Diagnostic Instrumentation

OCT: Enhance Patient Care with an Essential Clinical Tool

By Mile Brujic, OD

June 10, 2015


An OCT allows you to enhance patient care by extending your abilities to diagnose, treat and monitor a host of eye conditions and diseases. Measure cost and ROI.


MEASURE COST & POTENTIAL ROI. Compute payments$1,000 per month with a lease vs. loan; profits exceed monthly payments immediately after OCT is put in use.
ENHANCE PATIENT CARE. Can see up to six patients per day requiring OCT, elevating patient care.
EDUCATE PATIENTS. Let patients know why the OCT scan is being performed and how it helps you better care for them.

An OCT takes patient care to the next level, allowing you to better screen for, and monitor, serious eye conditions. It also can be an important part of building your practice–and enhancing profitability,in the process. It allows you to manage conditions, such as glaucoma and macular degeneration, that are difficult to manage without the technology. The equation is simple: Take the best care of your patients, and profitability will follow. Now that I have had an OCT, and use it in about one-fourth of all exams, I can’t imagine practicing without it.


iWellness is a quick and easy OCT scan that provides a single report displaying retinal thickness and GCC thickness with normative comparison and symmetry analysis.

Offering the iWellness exam benefits patients and the practice.

• Gain valuable information to aid in early diagnosis of ocular disease.

• Create a new revenue stream to offset the cost of the OCT system.

• Grow the medical practice with one fast and simple scan.

• Retain patients by delivering care that protects eye health.

• Differentiate the practice and increase referrals with state-of-the-art technology and enhanced patient education.

Measure Cost & Potential ROI

My five-OD, three-location practice uses the Optovue iVue model in our Bowling Green office, and the RTVue in our Lima location. We use two different instruments because of when we incorporated them into the practice. iVue wasn’t available when we first incorporated OCT in our Lima location. We purchased both on a note that we paid off early. RTVue was less than $65,000, and iVue was less than $45,000. For a five-year term with the iVue, the payment is less than $1,000 per month.

Assess How Many Patients Will Get OCT Scans

I typically see 15-20 patients a day, and of those patients, 2-5 will usually require an OCT. We performed about 400 OCT scans last year.

Enhance Care

I use my OCT on all glaucoma suspects or those diagnosed with glaucoma. I also use it to scan all patients with macular degeneration, epiretinal membrane, vitreomacular adhesion, diabetics with any hemorrhages within 1 disc diameter of the center of the fovea, and other macular conditions (i.e. Vitelliform dystrophy), keratoconus patients, Fuch’s endothelial dystrophy patients and scleral lens patients.

The OCT has a place in my contact lens practice, as well. When fittingscleral lenses, the success of the fit is highly dependent on the clearance of the lens over the cornea. An OCT allows you to measure the exact clearance of the lens over the cornea and minimizes errors in estimation of clearance that may occur with assessing clearance of the lens at the slit lamp. Without the OCT, we estimate the clearance of the lens using the slit lamp. This is a very difficult task to estimate with a high level of accuracy.

Code Carefully for Highest Reimbursement

For reimbursement, make sure you are representing the scans appropriately. The code 92132 describes anterior segment scans, 92133 describes the optic nerve scans and 92134 describes macular scans. The codes 92133 and 92134 cannot be billed on the same day.

Educate Patients About OCT

I let patients know that we need to take a more detailed look at the tissue that we are discussing, and let them know that we have the technology available in the office. Here is how I would describe OCT to a glaucoma suspect: “Glaucoma is a condition that can affect the optic nerve. We have technology that can detect damage to the optic nerve earlier than traditional technologies. These scans will help us keep your eyes as healthy as possible. We are going to perform the scan on your eyes now, and then I will go over the scans with you in the exam room after they are completed.”

There is usually no out-of-pocket expense to the patient since this scan is typically covered by medical insurance, especially if the patient has a condition or disease I believe necessitates an OCT scan.

Premier Vision Group

Mile Brujic, OD

Bowling Green & Lima, Ohio

Locations: 3 (two primary locations and a satellite office)

ODs: 5

Support Staff: 18

Annual Exams: 6,000

Prepare Staff to Use OCT

Our technicians perform the OCT scans, which usually just take a few minutes to complete.

The iVue was a remarkably easy instrument to be trained on. Almost everyone in the office can perform the scans. It is a pleasure having a technology that acquires such remarkable images, but is so easy for everyone in the office to use.

Related ROB Articles

OCT: Your Medical Eyecare Practice-Builder
VEP: Instrumentation to Enhance Your Medical Eyecare Services

Display Screens: Educate Patients with a Wow Factor

Mile Brujic, OD, is a partner of Premier Vision Group with primary locations Bowling Green and Lima, Ohio. To contact him: brujic@prodigy.net.

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