Optomap Retinal Images: The Modern Day Iridology?

I’m sometimes asked what pseudoscience I wish there was evidence for. For one thing, I would have to say that it would be pretty darn cool if all you needed to do was gaze into someone’s eyes to tell what ails them. Think of all the money one would save without the need for expensive and scary things like blood tests and imagine all the time saved avoiding doctor visits altogether. It would be super-sweet.

Yep, just glance into my eyes and then off I would go. I wouldn’t even have to put on that paper dress at the doctor anymore. It’s always cold in the waiting room. Have you noticed that? I could completely avoid that drafty experience and just let the doc have a look-see in my pretty brown eyes and then I’d hop on my unicorn and off I would go!

But alas, I live in reality and in the real world things like iridology are about as legitimate as my unicorn taxicab.

Iridology is based on the belief that all of the organs of the human body are connected and that each organ has a corresponding location that can be seen in the iris of the eye. The iris is the colored part of the eye that changes size depending upon how much light is needed. An iridologist believes that he or she can detect and predict illness by looking very close at a patient’s iris. There is no science based evidence behind this practice and most iridologists are not trained optometrists.

I’ve always thought iridology was silly in its oversimplification of the human body. The notion of someone gazing into my eyes and telling me what ailed me may sound romantic but it really is much more like fortune telling than any type of legitimate science. The human body is much more complex than what the eyes alone can possibly show. So when my eye doctor recently scanned my eye with an optomap retinal imaging system and told me a bit about the health of the rest of my body I was like, what? Wait. You can actually tell if I have cancer or diabetes from looking super-up-close at my eye? And this is actual modern-day science and not iridology? Really? Awesome! I must know more!

Amy eye
My left eye. The bright dot is the optical nerve.

It’s not simple nor is it a quick fix and unlike iridologists, optometrists don’t claim that they can predict or diagnose all ailments of the human body and they are not an alternative to regular doctor visits but they can see some pretty interesting things in a retinal image and it just might save your life!

Shelly Fukunaga, O.D. is a practicing optometrist at Blackstone Optometry in Los Angeles, California. She was kind enough to answer a few of my questions about retinal scans and provide us with some cool images!

First of all can you explain what an Optomap Retinal Image is and does it scan more than just the iris?
The Optomap Retinal Image is a digital picture of the retina, which is the layered tissue lining the inner surface of the eye. The Optomap imaging system bypasses the iris and scans approximately 200 degrees of the retina. The Optomap exam requires no contact with the eye and no dilation, which makes it easier for the patient. It was invented by Douglas Anderson, whose 5 year-old son Leif went blind in one eye from a retinal detachment that went undetected during routine eye exams.

What are you specifically looking for when you see a retinal image?
There are numerous pathologies we look for in the retinal images. We evaluate the optic nerve for glaucoma and the central retina for macular degeneration. We look for retinal holes, tears, thinning, and detachments. We also look for melanoma or any signs of diabetic or hypertensive retinopathy.

What ailments can be seen in a retinal image and how can you tell if there is a problem?
With regards to systemic ailments, hypertension can be detected by constricted blood vessels, hemorrhages, cotton wool spots, or optic nerve swelling. Diabetes can cause many problems to the back of the eye. It can result in hemorrhages, microaneurysms, hard exudates, cotton wool spots, new blood vessel growth (neovasularization), retinal detachment, and retinal edema. Cancer can also sometimes be seen in the retinal exam. Melanoma usually presents as a gray-green/brown or yellow irregularly shaped mass.

Have you ever spotted a serious illness that the patient was unaware of?
I recently had a young patient who came in complaining of slightly decreased vision in one eye. Her optomap image showed diffuse retinal hemorrhages and tortuous veins. She had a central retinal vein occlusion. I referred her out for further evaluation and blood workup. A few of the many probable causes of her vein occlusion are hypertension, atherosclerosis, and vasculitis. (see photo)
tortuous viens retinal hemorrages
My associate, Dr. Simon Cheng, had a 40 year old patient who came in complaining of decreased vision for the last 6 months. His last eye exam was about 10 years ago and he thought his diabetes was under control. His optomap revealed diabetic retinopathy with scattered hemorrhages and cotton wool spots. (see two photos)
diabetic retinopathy 1

diabetic retinopathy 2

How often would you recommend a patient get an eye scan?
We recommend patients have the Optomap images taken once a year, at their annual exam. We can then compare the new images to the baseline images and look for any changes.

Special thanks to Dr. Shelly Fukunaga, Dr. Simon Cheng and all the nice people at Blackstone Optometry. It was a fascinating look into the science of the eye!

Amy Roth

Amy Davis Roth (aka Surly Amy) is a multimedia, science-loving artist who resides in Los Angeles, California. She makes Surly-Ramics and is currently in love with pottery. Daily maker of art and leader of Mad Art Lab. Support her on Patreon. Tip Jar is here.

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  1. I am a severe myope (note cool glasses on 6 year old me) with a family history of glaucoma, diabetes, cataracts and macular degeneration, so I am at risk for all kinds of eye disease. I get examined by an ophthalmologist every year. My husband is legally blind. So I am an advocate of regular eye exams. I don’t know specifically about the Optimap, but am definitely an advocate for regular, professional eye examinations.

  2. And by the way, everything you’ve heard about girls who wear glasses is true…it’s that naughty librarian thing.

  3. @marilove: Me too – had one done at my last eye test last year and the picture was so amazing.

    The optician spent a good few minutes explaining what I was looking at on the pictures and I learnt that it’s actually possible to have a mole on your retina, which should be checked for changes now and again just like the moles on your skin.

    The coolest thing was that due to the environment it which it was taken, for a few seconds afterwards I could “see” all the veins in my eyes when I blinked.

  4. You can’t beat walking around with one iris dilated to the size of a golf ball. I really weirds out everyone you meet.

  5. Back in my Navy days in the early 2000’s I had recurring neck pain that just would not go away. I repeatedly went to see the medic who always sent me away with the standard issue 800 Mg ibuprofen.

    After a few weeks/months with progressively worsening symptoms (vomiting, stiffness) no one had a clue. It took until I started having vision problems until they found out what the problem was.

    An optician took one look at my retina and sent me for a CT. Brain Tumor! Apparently my brain had swollen to the point where my optic nerve and retina had started to swell and affect my vision.

    I had a Pineal Germinoma that my eye doctor helped diagnose. I went almost straight to surgery in DC and radiation therapy and all better now.

    I gained a lot of respect for optometrists that day. They weren’t just the people who told my I needed new coke bottles in my huge glasses anymore.

  6. I’ve had Optomap pictures done for the past several years at my eye doctor and I think it’s a great tool. Even though I can’t really interpret much of the image I can see when he compares the new image to the old one that nothing has changed. Seems a lot more accurate way to examine my retina then just dilating it and looking in there. I have to pay extra to have this done but to me it’s well worth it.

    Plus the process is not painful or uncomfortable, it’s just freaky weird in a fun way.

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