What if? Ophthalmology without OCT – Part 4

In celebration of Ophthalmology Times' 50th anniversary, we asked leading experts what the practice would look like today had optical coherence tomography (OCT), one of the biggest innovations in the field, never been invented.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Vivienne S. Hau, MD, PhD

It reminds me, though I remember when I was a medical student, and one of these famous attendings taught us about OCT and how to examine the eye, and he told me one thing. He said, You know, don't be so dependent upon the OCT that you lose your own clinical skills, exam skills. Now, while yes, it would change our ability to more quickly, efficiently and find certain type of diseases, because some of them you simply can't just from simply examining the eyes. But perhaps if we didn't have OCT, some of our clinical exam skills might even be stronger today.

David S. Liao, MD, PhD:

OCT, I think, has revolutionized treatment, not only in AMD and diabetes, I think we would still be looking through the 90 diopter lens at the slit lamp. OCT has revolutionized things, high resolution OCT, OCT angiography, surgical OCT is going to also revolutionize things that we do, and with these new therapies, we'll need better imaging to see what are the best patients to treat and how the patient's responding to this treatment.

Jennifer I. Lim, MD, FARVO, FASRS:

I think without OCT, we would be relying more often on fluorescein angiography. We would have more invasive ways of following the patients. It would be more uncomfortable for the patients, more labor intensive, more time intensive, and I think we'd really be missing out on a lot of structure-function correlations that we've learned through OCT.

Nimesh A. Patel, MD, FASRS:

I'm too young to answer that question, but I think it's really changed our practice, and it's made life very easy for us in terms of getting an accurate diagnosis. And I think the next frontier for OCT is it's going to be in optometry offices as well. So I don't really know where it would be without OCT. I'm too young. I've always had that crutch. So I'm always in awe of the doctors before us that were able to make any of these diagnoses before OCT.