As everyone is aware, technology has revolutionized the practice of medicine. We can diagnose disease at a much earlier state than ever, even before it begins in some cases. Patients can then receive treatment when it is still possible to avert debilitating symptoms or slow down disease progression. With the use of new imaging techniques in ophthalmology, we can precisely measure the optic nerve and retina. This ability allows us to detect glaucoma, diabetic retinopathy, and macular degeneration years before a patient develops symptoms and then initiate treatment to lower the risk of progression.

However, technology can also lead to unnecessary treatment and over-treatment unless it is used in an intelligent manner. A physician needs to guard against technological findings that are artifacts or spurious and do not fit with the clinical setting. For instance, over-reliance on a scan of the optic nerve in a patient with a normal clinical appearance can lead to initiation of drop therapy which is not required. The ability to carefully evaluate a patient in the exam chair with our analog slit-lamp microscope and diagnostic lenses, coupled with an extensive knowledge of ocular anatomy and normal variants, is critical to providing the right treatment at the right time. Some providers seek to impress the patient with a plethora of computerized exam instruments. However, these are only helpful if they are intelligently interpreted and used in conjunction with an accurate and insightful clinical exam.

Alfred Paul, MD