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My Standard of Care:

Why and How I Test Dark Adaptation Speed for Every Qualified Patient Over 50

My practice model is nothing earth-shattering: we prioritize doing the right thing for patients. When we implement new technology, we do it because it has the potential to create a better standard of care for our patients. That means that every patient should have access. In my practice, adding a new piece of technology doesn’t mean that we have a new “add-on” option or a new test to upsell; it means that every patient who needs that test will now have it performed as part of their comprehensive annual exam.

When we implemented the AdaptDx Pro®, we adopted our access model to account for age. Every qualified patient over 50 is given the Rapid Test as part of their annual comprehensive exam. Why 50? Because age is the biggest risk factor for AMD, and we want to catch it as early as possible. Plus, our entire team is very committed to the philosophy of wellness and early detection, so this was aligned with our priorities as a team.

AdaptDx Pro testing goggles - AMD

"We worked closely with our Practice Management Consultant to optimize our workflow to ensure that we could realistically test every patient over 50."
- Dr. Wally Kojima

Our office is located on the Big Island of Hawaii. On a typical day, we have two optometrists and three technicians seeing a total of six patients per hour. When we implemented the AdaptDx Pro, we worked closely with our MacuLogix® Practice Management Consultant (PMC) to optimize our workflow to ensure that we could realistically test every patient over 50.

From our initial device training to workflow implementation decisions to weekly check-ins, our PMC was with us every step of the way – virtually! It was easy to work with her over Zoom and fit each session into our schedule. We talked about the implementation of this new technology, discussed smart scheduling, and figured out how to maximize technician time while Theia™ performed the test. We also made sure every staff member tried the AdaptDx Pro themselves to meet Theia and better understand the patient experience.

Finally, we discussed the biology of age-related macular degeneration and the importance of early detection and treatment during a staff meeting. Educating the team and getting them excited about new technology is so important because it inspires confidence in our model and helps our staff communicate our priorities to patients.

All of our tests and screenings are offered as part of our comprehensive exam, so there’s no itemized price list to mull over. We share the patient’s Rod Intercept® (RI®) number with them so they gain an understanding of what it means and why this test is so valuable. With this model, we’re able to show our patients that we really walk the walk when it comes to doing what’s best for them – we’re not here to sell them a test, but to truly do our best to find and treat AMD or other diseases as early as possible.

We’ve performed the Rapid Test on more than 750 patients in just 5 months. Knowing that nearly a third of them will be coming back more frequently for follow-up testing, and the fact that I have so many more patients to screen each month, we’ve invested in a second AdaptDx Pro to keep up with the demand.


I’m fortunate to live and practice in Hawaii, which also comes with the privilege of caring for a more mature patient population due to our state’s popularity with retirees. This also means that we could easily be testing 15-20 patients on any given day for dark adaptation speed. Now, thanks to the help of Theia and our pair of AdaptDx Pros, I’m identifying AMD in patients I may have otherwise missed on structural exam alone, and I’m proactively managing their AMD. I am so thankful that we can take early action to ensure they will continue to see the beautiful beaches of Hawaii for years to come.

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Read more about how fellow colleagues utilize AdaptDx® technology to help improve AMD patient outcomes and their practices.

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