Virtual Visual Fields Improve Efficiency and Clinic Flow

I started practicing in an existing private practice that was medical based. The lead OD had one of the original Humphrey Field Analyzers. This device was a dinosaur, it sat in the corner, and it did its job. When I took over, I didn’t plan on upgrading it until I absolutely had to — it had been there for more than 20 years, but visual fields haven’t evolved much from putting your head in a bowl and having the patients sit there and click. One day about two years ago, we had a patient on the device doing a test, and the machine started malfunctioning. It never turned on again after that. 

This experience had us looking for a better way to conduct visual field tests, which led us to the virtual route. As a software tech developer, the biggest thing for me was that this new software would work the way I needed it to. It had to be functional, and everything else comes after that. Since we’ve gone the virtual route, we’ve improved our patient experience and also eliminated a tedious and time-consuming task for our team members. 

Getting Patients More Comfortable
In my practice, we utilize the Olleyes virtual visual field, which we’ve had great success with. One of the biggest things we’ve found is that we can administer these tests and have our patients be more comfortable than they were when we had the Humphrey, which has been the standard of care.

Visual fields are done to monitor glaucoma patients, patients who have had strokes or other optic nerve diseases, as well as patients on certain medications. Because we are located in Florida, we also have a lot of patients who need to renew their driver’s licenses, so we also do a lot of Esterman fields as well as ptosis visual fields for patients who want to get their lids done.

As the clientele we typically run visual fields on is an older demographic, it is difficult and uncomfortable for them to hold the same position for the entirety of the test. This holds true for any patient, young or old. Now that it’s mobile, it not only prevents a bottleneck in our clinic, but it’s a great experience for the patient and the staff. We have also found that because patients are more comfortable, their test results are better. We’re not worried about their heads moving, or them moving off to one side, or having to remind them to keep their eyes open — which happened fairly often. It’s a better patient and staff experience, which means better outcomes for everyone.

We’ve found that patients have really enjoyed this new virtual option for visual field testing. They’re the ones doing the tests, and many of them have been doing the same test the same way for the last 20 years. Now, they’re able to be more comfortable, and as a practice, we are  staying on the cutting edge of technology and offering them the best that’s out there. Our patients comment on how we are always bringing them new things, and their response has been positive since we’ve switched to this new method. 

Our patients have adapted to this new test easily as we are always bringing them new technology through either a piece of equipment or how they do business with us. I’ve heard other ODs say that some patients struggle with motion sickness when they put on the virtual reality (VR) headset, which can be a hesitation for making the switch to the virtual testing, but that hasn’t happened in our office. Patients are eager to sit in a comfortable chair and not be stuck in a dark room, so the positives definitely have outweighed any potential negatives. I think a lot of doctors would be surprised that there really isn’t much pushback even though there’s the technology element involved. In the world we live in, we’ve all quickly figured out how to use iPhones, so this isn’t a big adoption curve. It was a bigger adjustment for me as a doctor and for my staff because we had been utilizing the Humphrey Field Analyzer and understood the reports and progression analysis to help us analyze results. However, it was time to make the switch. We added new instruments, so space had also become a prime commodity in our practice.

Improving Clinic Flow
Another huge benefit of the virtual visual field is that it has drastically improved our clinic flow and freed up our staff from having to manually run these tests. From a staff standpoint, this task was incredibly mundane for them. If you’re a visual field tech, you could be running 20-30 of these tests per day, in a dark room, and this isn’t what our staff should be doing with their time. 

The training and onboarding to run the virtual visual field was a very easy learning curve. You have your login, you input the patient’s information, select what test you need to run, and the instruments does the rest by instructing the patient what to do. It also speaks several languages, which is also useful, and we have seen more compliance and better testing by using this part of the software.  

Clinical flow has also significantly improved, and we’re able to get patients through this part of their exam much faster. Visual fields are what would always clog up our schedule no matter how far apart we would schedule them. Now, with the virtual tests, when a patient checks in, if we know the patient needs a visual field screening, we seat them in our overflow exam lane, we start the test and are working up the next patient while the test is run. Once they finish, we load the results and away we go.

The Future of Technology
While these virtual visual fields are currently done in-office, it’s also important to consider how this could benefit other types of at-home care in the future. A patient could monitor their glaucoma at home on their own if they have a VR headset and do a quick test and send it off to their doctor. I think in the future we’re going to see more at-home eye care monitoring where we’ll be able to do more things along the telemedicine spectrum, making the patient a part of more of their own health care. 

This could also be beneficial in terms of improving patient compliance. Many glaucoma patients see the disease progress rapidly because of non-compliance with their treatment. However, this technology could make it possible to have these patients check in with their doctors more regularly and ensure that they’re doing the right things for their visual health.  

Grow Your Practice
My biggest piece of advice for practitioners considering this type of technology would be to just do it. Put it on your roadmap. Anything new comes with change. The adoption is quick, and it’s only going to help you, your staff, and your patients in the long run. Whatever you spend, you’ll make it up in time. Your staff will be happier, you’ll be able to take better care of your patients, and you’ll attract new patients by being the kind of practice that stays on top of the latest advancements in the industry. Our patients know us as being the kind of clinic that offers them everything we can, and that’s the kind of clinic I would want to go to as a patient.