As dedicated ophthalmic technicians, we should always be looking for ways to be more efficient. Efficiency makes us more valuable to our doctors, but it also makes our jobs easier.
An analysis published in Retina found that bottlenecks in patient flow were not caused primarily by a patient's age or the time of day, but rather slowdowns occurred due to the most commonly requested tests and tests that took the most time to complete (think visual fields).1
Another almost universal step in an exam is patient history and workup, so with that in mind, one of the easiest ways for us to improve patient flow—and lessen work for ourselves—is to minimize the number of keystrokes we have to enter during an exam.
The importance of shorthand for ophthalmic technicians
Why is shorthand important? According to the American Society of Administrative Professionals (ASAP), the average professional types around 60 words per minute.2 The average speed of conversational speech, however, is between 150 and 180 words per minute.
So even in the best conditions, we type less than half as fast as we speak. Abbreviations, or alphabetic shorthand, can greatly increase the technician’s typed words per minute and can aid in standardizing chief complaints, which leads to getting the patient in and out of the exam room as quickly as possible.
Download the Abbreviations for Ophthalmic Technicians cheat sheet here
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Must-Know Abbreviations for Ophthalmic Technicians
This cheat sheet outlines common abbreviations and modifiers used in ophthalmology.
Methods for memorizing common abbreviations
Rather than simply providing a list of common abbreviations, which is located at the bottom of this piece, it may be helpful to also share some memorization techniques and examples to help the memorization process.
There are hundreds of abbreviations in ophthalmology and optometry. Many technicians new to the field benefit from the use of flashcards to memorize them. This is just one part of a process called spaced repetition, in which the student—in this case a technician—reads, writes, says, rests, and revisits (RWSRR) the information in order to memorize it.3
This approach is called “spaced repetition” because these methods are spaced out in intervals, sometimes every few hours, every day, or every few days, to aid in memorization.
Using associative memory
Other ways of memorizing these abbreviations include psychological techniques such as associative memory. When using associative memory, a person takes two seemingly unrelated things to remember a word or information.4 It is often referred to when a smell or taste brings back a specific memory of a place or moment in time, but it's also a useful memorization technique.
For example, meeting a new co-worker named “Marissa” and associating that name with the 90’s television show “Clarissa Explains it All,” because “Marissa” and “Clarissa” rhyme is an example of using associative memory to remember that coworker’s name.
A more relevant example might be the abbreviations OD and OS, the common abbreviations for right eye and left eye. They’re derived from the Latin words “oculus dexter” and “oculus sinister.” Dexter is the root word of dexterity, and as the majority of people are right-handed, associative memory could be used to connect dexterity with right-handedness and right-handedness with the right eye.
In contrast, although the word "sinister" is commonly used today to denote something evil or bad, in Latin, it primarily meant “on the left side.” The left hand has biblical implications of judgment, which could help connect sinister with the left hand and left hand with the left eye when trying to recall their meaning.
Along those same lines, because when recording a patient's vision it is important to note if it was measured with or without correction, we use the abbreviations SC and CC, which indicate without or with correction. So, why not WC (with correction) or WOC (without correction)? These abbreviations come from the Latin words “sine correctore” and “cum correctore.” Using associative memory, one could remember that “con” means with in Spanish, and “sin” means without.
It’s important to use uniform preexisting abbreviations to avoid confusion; in a medical workup, “WC” often stands for worker’s compensation. It’s unlikely a doctor would confuse the terms “with correction” and “worker’s compensation” in context, but deciphering it would slow down their interpretation of the workup, which is the opposite effect abbreviations should have.
Prioritize memorizing abbreviations based on their usefulness
Thankfully, only a few ophthalmic abbreviations are based in Latin. Many of them are just the first letters of the English words or phrases they stand for. When learning abbreviations, prioritize the ones that will be most useful in whatever specialty you’re working in.
In oculoplastics, abbreviations like RUL (right upper lid) and RLL (right lower lid) would be very common, but not particularly useful in a LASIK (laser assisted in-situ keratomileusis) practice. If you’re unsure of what to prioritize, ask the doctor which abbreviations they find most useful, or look at recent exam workups from senior technicians in the office.
Before you go, check out the Abbreviations for Ophthalmic Technicians cheat sheet!
All about acronyms in eyecare
Sometimes acronyms take on new meanings. The abbreviation WDL, which stands for “within defined limits,” is written to convey a lack of abnormality; the word “defined” being used rather than “normal” because “normal” is a subjective term.
However, some doctors dislike this abbreviation because of its perceived overuse, quipping that WDL actually stands for “we didn’t look.” Abbreviations are meant to create shortcuts in charting, not as a means to cut corners in patient care. Acronyms also change with time; for example, emergency room (ER) has transitioned to emergency department (ED), as it has become more than a single room.
