Ophthalmic Surgeon DIMITRAKOPOULOS PANOS

Dynamic Retinoscopy is a specialised clinical method for the objective assessment of refraction. Through direct evaluation of the light reflex emerging from the eye, the physician obtains a dynamic representation of visual function, which is essential for:

• Accurate Prescription in Adults: It forms the basis for spectacle prescription, particularly in cases of accommodative dysfunction, where automated measurements may be unreliable.
• Paediatric Ophthalmic Examination without Discomfort: It allows comprehensive ophthalmic assessment in children, often without the use of cycloplegic eye drops. This avoids temporary blurred vision and photophobia, facilitating the child’s and family’s daily routine.
• Management of Visual Stress: It contributes to the diagnosis and therapeutic management of visual fatigue arising from the demands of modern daily life.
• Support of the Learning Process: It enables evaluation of visual behaviour and reading performance, ensuring that the child possesses the necessary visual skills for academic success.
• Clinical Reliability: It serves as a safeguard against the technical limitations of automated refractors, leading to fully balanced and individualised prescriptions.

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Contemporary surgical management of Myopia, Astigmatism, Hyperopia and Cataract.

The surgical approach is based on minimising contact with ocular tissues, with the aim of maximising safety and promoting rapid recovery:

• Myopia & Astigmatism:No-Touch laser techniques are applied using advanced laser algorithms, allowing refractive correction without mechanical intervention on the ocular surface.

• Hyperopia & Cataract: Minimally invasive microsurgical techniques are performed using advanced ultrasound technology, tailored to the individual anatomical characteristics of each patient.

• Individualised Surgical Planning: Each surgical intervention is determined following a thorough benefit–risk analysis. The choice of technique is based strictly on medical criteria, ensuring the most appropriate approach for the specific needs of each eye.

Surgical procedures (Laser, Cataract) are personally performed by the physician at specialised accredited ophthalmic centres in Athens and Patras, ensuring access to advanced technological infrastructure.

Specialised strabismological and neuro-ophthalmological assessment is performed, based on internationally recognised clinical protocols for the diagnosis and follow-up of serious conditions:

• Clinical Protocols: Established standards are followed, including OHTS for glaucomatous damage, ONTT for optic neuropathy (associated with Multiple Sclerosis), and Leber Optic Neuropathy.

• Strabismus Evaluation: Assessment and management of strabismus in both children and adults are conducted using specialised scoring systems (such as the Newcastle Control Score).

• Goldmann Kinetic Perimetry: Classical manual Goldmann perimetry is utilised for precise visual field assessment. The method relies on examiner expertise, providing high-reliability data in cases where automated systems are limited.

Through Neuro-ophthalmology, the critical importance of early diagnosis is highlighted. Clinical ophthalmic evaluation precedes and guides the use of technology, ensuring that each case is managed with appropriate scientific rigour.

Vision is a complex function closely linked to learning and development. Assessment extends beyond simple visual acuity measurement, focusing on how visual information is processed within the educational environment.

• Dynamic Assessment (Mohindra & Book Retinoscopy): Specialised retinoscopy techniques are applied to assess refraction under resting conditions as well as during reading tasks.

• Binocular Vision Assessment: Evaluation of stereopsis, convergence–divergence reserves and phorias is performed (von Graeffe method).

• Reading Readiness Assessment (DEM Test): A specialised test is conducted to evaluate oculomotor performance, critical for the prevention of learning difficulties.

• Individualised Counselling: Comprehensive paediatric ophthalmic examination is provided, along with guidance on optimal study strategies and indications for vocational orientation based on the optometric profile.

The management of dry eye disease and ocular surface inflammation requires a structured and methodical approach, avoiding unnecessary diagnostic testing.

• International Protocols (TFOS-DEWS II): Diagnostic evaluation and therapeutic management are aligned with the principles of the global TFOS-DEWS II guidelines.

• Advanced Meibography: Specialised imaging is used to assess the meibomian glands, allowing the design of targeted and effective treatment strategies.

• Rational Diagnostic Approach: Priority is given to establishing a relationship of trust with the patient. A focused diagnostic pathway is followed, centred on meaningful therapeutic outcomes and improvement in quality of life.