Diagnostics

Getting started in ophthalmic imaging

Learn what it takes to develop this valuable role within your practice.

BY TIMOTHY J. BENNETT, CRA, OCT-C, FOPS

The increased utilization of imaging in ophthalmology has created new opportunities for ophthalmic medical personnel to play more valuable roles on their eye-care teams. Whether you are looking to take on a new position as a dedicated imager or add a few new skills to your repertoire, the challenge is 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.

Educational resources

A number of educational resources 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 optical coherence tomography (OCT) with an opportunity to try various imaging devices. The next crash course will be held at the annual OPS meeting in Chicago in October.

Practice and experience

Lectures, books, instrument manuals, tutorials, and 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. When the patient becomes fatigued during an imaging session and can no longer cooperate, you reach a point of diminishing returns. In these cases, moving quickly and efficiently usually results in the best image quality.

Consider progressing gradually, starting first with OCT. In many practice settings, OCT is a high-volume test that patients easily tolerate, giving you plenty of opportunity to hone your skills. Once you get comfortable with patient management techniques and recognizing ocular anatomy and pathology with OCT, consider 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. 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, look for a mentor, such as 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. You can also reach out to the doctors who work with you. In addition, spend time with a physician reviewing images of interesting cases or unusual findings. This can give you 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. OPS’ and JCAHPO/ATPO’s Facebook pages provide a free informal networking opportunity to share images, news, and educational opportunities. Another networking service, 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, OPS’ or JCAHPO’s certification programs offer exam content outlines that 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 builds skills while helping to prepare you for certification. Getting certified is formal recognition that you have the skills needed for the job.

Imaging plays a vital role in eye care and offers a challenging and rewarding career. Getting started may be easier than you think. OP

Mr. Bennett is an ophthalmic photographer in the Penn State University Department of Ophthalmology at Milton S. Hershey Medical Center. He is a nationally recognized author, lecturer, and educator in the field of ophthalmic photography and has served as president of the Ophthalmic Photographers’ Society.