Picture archiving and communication systems (PACS) have revolutionized medical imaging across many specialties over the past few decades. In ophthalmology, PACS have facilitated digital image capture, storage, distribution and analysis, improving efficiency and diagnostic accuracy. This article will explore the growth of ophthalmology PACS and their impact on eye care.

Early Digital Imaging Adoption

One of the earliest medical specialties to embrace digital imaging was ophthalmology. Fundus cameras capable of digitally capturing retinal images began emerging in the 1990s. This allowed images to be instantly viewed onscreen, measured and saved electronically rather than developed as prints or slides. In the late 1990s, digital formats like JPEG 2000 further improved resolution and functionality. Digital imaging removed chemical costs and wait times associated with film processing. Physicians could review images anytime, anywhere via networked connections.

Development of Ophthalmology PACS

By the early 2000s, Ophthalmology PACS were accumulating large digital image libraries. Storing, organizing and sharing these images required dedicated picture archiving systems. Some early commercial ophthalmology PACS provided basic image storage and lookup tools. Over the next decade, vendors incorporated greater functionality including reading rooms, multimodality support and integrated electronic health records (EHR). PACS allowed easy comparison of current and historical exams, facilitating detection of subtle changes over time.

Widespread Adoption in Clinics and Hospitals

By 2010, most ophthalmology practices had implemented PACS either as standalone systems or integrated with larger hospital-wide versions. Optometry and eye surgery centers quickly followed suit. PACS streamlined workflows by eliminating physical film handling, darkrooms and file rooms. Images were instantly available at the point of care for review by multiple clinicians. Specialized tools like angle measurements, image sharpening and report linking aided clinical decision making. Storage costs fell dramatically compared to maintaining physical films and folders.