The challenge of external photography is that it appears to be so easy. External photography is an exercise in information transferal. Light encodes physical aspects of the patient into descriptive groups of colors, shapes and lines. Successful external photography conveys specific information concerning tissue size, color, position, asymmetry, motion and modification. Unless we take careful steps to accurately capture this visual information, photographs may fool us by displaying false color, distorted perspective, or insufficient information. This paper describes the tools necessary to create useful external photographs, the standards required to promote their accuracy and a method for successfully completing this clinical procedure.

External ocular photography documents the external eye, lids and ocular adnexa (Figures 1 and 2). Photographs can record the eye and its motion more accurately than physician chart notes or drawings. External photography is used to follow patients for insurance documentation and for patient and health professional education. Clinical research uses external photographs to objectively document findings. Patient trauma images are useful in legal proceedings, while cosmetic surgeons use photography to document pre-existing conditions. External photography is especially useful when a difficult case must be discussed with a colleague, or when further study of eye movement is required after the patient has left the clinic.

The CPT procedure code 92285 External Photography describes external photography. This code does not differentiate between external and slit lamp photog- raphy, between film and digital media, or between still and video images. External photographs are an integral part of a patient’s medical records and are subject to HIPAA (Health Insurance Portability and Accountability Act) regulations. The specialists who most often request this procedure include pediatric ophthalmologists and ophthalmic plastic surgeons, although virtually every ophthalmologist may request external photography.

Download