To Dilate or Not to Dilate

November 28, 2018

To dilate or not to dilate?  As ultra-widefield imaging (UWFI) technology becomes more affordable and readily available, this question is the focus of passionate debate in optometric circles. So it’s not surprising that the issue surfaces occasionally at the ABO with respect to our SAMs and PPMs.  In response to a recent inquiry, we reached out to two of our Diplomates for their expert opinions on this subject.

Mohammad Rafieetary, OD, FAAO is a consultative optometric physician at the Charles Retina Institute in Memphis, Tennessee.  Dr. Rafieetary emphasizes that dilated funduscopy is still considered the standard of care and new technology doesn’t replace dilation.  Almost every one of Dr. Rafieetary’s patients gets dilated, despite the extensive imaging technology available in his retina practice.  Dr. Rafieetary also points out that the companies that provide UWFI technology do not advocate that these instruments replace the doctor’s examination; rather, they serve as an integral diagnostic arsenal to augment the doctor’s diagnostic abilities.

Paul Ajamian, OD, the center director for Omni Eye Services of Atlanta and a founding Board member of ABO, agrees that dilated funduscopy is the standard of care. He has served as an expert witness for optometric malpractice cases in which the failure to dilate was a key factor. Dr. Ajamian cautions that if a practitioner deviates from standard of care it could result in harm to the patient if crucial findings are missed and consequently lead to litigation and judgment against the optometrist.

Dr. Ajamian is developing a CE course for ABO Diplomates titled “Avoiding Malpractice,” based on lessons learned from expert witness cases, to be presented in January 2019.  Keep an eye on your inbox for more information – you won’t want to miss this one!



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