We generally use photography to record people, places and events which we consider to be important. However, most people would not be aware of its value in the diagnosis and assessment of eye diseases and other anomalies.
A young patient recently presented with a strabismus (commonly called a “crossed eye”) which had not previously been detected as the “turn” was not large. However, family photographs established that the condition had been present from a very early age, indicating that treatment would be more difficult and prolonged.
The same principle is used clinically with highly sophisticated cameras which are designed to photograph the inside of the eye in order to diagnose and track the progress of certain diseases.
Some years ago a patient with a family history of glaucoma consulted me. Although there was no evidence of the disease at that stage, photographs were taken of the optic nerve to provide a reference point by which future changes could be assessed. Although it was still within normal limits several years later, comparison with the photographs showed an alteration in shape which led to an early diagnosis of glaucoma.
Another important application is tracking the progress of conditions such as diabetic eye disease in which small haemorrhages and signs of nerve damage in the retina provide an indication of the likelihood of loss of sight. Photographically recording the appearance of the retina allows a significantly more accurate assessment of the effectiveness of treatment.