Ami Halvorson, OD
PCLI—Portland, OR
From the EDITOR In my nearly 20 years of practice, advances in instrumentation, imaging, and diagnostic testing have greatly improved our ability to detect and monitor eye diseases. Understanding that many practices cannot justify investing in every technology, we are happy to offer select diagnostic services. In this issue, my colleague Kim Calnan-Holt details the services available at PCLI for patients who may benefit.
By Kim Calnan-Holt, OD | PCLI—Spokane, wa
PCLI Diagnostic
Over the past several decades, diagnostic testing and imaging have transformed modern eye care from primarily observational to highly quantitative. While clinical examination remains foundational, advanced diagnostics provide objective data that can:
- Enhance diagnostic accuracy
- Guide treatment decisions
- Improve longitudinal monitoring
- Strengthen documentation and patient education
ESSENTIAL TECH
Technologies such as visual field testing, corneal tomography, OCT, axial length biometry, endothelial cell analysis, B-scan ultrasonography, and digital photography are now essential to comprehensive care. They support earlier disease detection, more precise monitoring, and clearer inter-provider communication through reproducible, measurable data.
However, maintaining cutting-edge equipment requires significant investment, ongoing maintenance, and upgrades—costs that can be challenging for many practices. At PCLI, we may be able to help bridge that gap by offering advanced diagnostic services in the communities we serve.
OUR SERVICES
Our diagnostic services include the following. Please note that some services vary by PCLI location. Also, unless requested, our results are returned without interpretation.
Services
1. Visual Field Testing
We provide Zeiss Humphrey perimetry, allowing precise functional sensitivity testing with normative database comparison. Visual fields are indispensable for glaucoma management, retinal disease evaluation, and neuro-ophthalmic assessment. Establishing reliable baselines and monitoring progression over time remain critical to long-term disease control.
Pentacam keratoconus
2. Corneal Tomography
Using the Pentacam, we obtain three-dimensional imaging of the cornea and anterior segment. This technology evaluates corneal thickness, curvature, and irregularity, and is useful for diagnosing keratoconus, monitoring ectasia or edema, assessing pterygia and corneal scars, and planning refractive or cataract surgery. It also assists with post-surgical evaluation and phakic IOL assessment.
3. Digital Photography
These images enhance patient education, documentation, and collaborative care.
- Fundus photography – captures high-resolution images of the retina, optic nerve, macula, and vasculature.
- Anterior segment photography – documents eyelid, conjunctival, corneal, iris, and lens pathology.
ABOUT THE AUTHOR
Kim Calnan-Holt
PCLI SPOKANE, WA
Positive, outgoing and down-to-earth, Kim Calnan-Holt’s hands-on approach and straightforward manner make it easy for people to trust her. Born and raised in Butte, Montana, Kim grew up among the trees and wildlife. She enjoys traveling, camping, swimming, boating, water skiing, and snow skiing. Kim and her husband, Bill, a national account manager for a large company, live in Spokane, Washington. They have twin sons and a daughter—Tegan, Rylan and Joelle.
Next
Why Axial Length Monitoring Matters
Progressive myopia has risen dramatically worldwide, particularly among children. Beyond refractive error alone, axial elongation increases the lifetime risk of retinal detachment, myopic maculopathy, glaucoma, and earlier cataract development.
Axial growth is the structural driver of myopia progression. Monitoring axial length provides an objective, quantifiable metric for assessing progression and treatment effectiveness.
Axial length measurements are typically recommended every six months during myopia control treatment, and more frequently in rapidly progressing patients.
Objective axial monitoring allows clinicians to shift from reactive refractive management to proactive structural risk reduction.
4. Optical Coherence Tomography (OCT)
OCT provides detailed cross-sectional imaging of ocular structures.
- Macular OCT – evaluates retinal thickness and layer integrity, identifying intraretinal or subretinal fluid, epiretinal membranes, vitreomacular traction, macular holes, pigment epithelial detachments, age-related macular degeneration, diabetic macular edema, and vascular occlusions.
- Optic Nerve Head and RNFL Analysis – measures retinal nerve fiber layer thickness, neuroretinal rim parameters, and ganglion cell complex integrity—key metrics for glaucoma detection and progression monitoring, as well as evaluation of optic neuropathies.
- OCT Angiography (AngioVue) – noninvasively visualizes retinal and choroidal microvasculature without dye injection, assisting in the detection of choroidal neovascularization, diabetic retinopathy, macular ischemia, and vascular occlusions.
- Anterior Segment and Corneal OCT – evaluates angle anatomy, anterior chamber depth, pachymetry mapping, epithelial thickness, post-surgical status, and Descemet membrane pathology.
5. B-Scan Ultrasonography
B-scan ultrasound allows evaluation of the posterior segment through dense media opacities, such as advanced cataract or vitreous hemorrhage. It is valuable in diagnosing retinal detachment, intraocular tumors, vitreous pathology, and retained foreign bodies.
6. Endothelial Cell Analysis
Specular microscopy measures endothelial cell density and morphology. This testing is particularly useful in patients with corneal dystrophies, prior inflammation or trauma, and those considering intraocular procedures such as ICL or MIGS.
7. Axial Length Biometry
Non-contact optical biometry provides highly accurate measurements from the anterior cornea to the retina. Axial length data is essential for intraocular lens calculations and for classifying eyes as long or short. Secondary metrics—including anterior chamber depth and lens thickness—offer additional structural insight.
Increasingly, axial length measurement plays a central role in managing progressive myopia.
CONCLUSION
Advanced diagnostics are foundational to contemporary eye care. If we can support your clinical care with these services, we welcome your request and look forward to serving your patients.
Diagnostic Services Request forms are available on our odpcli.com website under “Order Materials.” Our results are returned without interpretation unless requested, allowing the referring provider to document and bill interpretation.
B-scan of a dense asteroid
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Questions If you have questions, feel free to contact any of our optometric physicians. We’re always happy to help.
Spring 2026 distributed quarterly to 2900 optometric physicians