To perform fluorescein and indocyanine green angiography for large or peripheral chorioretinal structures using a contact lens system that provides a 5-fold increase in the field of view of a confocal scanning laser ophthalmoscope (SLO).Methods: Separate handheld contact and noncontact ophthalmoscopic lenses were manually aligned with the optical axis of a confocal SLO to demonstrate the feasibility of wide-field SLO angiography. An integrated, widefield contact lens system was then designed and constructed to increase the SLO's 10°, 20°, and 30°imaging fields to 50°, 100°, and 150°, respectively.Results: Simultaneous fluorescein and indocyanine green angiography was performed with the integrated, widefield contact lens system for more than 50 patients with disorders that affect their peripheral retina and choroid. Retinal and choroidal abnormalities, including neovas-cularization and capillary nonperfusion, are easily detected and documented well beyond the range of conventional fundus cameras and SLOs. Peripheral retinal and choroidal hemodynamics can be readily observed and recorded.Conclusions: A confocal SLO has adequate resolution for clinically useful reflectance and angiographic imaging even when its field size is increased 5-fold by a widefield contact lens system. Dynamic and static wide-field angiography can be performed without the limitations of manual or computer-automated photomontages. Peripheral retinal conditions can be studied and recorded to confirm observations from indirect ophthalmoscopy and to facilitate retinal photocoagulation and vitreoretinal surgery.

Ophthalmoscopic contact lenses for transpupillary thermotherapy (TTT) must provide effective visualization of retinal treatment sites and transmission of infrared diode laser radiation. Selection and proper use of retinal laser lenses requires knowledge of their lateral magnification, laser beam magnification factor, field of view and resolution. Optical performance is analyzed for Goldmann-type lenses and a series of inverted image lenses of differing magnification. Goldmann lenses have the highest resolution, but inverted image lenses of comparable magnification have 2.5 times or more their field of view. Inverted image lenses of similar magnification can differ in resolution. They require 2-4% more incident laser power to produce the same retinal irradiance as a Goldmann lens, but this difference is small in comparison to other clinical variables. Tilting an ophthalmoscopic contact lens up to 15 degrees causes little distortion in the circularity of the retinal spot formed by a laser beam or difference in retinal irradiance across the spot. Inverted image lenses produce higher anterior segment irradiances than Goldmann-type lenses, but anterior segment injuries are less likely in TTT than conventional visible light, short-pulse retinal photocoagulation because of the comparatively low irradiances used in TTT and the decreased absorption of diode laser infrared radiation in ocular media and melanin.

Abstract. We developed a clinical strategy for dealing with situations in which ophthalmoscopic examination and vitreoretinal surgery are difficult in patients with an ARRAY® refractive multifocal intraocular lens (IOL) implant. The ARRAY zonal-progressive IOL has a central 2. 1 -mm distance-vision zone for optically-unobstructed posterior pole observation. A concentric near-vision zone (+3.5-diopter add) surrounds this central zone. Optical ray-tracing is used to determine how a 2.1-mm pupil limitation restricts monocular and binocular retinal image size in head-mounted, slitlamp, and operating microscope ophthalmoscopy. A 2.1-mm pupil decreases the retinal field of view of high magnification, narrow field lenses much more than that of wider-field, lower magnification lenses. This "worst-case" analysis suggests an ophthalmoscopic strategy, but is not strictly valid for the ARRAY lens because the near-vision zone surrounding its 2.1-mm central zone is not opaque. The near-vision zone contributes defocused information to the ophthalmoscopic image, diminishing its resolution and depth information. Wide-field, low magnification lenses are potentially less problematic than higher magnification lenses for examining and treating patients with an ARRAY IOL implant. This strategy is useful for panretinal photocoagulation or photodynamic therapy, but not for procedures requiring high magnification stereoscopic vision such as macular vitreoretinal surgery. [Opthalmic Surg Lasers 2002;33:74-76]

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Abstract. A new inverted-image Ophthalmoscopic contact lens provides 2X laser spot magnification and a 117° degree instantaneous field of view. It has three times the resolution of very wide-field, inverted-image Ophthalmoscopic contact lenses to permit effective use of higher slit-lamp magnifications. The lens was designed for transpupillary thermotherapy with large lesions and panretinal photocoagulation with hazy ocular media. [Ophthalmic Surg Lasers imaging 200334:76-77]