Similarly, when the International Classification of Disease, Tenth Revision (ICD-10) medical coding was released in 2015, the abbreviation BDR (background diabetic retinopathy) was changed to mild, moderate, and severe NPDR (non-proliferative diabetic retinopathy) along with which eye, if not both, are affected to recognize the different severities of diabetic retinopathy and the associated complications.5
This is to say that abbreviations may change over time as medical advancements are made, and ophthalmic technicians should embrace these advancements, even if it means having to learn something new.
The FOLDAR method of history taking
Acronyms and mnemonic devices are another way technicians can get in and out of an exam lane quickly. For example, the acronym FOLDAR, which stands for frequency, onset, location, duration, and remedies, can concisely provide the doctor with an incident report.
There are several people who are given credit for the invention of the acronym; I learned it from a doctor I was working for in Vermont in 2009, who learned it from a professor at the New England School of Optometry in the late 1980s. It’s proven to be a valuable acronym that I continue to teach every new technician I train.
Think of the FOLDAR as the “who, what, when, where, why” of patient history taking:
- Frequency: How often a symptom occurs.
- Onset: When did the symptoms start?
- Location: Where on your body are you affected?
- Duration: How long do the symptoms typically last?
- Remedies: How have you tried to relieve your symptoms?
The technician can be sure they’re gathering the key bits of information the doctor may need going into the room. This acronym is also helpful when trying to determine what to omit from a patient history, as patients will often give copious amounts of detail, not all of which is pertinent (who they were with, what the sandwich special was at the restaurant that day, why they were mowing the lawn on a Tuesday, etc.).
Ophthalmic abbreviations to know as an ophthalmic technician
The following is a list of common, daily used abbreviations for the ophthalmic technician. As stated previously, there are hundreds of ophthalmic abbreviations, and listing every one would be both tedious, and not particularly helpful, as only a few dozen are commonly used, and even less than that are used frequently.
These abbreviations have been roughly organized from the front of the eye to the back, or the beginning of a patient exam (vision, pressures, pupils) to the end (ocular surface assessment, fundus exam).
Table 1 lists common ophthalmic abbreviations.
| Abbreviation | Definition |
|---|---|
| OD (oculus dexter) | Right eye |
| OS (oculus sinister) | Left eye |
| OU (oculus uterque) | Both eyes |
| BCVA | Best-corrected visual acuity |
| SC | Uncorrected vision/without corrections |
| CC | Corrected vision/with corrections |
| PH | Pinhole vision |
| CF | Count fingers: Generally followed by a gross distance, ex. 12in, 3ft, etc. |
| HM | Hand motion |
| LP | Light perception |
| NLP | No light perception |
| F&F | Fix and follow; mainly used for infants or other nonverbal patients |
| K | Keratometry readings (i.e., the curvature of the cornea) |
| Cyl | Cylinder (i.e., the amount of astigmatism a patient has) |
| IOP | Intraocular pressure |
| APD | Afferent pupillary defect |
| DES | Dry eye syndrome |
| DED | Dry eye disease |
| IOL | Intraocular lens |
| PC | Posterior chamber |
| AC | Anterior chamber |
| POAG | Primary open-angle glaucoma |
| ARMD or AMD | Age-related macular degeneration |
| RD | Retinal detachment |
| PVD | Posterior vitreous detachment |
| WDL | Within defined limits |
Modifiers
Table 2 lists common modifiers used in eyecare.
| Abbreviation | Definition |
|---|---|
| Sx | Surgery; *may also be used to mean symptoms |
| s/p | Status post, after |
| w/ | With |
| w/o | Without |
| y/o | Year old (to indicate a patient's age) |
| < | Less than |
| << | Much less than |
| > | More than |
| >> | Much more than |
| ~ | Roughly, around |
| △ | Change |
Abbreviations in action: a case report
A 76-year-old patient comes in and has poor vision. They're wearing glasses. The left eye is much worse than the right eye. They tell you they’ve had cataract surgery in the right eye roughly 3 years ago with good results, but recently both eyes are seeing poorly. Driving at night is especially bad. Right eye sees 20/30 with glasses, left eye sees 20/60 with glasses.
Abbreviated case: 76 y/o presents with decreased VA OU, occurring slowly over time. PC/IOL OD ~2021. OS >>OD. Worse when driving at night. CC: OD 20/30 OS 20/60.
Using abbreviations like this reduces the keystrokes from 68 words to only 30, and it gives the ophthalmologist all the information they’ll need without having to read an entire paragraph.
In closing
One of the major topics of discussion post-pandemic in ophthalmology has been a decrease in reimbursement by insurance companies,6 and to offset that, along with premium IOLs and elective services, many ophthalmologists have increased the amount of patients they see in a day.
Although there are countless areas in a practice that can be optimized to reduce bottlenecks, using abbreviations is one way a technician can relieve some of the pressure added by an increased patient base while still providing a premium level of care for their patients.
