We are in the market for a new automated perimeter. Your feedback regarding benefits, drawbacks, and cost of machines with which you are familiar would be appreciated. TIA!
We are in the market for a new automated perimeter. Your feedback regarding benefits, drawbacks, and cost of machines with which you are familiar would be appreciated. TIA!
depends what you are looking for it to accomplish with the device:
FDT only good as a basic screener, but it is pretty quick
humphrey matrix, several people i know like them, no progression analysis as far as i know
humphrey 7xx series is "standard of care" and what most ophthalmologists and optometrists are familiar with... strange how its far and away the most expensive. biggest advantage is the 60degree fields. very expensive to have warranty service with
oculus easyfield, decent, small, portable
dicon, no idea
medmont, no idea
haag streit octopus, seems interesting. most docs that have it ike it. only stores around 50 fields on the device and you have to upload the rest to a computer. does have some progression analysis like the humphrey, but the results are "different" than was most are used to. the macular testing part tests points at 0.7 degrees instead of 2 degrees like the humphrey, so "more" of the actual field is tested.
Thanks for the feedback.
This appears to be a studly version of the FDT (which I like). The Zeiss Meditec website states: "The Humphrey Matrix Perimeter comes equipped with Glaucoma Asymmetry Test and serial field overview software for comprehensive threshold exams and charting change over time." I'm not sure how that compares to the HVFA II.Originally Posted by orangezero
I've read various complaints about this one being difficult for patient positioning.
Related threads:
http://www.optiboard.com/forums/showthread.php?t=15288
http://www.optiboard.com/forums/showthread.php?t=1813
Last edited by 1968; 05-02-2007 at 10:38 PM.
I "think" the oculus has an optional chinrest now, but I have heard that complaint as well.
The matrix seems to definitely be positioned more as a screening device, but I suppose that makes sense considering what else they sell. I'd say the matrix is 100x better than the old, worn out perimeters most offices have. Still, I'm not convinced it would be the ideal way to deal with glaucoma management, and it seems it would only do the most basic of neurological assessment. Gives a result, and shows you a pattern, but how small are the test points? Much better than FDT, but definitely not anywhere close to the other more full featured perimeters. I just read about an octopus 900, but didn't see many details.
I've got a Matrix. I bought it as FDT is considered more sensitive to early glaucomatous loss. Good points
1) nice and small - fits well in my small consult room
2) tracks fixation quite well, which means that my little old ladies who can't keep still tend to have a few less fixation errors
3) Don't need trial lenses
4) can be done in mesopic illumination instead of full darkness
Bad points
1) No chin rest, so the talkers keep talking
2) you have to manually move the patient to get them into the correct position, as opposed to just moving the chin rest
3) Mine broke down in just under 3 years, and cost close to $3000 to fix!
4) No Estermann fields
Got a Humphrey in our other practice - works great - expensive, but still the gold standard. I'm sure you know the good and bad points here.
Medmont
Cheap, but I think it looks a little tacky (you hook it up to a computer). A lot of ophthals here don't like/don't know how to read a medmont printout, so do their own fields on referral.
Hope this helps
steff
I think the Matrix is too new to know exactly how it will fare in monitoring the progression of glaucoma. As steff has alluded to, the literature shows it to be good for the detection of (early) glaucoma but longitudinal research will need to be done to see how it fares against the HVFA II and the like for management.
Steff would know more than I, but I believe the test "points" on the Matrix's 24-2 and 30-2 are 5 X 5 degrees. Comparing the stimulus size of FDT technology to that of other machines might be a bit like comparing apples and oranges though since different cell layers are being targeted.
good points.
I'm not entirely comfortable making financial decisions for my practice based on what some referral doc may or may not prefer. In all likelyhood, the tests would be repeated in their office anyway, no matter what results I give them (for various reasons).
Also, I think this will become less and less of an issue as we rely more and more upon lasers to determine early treatment for glaucoma.
And finally, I have a bit of a problem with some companies that charge what I consider to be ridiculous service and maintenance fees for their overpriced products that may be "standard of care." I guess we should give zeiss some credit for moving away from their monstrosity that was the 600 series, but the 700 is just dated tech compared to a lot of the other offerings. The thing they have in their corner is their vast research history. But, the question we need to ask ourselves is, does this alter our treatment plan? Do the others not let us see there is a readily apparent neurological problem? How much faith should we be putting in fields anyway? (rhetorical questions, perhaps)
Its somewhat sad when you can buy an FDT, oculus easyfield, and octopus for the same price as the humphrey 750i.
5x5 degrees in the 24-2 and 30-2, goes to 2x2 degrees for a 10-2.
If you are unsure, why not call your friendly local rep? We did, and borrowed the machines for a couple of weeks to see what we liked. It's a significant investment, so you've got to makes sure you're comfortable with what you buy.
steff
OrangeZero is dead on... and your decision boils down to what you want to do.
They all have pros and cons. Confrontations are actually amazingly sensitive :) If you want it for screening purposes, FDT is great. If you're gonna do heavy OAG stuff, then you're probably on more solid ground with an HVF. We've debated this for a couple years now in our office.. our decision was FDT & HVF.
-Brian
We have a matrix. Aren't sad that we didn't buy "THE BOX". Our problem:
Everything we have (lensometer, topographer, autorefractor, tonometer, retinal camera) EXCEPT the Matrix will download the information to our network and EMR. No way to transfer data from the matrix unless you are a computer programmer with a spare month.
You may want to check on this but I'm pretty sure that you cannot bill insurance companies for an FDT test. However, you can certainly bill for testing with the Humphrey. I personally checked on this last year and verified that the FDT was not billable (considered a screening test only). Therefore, if the patient is paying privately or if you are doing it for free you won't run into a problem.
You may want to check with your EMR vendor, I have had programs written in the past for non-compatable machinery.
It is true that you cannot bill for an "Expanded" which is the upper payment of the three VF codes. You can bill for the lower of the three. My memory is not good, but I think that the FDT's most intensive test (30-3??) qualify for the middle code. Someone can tell me if I an wrong or not. The code book gives examples of which test goes with each code.
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