Light induced visual-response (LIV)—the use of light to stimulate electrical responses from cells within the eye—has recently emerged as a better way to describe visual electrophysiology testing.
There is an old perception that electrophysiology is mostly used to detect esoteric eye disease and for monitoring subtle changes in rare pathologies in the institutional setting.
In reality, modern LIV tests can help guide clinical decision making in pathologies that we see on a routine basis by using streamlined protocols and platforms which fit into the practice setting.
Modern LIV platforms do not require a PhD level of technical understanding. The reports generated by my in-office platform use green-yellow-red color-coding to note healthy, caution, and likelihood of pathology, respectively (Diopsys).
The testing is comfortable for patients, does not require a contact lens, and is more patient-friendly than a visual field.
Additionally, using LIV has not negatively impacted our efficiency. We have a designated technician who performs all necessary testing, including OCT, visual fields, and LIV. At the same time, the platform we use has a template for running the chosen test that integrates with our electronic records systems for generating reports, patient follow up, scheduling future tests, and integration into coding and billing.
Clinical studies have long supported the use of these types of objective, functional tests for common ocular pathologies, and now modern devices make the technology accessible to the practice.
Steven M. Silverstein, MD, is president, Silverstein Eye Centers in Kansas City, MO. He is a speaker for Diopsys.
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