October 3, 2007
How the composite image was created
Capturing a sharp and seamless image of the inner eye
In 1995 Richard Hackel, C.R.A., changed the way we view complex images of the retina.
ANN ARBOR, MI - A good ophthalmic photograph can illuminate images of the eye’s interior, providing the ophthalmologist with important details about the structure of the eye and the health of a patient’s vision. The Kellogg Eye Center has an outstanding group of ophthalmic photographers, and they are directed by Richard E. Hackel, C.R.A., FOPS. He has won numerous national awards for his work, edits a column in EyeNet, and a little over ten years ago, developed an imaging technique that changed the nature of ophthalmic photography.
Ophthalmic photographers produce detailed images of the retina, optic nerve, and other structures that may reveal the course of a particular disease. However, photos taken through the patient’s pupil capture only a small part of the whole, much like the limited view of a room as seen through a keyhole. Photographers traditionally pasted multiple images together, but the process left visible edges and a less than perfect image.
Richard Hackel’s achievement in 1995 was to stitch together some 92 images to create one clear seamless image. The result: the first digital composite of the retina. “I was on vacation when I received the images for the cover of a journal I was editing at the time,” says Mr. Hackel. “I spent the better part of the week scanning digital photos and then piecing them together with a software imaging program.” Word spread quickly, and software developers responded by adding a montage feature to imaging software.
With today’s software the process is much simpler. “You can create a fairly good composite rendering in 5 to 10 minutes,” explains Mr. Hackel. “But the image will be much more useful if you spend the extra time refining it. If that takes 3 to 4 hours, it’s still better than the 60-plus hours I spent on the very first image.”
Mr. Hackel and colleagues Robert Prusak and Linda Goings photograph the eyes of 30 to 60 patients a day. They know that a large part of their job is to help patients feel comfortable as they enter an unfamiliar setting. “Patients are often afraid and worried about their vision,” he observes. “The photos are unlike any they’ve seen before, so it helps to explain what appears on the computer screen.”
The academic setting creates another set of challenges. While Mr. Hackel provides images for case presentations and journal articles, he is also involved in research, including the current Kellogg initiative to develop the first metabolic imaging device.
Then there is the constant need to keep pace with the newest technology. The Department will soon have high-speed spectral domain imaging equipment that will display three-dimensional cross-sections of the retina in exceptional detail. When Eye Center clinics move into a new facility in 2010, Mr. Hackel and his staff will occupy a newly designed photography lab equipped with state-of-the-art equipment to serve Kellogg’s patients and faculty.
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Our ophthalmic photography group is on the 2nd floor of the W.K. Kellogg Eye Center. Patients who need to have photographs taken are referred by their ophthalmologists.
Written by Betsy Nisbet