weavers would be in the back of my mind.

Cheers,

Phil Hobbs

#25 07-02-2007, 03:48 PM

"Phil Hobbs" <pcdh[at]SpamMeSenseless.pergamos.net> wrote in message
news:4683E294.8060901[at]SpamMeSenseless.pergamos.net...

- quote -

> Sounds like a project I managed to wiggle out of, about a dozen years
> ago...a contact lens company wanted to put automated eye exam kiosks in
> malls, so that they could get past the dominant position of optometrists
> and sell disposable contact lenses by mail, direct to consumers. Not a
> truly terrible idea, but the development cost would have been fairly
> staggering--mostly in the interpretation rather than the optics. We
> managed to help them with an improved business model rather than a kiosk,
> so everybody went away happy. So far, optometrists still drive Mercedes.

You blew it big time.

Once the optics would have been designed (perhaps not as easy a task as
you imply), the data should have been sent immediately to a real optometrist
in India for interpretation and prescription.

Et voila! :-)

Just as certain hospitals (allegedly) send their X-rays to India for
interpretation by qualified radiologists.

As an optical engineer and having worked with optometrists and
ophthalmologists (*) I have found out that optometrists know their
optics while ophthalmologists are for the most quite hazy about it.

Let me say that's not their forte while they may well be medically
speaking truly outstanding.

Therefore while optometrists (allegedly) enjoy their "dominant position" and
as you put it "drive Mercedes" they still perform a useful function.

(*) One of the project I was working on before was refractive surgery (on
the cornea): radial keratotomy, keratomileusis and (excimer laser) ablation.

Now and as far as I am aware the ophthalmologists who perform this type of
surgery rely on optometrists for the initial optical diagnostic and follow
up.

Or at least they should!

#24 06-29-2007, 12:50 PM

On Jun 28, 12:32 pm, Phil Hobbs <p...[at]SpamMeSenseless.pergamos.netwrote:
- quote -

> Helpful person wrote:
> > On Jun 26, 3:11 pm, Helpful person <rrl...[at]yahoo.com> wrote:
> > > On Jun 26, 11:48 am, Helpful person <rrl...[at]yahoo.com> wrote:
> > > > I have a project to design a special purpose fundus camera. Although
> > > > an experianced optical engineer and lens designer I have never
> > > > examined the field of opthalmology.
> > > > I am looking for on line references, books and technical papers that
> > > > describe such cameras from an optical viewpoint. So far I have found
> > > > an excellent article athttp://www.emedicine.com/oph/topic756.htm
> > > > All help will be apreciated.
> > > > Please visit my web site atwww.richardfisher.com
> > > Please people, I really do know what I need. Can anyone help with
> > > literature suggestions?
> > > www.richardfisher.com
> > Thanks for the quick responses, expecially William and Marc.
> > I'm afraid I can't write about my special purpose except to say it
> > consists mainly of repackaging and producing an inexpensive product
> > for a specific application. My main area of concern is the instrument
> > pupils, illumination and imaging. My present assumptions are:
> > There has to be spatial separation between the illumination and
> > imaging pupils. This seems to be usually achieved by illimination
> > through an annulus at the eye pupil and imaging through the center of
> > this pupil. My present quandry is that I do not have a good feel as
> > to the size and required separation of the these two pupils.
> > It seems that the illumination pupil needs to be small enough to avoid
> > scattering from a dilated eye. A guess (and at present that's all it
> > is) is that it's maximum size needs to be less than 6mm with it''s
> > inner radius at maybe 4mm. To limit glare I would guess that the
> > imaging pupil should have a diameter of 2mm.
> > Any comments?
> > www.richardfisher.com
> Sounds like a project I managed to wiggle out of, about a dozen years
> ago...a contact lens company wanted to put automated eye exam kiosks in
> malls, so that they could get past the dominant position of optometrists
> and sell disposable contact lenses by mail, direct to consumers. Not a
> truly terrible idea, but the development cost would have been fairly
> staggering--mostly in the interpretation rather than the optics. We
> managed to help them with an improved business model rather than a
> kiosk, so everybody went away happy. So far, optometrists still drive
> Mercedes.
> Cheers,
> Phil Hobbs- Hide quoted text -
> - Show quoted text -

I don't know about wriggle out. Sounds like a really fun project,
although as you stated, extremely difficult (and expensive on NRE) to
achieve. Maybe a better business plan would have been to develop an
instrument for ophthalmologists (you try spelling this word!) and then
try to fully automate for consumer use. Still sounds like reinventing
the wheel.

