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NNSL Photo

WestNet Tele-Ophthalmology project manager Jason Howden demonstrates how the portable stereoscopic digital imaging equipment works on Heather Webb, an intern at Stanton Territorial Hospital's eye clinic. - Erin Fletcher/NNSL photo

Eyeballs on the record

New equipment will make for faster diagnosis, permanent photographic record

Erin Fletcher
Northern News Services


Yellowknife (Feb 03/03) - Diagnosing retinal problems is improving by leaps and bounds in NWT.

Over the past six months, WestNet Tele-Ophthalmology project technicians have been travelling the territory taking photographs of diabetics' retinas with new portable stereoscopic digital imaging technology.

The equipment, which includes a digital camera to record the retinal image, is making diagnoses easier.

Before the camera, optical specialists had to rely on the technicians written interpretation of a patient's condition. If the technician suspected a problem, the doctor and patient would have to meet. With the camera, doctors can now see the retina as the technician does.

The project is managed by the GNWT through the Stanton Regional Eye Clinic in Yellowknife. Last week, Health Canada announced a $436,177 contribution to the initiative. The funding will be used to pay for the equipment, do the analysis and review the viability of the portable component.

The eye clinic technicians took the equipment on their regular rounds to Hay River, Fort Smith, Fort Simpson and Inuvik over the past six months to take retinal photographs and create the report.

"Patient care-wise it's not a huge improvement," project manager and ophthalmic technologist Jason Howden said of the equipment.

"It's better documentation and it's permanent. It's a better way to follow up and that's where the improvement is."

Diabetics, especially those who have had the disease between five and 10 years, are vulnerable to diabetic retinopathy, a micro-vascular disease affecting the tiny blood vessels at the back of the eye. The vessels weaken, often leaking blood or fluid onto the retina -- the light-sensitive membrane at the back of the eye that allows you to see.

If left untreated the blood or fluid will cover the retina, permanently obscuring vision and eventually causing blindness.

Although there is no cure for the condition, once it is detected the patient can go to Edmonton to have laser surgery to contain the leakage and maintain the current level of sight, said Howden.

The main unit has been around for 20 years but the ability to capture the retinal images is new.

Now a six-megapixel digital camera is attached to the main unit and takes a photograph of the retina. The image appears on the computer and can be burned onto CD then sent by courier to a specialist at the Royal Alexandra Hospital in Edmonton. E-mail is not used because of confidentiality issues, said Howden.

Until now, digital camera resolution -- key to the photographic quality -- was too low to be helpful as a diagnostic tool, said Howden.

Now the images are perfect enough for a doctor to diagnose patients with.

"It's almost like bringing the patient to the doctor than bringing the doctor to the patient," said Howden, adding it's more precautionary.

He said under the new system it will take a week to diagnose patients instead of the two or three months it currently takes.

The retinal images are more than permanent medical records for patients. Howden said the images can also be used as educational tools and for research.

Even if the report determines the equipment is too expensive to travel around with, the technology will continue to be offered in Yellowknife, said Howden.

Technologists regularly visit communities eight to 10 times a year.

More than 15,000 people a year get a regular eye exam in the territory. Between 1,200 and 1,300 of those are diabetics.

Diabetics, regardless of the stage of the disease, should have an eye exam annually, said Howden.

The report will be released at the end of March.