Device saves lives and sight

New optical equipment at the Lions Eye Clinic at the Cayman Islands Hospital is not only saving people’s eyesight, but is saving lives, according to doctors.

The Optical Coherence Tomography machine arrived in Cayman in March and since then, more than 200 patients have gazed into its lens and have had their eyeballs imaged.

On Wednesday, one patient who was having sight issues was diagnosed in seconds as being in danger of having his retina detached and a surgical appointment was quickly made for him at a Miami treatment centre.

‘I couldn’t have seen that before we got the OCT. There were no symptoms in the initial examination of the retina detaching,’ said Dr. Jyotin Pandit, who examined the patient.

‘You can see the vitreous is lifting the retina,’ pointing to squiggly green, blue and yellow lines on a computer screen that showed an arc of the vitreous – the liquid, viscous part of the eye – pulling at the retina.

‘This patient will get treatment much sooner that he normally would have,’ he said. ‘We can make a much quicker diagnosis with this. With earlier treatment, you get better results.’

He told of a diabetes sufferer who came to see him in July when she had eye issues – diabetics frequently develop eye problems.

A preliminary examination showed an abundance of blood vessels and also a small mole-like shadow. When the new machine took an image of that part of her eye, the doctor could see that the ‘mole’ was in fact a tumour.

Eye tumours are one of the most common forms of melanoma, or skin cancer, according to Dr. Pandit.

The patient opted to remain in Cayman and undergo experimental radiation treatment rather to go to Miami. The tumour is at the back of the eye, half a millimetre from the optical nerve, so it cannot be operated on.

‘Before, I could not have seen the back of her eye to make a treatment decision,’ the doctor said.

Showing a comparison of the tumour in July and another one taken more recently, it appears to be reducing in size.

‘If we had not treated this, it would have spread all over her body. This is saving lives,’ said Dr. Pandit.

Diabetes is a prevalent and growing problem in Cayman, and with the disease’s attendant eye problems, the OCT machine seems destined to continue to be used frequently to determine the extent and seriousness of those problems.

‘We know diabetes is out of control. We’ve noticed many more patients with diabetes coming in with eye problems. We can now monitor them more closely, and diagnose and treat them quicker,’ said Dr. Pandit.

Each patient has an average of four scans, meaning the $70,000 machine has carried out about 800 scans since March. The scans are usually covered by health insurance, so Dr. Pandit estimated that the equipment had already paid for itself in the six months it has been on island.

The OCT is a non-invasive technology used for imaging the retina, the multi-layer sensory tissue lining the back of the eye, allowing for early detection and treatment of eye conditions.

The machine can reveal a two- or three-dimension image of a part of the eye, explained Diane Benson, an ophthalmic technician.

‘This gives a much more detailed image of the small areas of the eye,’ said Ms Benson.

Similar to CT scans of internal organs, the OCT device uses the optical backscattering of light to scan the eyeball and then displays a pixel representation of the anatomic layers within the retina. Each layer can be differentiated and measured to establish if there are any anomalies.