However, this project is actually fairly simple. The only dificult
problem is my lack of experience in ophthalmic instruments.

www.richardfisher.com

#23 06-28-2007, 04:32 PM

Helpful person wrote:
- quote -

> On Jun 26, 3:11 pm, Helpful person <rrl...[at]yahoo.com> wrote:
> > On Jun 26, 11:48 am, Helpful person <rrl...[at]yahoo.com> wrote:
> > > > I have a project to design a special purpose fundus camera. Although
> > > an experianced optical engineer and lens designer I have never
> > > examined the field of opthalmology.
> > > I am looking for on line references, books and technical papers that
> > > describe such cameras from an optical viewpoint. So far I have found
> > > an excellent article athttp://www.emedicine.com/oph/topic756.htm
> > > All help will be apreciated.
> > > Please visit my web site atwww.richardfisher.com
> > Please people, I really do know what I need. Can anyone help with
> > literature suggestions?
> > > www.richardfisher.com
> Thanks for the quick responses, expecially William and Marc.
> I'm afraid I can't write about my special purpose except to say it
> consists mainly of repackaging and producing an inexpensive product
> for a specific application. My main area of concern is the instrument
> pupils, illumination and imaging. My present assumptions are:
> There has to be spatial separation between the illumination and
> imaging pupils. This seems to be usually achieved by illimination
> through an annulus at the eye pupil and imaging through the center of
> this pupil. My present quandry is that I do not have a good feel as
> to the size and required separation of the these two pupils.
> It seems that the illumination pupil needs to be small enough to avoid
> scattering from a dilated eye. A guess (and at present that's all it
> is) is that it's maximum size needs to be less than 6mm with it''s
> inner radius at maybe 4mm. To limit glare I would guess that the
> imaging pupil should have a diameter of 2mm.
> Any comments?
> www.richardfisher.com

Sounds like a project I managed to wiggle out of, about a dozen years
ago...a contact lens company wanted to put automated eye exam kiosks in
malls, so that they could get past the dominant position of optometrists
and sell disposable contact lenses by mail, direct to consumers. Not a
truly terrible idea, but the development cost would have been fairly
staggering--mostly in the interpretation rather than the optics. We
managed to help them with an improved business model rather than a
kiosk, so everybody went away happy. So far, optometrists still drive
Mercedes.

Cheers,

Phil Hobbs

#22 06-28-2007, 02:22 PM

Not quite sure what exactly what "on topic' is, but it is nice to
see, with the new resolution of the FD-OCT, the improvement over the
old OCT's "coarseness". One could get spoiled quickly.

Don W.

#21 06-28-2007, 01:56 PM

I realize it is a bit off topic, but spectral-domain / Fourier-domain
OCT systems just came to the market. One great thing about this new
technology is that it acquires data so quickly that you can actually
make plan view pictures (reduced from a 3D volume).

On Jun 27, 8:41 pm, Don W <dwil...[at]prodigy.net> wrote:
- quote -

> To my knowledge, in analyzing retinal problems presently, the OCT
> and the Fourier Domain OCT (which hopefully will get to be more
> common) are presently equipments of choice. But these give the
> pictures in the z direction. As far as plan view pictures, one thing
> I would like to see is the ability to cross correlate pictures from
> two different time periods, and then take the difference to show how
> treatments and/or symptoms are progressing (regressing?) But that
> doesn't sound like the approach you are contemplating. Just musing.
> Don W.

#20 06-28-2007, 12:41 AM

To my knowledge, in analyzing retinal problems presently, the OCT
and the Fourier Domain OCT (which hopefully will get to be more
common) are presently equipments of choice. But these give the
pictures in the z direction. As far as plan view pictures, one thing
I would like to see is the ability to cross correlate pictures from
two different time periods, and then take the difference to show how
treatments and/or symptoms are progressing (regressing?) But that
doesn't sound like the approach you are contemplating. Just musing.

Don W.

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