Diagnostic Equipment

Since its inception, the Para-clinical department of Noor Eye Hospital has been providing the most advanced diagnostic equipment, according to the highest para-clinical standards of the best ophthalmology centers in the world, and it now offers a full range of diagnostic services to a large number of patients. The equipment is as follows:

- Contact A-Scan Ultrasound Device: The contact A-scan ultrasound biometry devise is used to calculate intraocular lens (IOL) power; it requires direct contact with the cornea. The procedure of A-scan is simple; first the ultrasound waves are transmitted into the eye. When the sound wave encounters a media interface, part of the sound wave is reflected back toward the probe. These echoes, which are converted into virtual images and mathematical formulas, allow us to provide key information and values necessary to determine the power of intraocular lens.

- IOLMaster: The IOLMaster is a noncontact biometry device to calculate intraocular lens (IOL) power. It is capable of fast and precise consecutive measurement of the necessary eye parameters for IOL power calculations, such as axial length, corneal curvature and anterior chamber depth, by using a high-speed laser light. Eventually after applying very complex mathematical techniques and based on the obtained formulas, the result of these calculations is recorded for the ophthalmologist. IOLMaster testing is a useful pre-operative diagnostic test allows the eye surgeon to select the appropriate intraocular lens, such as monofocal, multifocal, Toric, accommodative, or astigmatism correcting intraocular lens, for each patient.

- Orbscan Corneal Topographer: The orbscan corneal topography system is used to assess the corneal surface curvature as well as corneal irregularities. In fact, the orbscan provides an ophthalmologist with a qualitative and quantitative assessment of the anterior and posterior corneal surfaces. In this method, light is focused on the anterior surface of the patient's cornea and reflected back to a digital camera at the device. The topology of the cornea is revealed by the shape taken by the reflected pattern. A computer provides the necessary analysis, typically determining the position and height of several thousand (8000 to 10,000) points across the cornea. The topographical map can be represented in a number of graphical formats. Corneal topography can be used as a pre-operative test to diagnose keratoconus, or for corneal transplant surgery (Keratoplasty), and it used as a post-operative diagnostic test for corneal or refractive laser eye surgical procedures (to evaluate whether the patient is a good candidate for a refractive eye surgery or not.)

-Pentacam: The pentacam, a particular imaging system, can provide ophthalmologists with more accurate information about anterior and posterior corneal surfaces compared to corneal topography. This diagnostic system is used for measuring and examining the anterior segment. By measuring more than 25,000 true elevation points on the corneal surface, the pentacam provides accurate topographic information about corneal thickness, the anterior chamber depth and volume, intraocular pressure, as well as high-resolution imaging of the iris or the cornea, to study corneal density. The pentacam provides more accurate and reliable measurements compared to the orbscan. It is used for determination of lens opacities and the exact location of cataracts, contact lenses fitting, especially hard lenses, and assessing the effectiveness of soft contact lenses. It can also be used as a pre-operative diagnostic test prior to refractive laser eye surgeries to screen candidates for normal corneal shape, patterns and ruling out suspicious or to diagnose early keratoconus suspects and keratoconic patterns.

- B-Scan Ultrasound (Ocular Echography) Device: This device is used to measure the lens, and to examine the retina, vitreous membranes, ophthalmic tumors and other ocular tissues.

-Intraocular Pressure Measuring Device: This device is used to measure eye pressure of people with glaucoma and other diseases of the retina, and the ophthalmologist measures the accurate pressure of the eye by observing the information obtained by the device.

The retinal imaging (OCT & Angiography) department of Noor Eye Hospital includes a set of eye imaging services utilizing the most advanced ophthalmic equipment and experienced specialists to provide patients with the latest diagnostic technologies and state-of-the-art techniques. In this department, there are four angiography devices, three OCT devices and one fundus camera, by which specialists of this department, in a peaceful environment, offer diagnostic services to the patients.

1- Optical Coherence Tomography (OCT): It is a type of retinal imaging that does not require the injection of contrast agents. In this method, patient collaboration and the skill of who takes the images –whether an ophthalmic photographer or a technician- to produce pictures of consistently high quality are important in achieving the desired result.

• Retinal OCT Imaging: Retinal OCT imaging is used to examine the retinal layers and to assess the extent of possible damage to this area. This diagnostic imaging test is used in early detection and follow-up of diabetic eye diseases, inflammatory eye diseases, macular degeneration in the elderly and various types of retinal disorders.

• Corneal OCT Imaging: Corneal OCT imaging is used to measure the angle of the eye, the thickness of the cornea and its various layers, as well as measure the corneal flap in candidates for a second LASIK surgery.

• Retinal Nerve Fiber Layer (RNFL) & Optic Nerve Head (ONH) OCT Imaging: RNFL and ONH OCT imaging are used to evaluate and measure retinal layers within the optic nerve. This technology is very helpful in early detection and timely treatment of glaucoma and any optic nerve disorders.

• OCT Angiography (OCTA): OCTA is a no-injection, dye-free angiography. This is one of the newest methods of examining the retina in the center of vision. Since OCTA imaging is a new method, it cannot be a perfect replacement for dye-injected angiography. However, according to new studies, it is very effective in the differential diagnosis of some retinal vascular disorders.

2- Dye-injected Angiography: This angiography is a diagnostic outpatient procedure that requires the injection of dye and uses a special camera to record the blood flow in the retina. Noor Subspecialty Eye Hospital utilizes the-state-of-art imaging technologies and equipment in the OCT & Angiography Department and has always been committed to upgrading its diagnostic equipment and technologies.

There are two types of dye-injected ophthalmic angiography:

2-1. Retinal Angiography:

• Fluorescein angiography (FA): It is a technique for examining the circulation of the retina and retinal vessels.

