In this month’s issue on diagnostic skills and techniques, there’s an interesting dichotomy afoot: old vs. new. The series starts off with a thorough, eight-page look at OCT angiography, the very latest addition to an always-evolving technology platform. But there’s also a lengthy piece on handheld condensing lenses, one of the oldest technologies for examination of the eye. That article even features an explanation of the optical principles of how lenses work—equations and everything!—reminiscent of the days when this magazine was called The Optical Journal & Review of Optometry. (If you’re breathless with anticipation and want to get right to the math equations, they’re on page 60.)

The contrast between old and new is front and center in our point-counterpoint on ultra-widefield imaging, probably the most polarizing piece of technology optometry has encountered. We thank our contributors, Ken Jeffers, OD, and Paul Ajamian, OD, for each staking out a position and speaking so candidly on the positives and negatives of this disruptive technology. Want to sound off on that, too? Email me at and we’ll share reader reactions in an upcoming letters to the editor section.

Another strain that I hope comes through in this series is the importance of the clinician as the ultimate arbiter of all this data, a theme we might call man vs. machine, if you can forgive the gendered language in that phrase. As technology continually gets better, its pronouncements get closer and closer to sounding like objective facts. But doctors should take care not to mistake data for diagnosis. That’s the advice from James Fanelli, OD, and Bill Potter, OD, in their article on so-called “red disease” in glaucoma, the false positives that an OCT scan can generate and might lead the doctor to treat a disease that doesn’t exist.

Technology will help you gain insights you might not have had otherwise, but ultimately it’s you who makes the call—and takes responsibility for it. Brian Chou, OD, reviews principles of medicolegal protection in his article that closes out the series. Last summer, when we were planning the content for this issue with the editorial board, it was Randall Thomas, OD, who pointed out that a clinician’s three most feared words are (or ought to be) “failure to diagnose.” That’s a heavy burden, and we hope this month’s series helps to lighten it a little.

Optometrists are fortunate that the medical device industry has given them so many exceptional tools. But at the recent AFOS meeting during this year’s SECO, I was reminded again of just how much the best clinicians can get just by listening. During her talk on tumor diagnosis, Kelly Malloy, OD—a neuro specialist from PCO—gleaned enough pertinent information just from talking with patients that she was pretty sure what she would find in her exam—and what it would mean. That’s old-school diagnostic acumen no machine can replace.

Remember, the best diagnostic device you own is the one you have with you all the time—your brain.