Clinic prep: General MEC guide

Question 1

Username and Password for ImageNet (OCT)

Answer 1

Username: Topcon
Password: Topcon

Question 2

Username and Password for Sunix:

Answer 2

Username: UME
Password: student

Question 3

Username and Password for Optos:

Answer 3

Username: click on first image on left (on touchscreen, should say Unimelb optometry or something)

Password: optomap

Question 4

Username and Password for Consult room computers (or any computer)

Answer 4

Should automatically login, but if not:
Username: student\abowden
Password: your unimelb password

Question 5

What is the name of Sunix on the desktop or when searched in windows?

Answer 5

V2000

Question 6

How do you perform an Estermann VF test with the VF machine? How do you instruct the patient for the test.

Answer 6

Main menu –> Show Test Library –> Specialty –> Binoc Estermann (px does with both eyes open)

This tests takes 5 minutes, and inform the patient similarly to other VF tests:
“This is a test of how well you can see across your visual field/entire range of vision”
“Spots will appear on the screen, some of these spots may appear brighter/darker, they can be closer or further away, and the time they appear can be different. If you see a spot I want you to press the button”

Question 7

Where in sunix should you place BV testing results?

Answer 7

“In pupils” - Christine Nearchou

Question 8

What are the following Medmont equivalents to the following Humphrey VF tests:
10-2
24-2
30-2

Answer 8

10-2 = macula
24-2 = central test
30-2 = glaucoma test

Question 9

How do you send a letter through MEC?

Answer 9

In sunix: letter –> new px letter –> report to gp (usually) to generate a template

Complete template –> place eyecare letterhead in printer –> inform staff you are printing letter –> get supervisor to sign printed letter –> scan letter (front side up) to myscans

In consult room: images –> import the image –> email to uni-eyecare@unimelb.edu.au

Front desk: forward email to patient email from front desk with no name after “regards”

Question 10

Topography result not showing up when trying to import images, even though it saved to myscans?

Answer 10

It’s the name. Import images only shows the top 6 recent images, however if you rename the file it will go to the bottom because it’s also alphabetical.

Can solve by putting AA at start of file or simply by not renaming the file.

Question 11

How do you save topography results to my scans?

Answer 11

Print as pdf

Question 12

How are topography scans taken?

Answer 12

Automatically as patient looks at target centre yellow circle.

Question 13

When performing Visual fields, where is the trial lens set?

Answer 13

In a box to the left/behind on the table on left side of the room

Question 14

How do you perform a Humphrey Visual Field at MEC? (4)

Answer 14

1. Search for patient via ID or last name
2. Enter details on right side of screen (incl distance prescription and trial lens used for near) - if relevant, also includes choosing type of test
3. Give patient eyepatch with tissue to cover eye that’s not been tested
4. Gaze initiation –> then when done –> start test (read instructions out from screen during this process for standardisation)

Question 15

Should you use SITA faster when doing Humphrey VF testing?

Answer 15

No, generally not. SITA faster doesn’t have reliability indices like false negatives so is not a reliable test. Better off with SITA standard (or SITA fast if patient is having issues with long duration, e.g. fatigue I guess, elderly)

Question 16

When you have finished a consult at the MEC, what should you do with the patient info screen?

Answer 16

Brief summary of consult with date and name + OD4.

Question 17

If a patient needs new spectacles ordered at MEC, what do you do?

Answer 17

This is handled by front desk. Tick dispensing sheet for the type of specs, adding additional info if necessary, then do a handover to the front desk for them to assist with choosing of frames etc.

Question 18

On OCT, what value near the fovea is considered potential swelling?

Answer 18

Anything > 250.

(NB: the fovea is the inner circle within the bigger circle with the X)

Question 19

What are the four standard screening tests that we typically do on basically everyone?

Answer 19

Cover test (D+N)
Ocular Motility
Confrontation
Pupils

Question 20

Should you ever copy patient info over from previous consults?

Answer 20

NOOOOOO!!!! It is very bad, because you never actually asked those questions and things could have changed. Anyone can just look at previous consult to get that info rather than copying over.

Question 21

What is mac vertical used for (OCT)?

Answer 21

Glaucoma TSNIT

Question 22

What is mac horizontal used for (OCT)?

Answer 22

Subjective general assessment/other conditions e.g. AMD

Is qualitative

Question 23

When do we do a “follow up” scan?

Answer 23

only for a specific lesion that you want to isolate in on (usually one cross section)

Question 24

When should you consider smaller size in OCT angiography?

Answer 24

Older patients with fixation problems (otherwise, just use longer scan/larger size)

Question 25

Which is faster, 3D mac V or H?

Answer 25

Mac V is a bit faster

Question 26

Does 3D wide give you info about macula thickness?

Answer 26

No it doesn’t. Some kind of glitch.

Question 27

What is the purpose of 3D radial?

Answer 27

it can help to show a lesion in different aspects (cf cross). Good for looking at things away from ON region

Question 28

What is a 3D cross and how does it work?

Answer 28

5 lines horizontal, 5 lines vertical. Does a scan for each.

Question 29

Can BVs cast a vertical shadow on OCT?

Answer 29

Yes.

Question 30

Should you use the auto-vert at MEC?

Answer 30

No. Use the manual vert or else Shane may get upset.

You may be able to justify auto vert for PALs perhaps. NB: This is unlike ACO, where at ACO you can do what you like with vert honestly.