• Indocyanine Green Angiography (ICGA): It is a technique for examining choroidal circulation and vessels.

2-2. Corneal Angiography: Angiography for the anterior segment is a technique for examining the assessment of corneal vascularisation.

Preparation for Angiography: Prior to angiography, you should be prepared for the test and tell your ophthalmologist about any recent illnesses, medical conditions, medications you're taking, allergies, or any special conditions you have. So, if you have any of the following items, be sure to notify your ophthalmologist before the test.

1. Respiratory or cardiovascular diseases

2. Kidney or liver diseases

3. If you have a history of allergic reactions to a special food or medication

4. If you have a history of seizures, epilepsy, myocardial infarction

5. If you are pregnant or breastfeeding

6. If you have any specific disease

After this stage, your physician will perform the test by inserting standard dilation eye drops into your eyes. These make your pupils dilate. Usually the pupils of the patients referred from Retina Clinic to Angiography Department have already been dilated, otherwise special dilation eye drops will be used to dilate their pupils.

It should be noted that after the test, pupil dilation will make your vision blurry up to 24 to 48 hours.

How Is a Dye-Injected Angiography Administered?

The procedure may take from 10 minutes to an hour, depending on the patient's medical condition, the ophthalmologist's order and the type of angiography. In this method, a dye, fluorescein or ICG, is first injected into a vein in the patients arm and after dye injection the images are obtained. Using the images, the circulation of the retina and the choroid and also choroidal and retinal vessels are examined.

Dye-injected ophthalmic angiography provides a high precise diagnostic examination for diabetic eye diseases, inflammatory eye diseases, and various types of retinal disorders. The data are collected and submitted to the ophthalmologist. In many patients, undergoing an ophthalmic diagnostic angiography is necessary to determine their final treatments.

3- Fundus Photography: It is a simple method of retinal imaging that requires no further analysis or action. Fundus photographs are visual records which document the current ophthalmoscopic appearance of a patient's retina to follow up on the progress of the disease (glaucoma, eye tumors, and retinal diseases.)

Types of fundus photography procedures include:

• Color Fundus Photography

• Multi-color Fundus Photography

• Auto Florescence (FAF) Fundus Photography

• Red Free/IR Fundus Photography

• Wide Field Multi color Fundus Photography

The pathobiology laboratory of Noor Subspecialty Eye Hospital started its activates in 2007, when Noor Ophthalmology complex was built. From the very beginning, the first goal of this laboratory was to be as a premier laboratory in Tehran, which works in all medical fields, and its next goal was to provide special ophthalmic services to patients, as a superb subspecialty ophthalmology laboratory. Fortunately, this laboratory has been very successful in achieving its goals.

Laboratory Services

The pathobiology laboratory of Noor Subspecialty Eye Hospital equipped with state-of-the-art equipment, devices and techniques, offers a full ranges of laboratory testing services from primary to specialty ones. What distinguishes the pathobiology laboratory of Noor Subspecialty Eye Hospital from other laboratories in Tehran is providing specialized diagnostic testing services for specific eye diseases. Many of these specialized diagnostic tests for the first time in Iran were offered to patients with specific eye diseases at Noor Eye hospital. Using cutting edge technology and employing well-trained laboratory staff, many eye diseases which were previously diagnosed after several weeks and performing invasive diagnostic tests, such as eye biopsy, today are easily diagnosed in less than a day without causing any invasive damage to the surface of the eye.

Laboratory Equipment

As mentioned earlier, in the pathobiology laboratory of Noor Subspecialty Eye Hospital we use the latest laboratory devices, equipment and techniques to offer a full ranges of laboratory testing services from primary to specialty ones. Some of these diagnostic laboratory tests, which are performed at Noor Eye Hospital for the first time in Iran, are as follows:

-Confocal Laser Scanning Microscopy: This device is different from the common similar imaging devices and provides very high resolution optical images. It can display the pathobiology of the corneal surface very well after scanning it. Before using this technique, performing microbial tests to diagnose very serious complications such as ocular surface infections, especially eye infections caused by the use of soft lenses, was necessary. The analysis of microbial tests for final diagnosis and result took about 3-4 weeks and during this long period of time, the cornea could become more damaged, but using confocal laser scanning microscopy, the analysis and test result just take 2 minutes.

-Impression Cytology: The only method for the detection of ocular surface squamous neoplasia cells and tumors in the past was eye biopsy. For eye biopsy, the patient was taken to the operating room to remove a sample of tissue (biopsy) from the eye and follow its pathobiological steps. This invasive test took between six and seven days to result, and was very expensive too. In the modern technique of cell collection, impression cytology, these steps are performed using only special filter paper and the cells attached to the paper are examined under a microscope and the analysis of the cells and receiving the test result just takes 24 hours.

-Hormone Measurement Equipment: The pathobiology laboratory of Noor Subspecialty Eye Hospital equipped with state-of-the-art equipment and techniques, using the best laboratory consumables, catalysts and international standards of the analytical accuracy and precision of the tests offers a full ranges of laboratory testing services, such as important hormone tests.

- Automation System: The Pathobiology Laboratory of Noor Eye Hospital is connected to a unique automation system that performs various tests, from performing to analyzing them, with minimal human intervention in the process. The aim is to increase the speed and accuracy of general and specialized pathobiology tests.

-Client Services: The Pathobiology Laboratory of Noor Eye Hospital provides all laboratory services, including all general tests, specialized ophthalmic tests and other common tests, to all Iranian and foreign patients.

- Test Results: You can receive your lab test result online at the website of Noor Eye Hospital. After going to the laboratory of Noor Eye Hospital in person, you receive a receipt with an activation code. At the determined time for receiving your lab test result, you can visit the hospital’s website and enter the code to view and print your test result.