Eye health resource
What Can Retinal Imaging Detect?
Learn what Optos ultra-widefield retinal imaging can show, how it differs from OCT, and when dilation or additional testing may still be needed.
Reviewed for accuracy by Justin Bazan, OD on .
Retinal imaging gives your eye doctor a documented picture of the back of the eye. At Park Slope Eye, we use Optos Daytona ultra-widefield retinal imaging to capture a broad retinal photograph quickly and without touching the eye.
The simplest way to think about it is this: Optos gives us a very wide surface view of the retina, while OCT gives us cross-sectional detail through retinal and optic-nerve tissue. They answer different questions, and neither one automatically replaces a dilated examination when dilation is clinically important.
What Does Optos Ultra-Widefield Imaging Show?
An Optos image shows the optic nerve, macula, retinal blood vessels, and a large portion of the peripheral retina in a single capture. Because the image becomes part of the clinical record, it is also useful for comparing findings over time.
Nearly all Park Slope Eye patients choose retinal imaging. In routine care, it very often provides the retinal view and documentation the doctor needs without routine dilation. That is a convenience benefit, not a promise that dilation will never be necessary.
Optos vs. OCT: What Is the Difference?
Optos is a photograph; OCT is a structural scan.
- Optos ultra-widefield imaging: shows a broad surface view of the retina, including much of the peripheral retina.
- OCT: uses light to create cross-sectional images of retinal and optic-nerve layers, allowing the doctor to evaluate tissue thickness, contour, fluid, and other structural changes.
A photograph may show where something looks abnormal, while OCT may help show what is happening within the tissue layers in a smaller area. For some patients, the two tests are more informative together than either test alone.
For a deeper explanation, see What Is Optical Coherence Tomography (OCT)?
What Conditions Can Retinal Imaging Help Identify or Monitor?
Retinal imaging can reveal or document findings associated with many eye conditions, including diabetic retinopathy, macular degeneration, retinal tears or detachments, vascular changes, optic-nerve abnormalities, retinal lesions, and other retinal disease. A photograph by itself does not diagnose every condition, so the image is always interpreted in the context of the rest of the examination.
Diabetic Retinopathy
Diabetes can damage the small blood vessels of the retina. Retinal photography can document hemorrhages, vascular changes, and other visible findings that may occur with diabetic retinopathy.
If the doctor needs to know whether there is retinal swelling or other structural change, OCT may add information that a photograph cannot. Depending on the findings, dilation, additional testing, closer follow-up, or referral to a retina specialist may also be appropriate.
Age-Related Macular Degeneration
Optos can document visible changes in and around the macula. OCT is often especially useful in macular disease because it can show cross-sectional changes such as fluid, thinning, or distortion of the retinal layers.
Glaucoma and Optic-Nerve Changes
A retinal photograph can document the appearance of the optic nerve and create a visual record for future comparison. Glaucoma, however, is not diagnosed from a photograph alone.
Depending on the situation, a glaucoma evaluation may also involve eye-pressure measurement, OCT of the optic nerve or retinal nerve-fiber layer, visual-field testing, examination of the drainage angle, corneal measurements, and other findings.
Retinal Tears and Detachment
Ultra-widefield imaging can sometimes document peripheral retinal abnormalities, including retinal holes, tears, or areas of detachment. But a suspected retinal tear or detachment may require a prompt dilated examination and specialist care rather than relying on photography alone.
Sudden new flashes, a shower of new floaters, a curtain or shadow in the vision, or sudden vision loss should be evaluated urgently.
Retinal Blood-Vessel Changes
High blood pressure, diabetes, retinal vein or artery problems, and other systemic conditions can produce visible changes in retinal blood vessels. The retina therefore sometimes provides useful clues about both ocular and general health.
Retinal or Choroidal Lesions
Photography can document nevi, pigmentation changes, scars, and other lesions at the back of the eye. If a lesion looks suspicious or changes over time, additional examination, imaging, or referral may be needed.
Does Retinal Imaging Replace Dilation?
Not in every situation. Optos photography and a dilated retinal examination overlap, but they are not identical.
If symptoms, risk factors, or an imaging finding make a direct dilated examination important, the doctor may still recommend dilation. New flashes and floaters, a suspected retinal tear, unexplained vision loss, or certain medical retinal findings are examples of situations in which additional examination may be necessary.
For the fuller answer, see Will I Need to Have My Eyes Dilated at My Eye Exam?
Is Retinal Imaging Worth Doing If I See Well?
Often, yes. Some eye disease can be present before a patient notices symptoms, and a baseline image can make future comparison easier if something changes later.
Retinal imaging is not a guarantee that every problem will be found, and it does not replace the rest of a comprehensive eye examination. It is one useful part of the overall assessment.
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Originally published . Substantially updated .