Can't add much to what Dr. Silberberg stated about the optos. My experience: I had the daytona installed 3 weeks ago and it was quite honestly one of the toughest decision I have even made IN LIFE, not just at the practice! 80k+ is a tough nut to chew but I had done the math and knew it wouldn't lose me money.
I don't have anywhere near the volume he has and I'm confidently estimating we'll have 100 pt's a month say yes to the scan compared to his 400. I charge the same as Steve and it is making money for me...not a cash cow but making money. It makes money in other ways also that is harder to track including follow up visits, pt's having friends(new pt's) come in to have the image done and potentially seeing more patients in a day because I won't be dilating healthy non symptomatic pt's as much.
It has changed the way I practice for sure. Have found many peripheral bleeds, holes, nevi etc that I quite honestly would have missed pre-daytona and the retina folks have been shocked I've seen some of the stuff I've sent them.
The autofluoresence feature has also been helpful. I sleep better knowing that I am getting great retinal images for some reason. Perhaps I didn't have the greatest confidence in my BIO skills before, who knows. I still dilate and I still use my older canon fundus camera for more detailed and magnified posterior pole imaging. If you have the volume and the funds to make daytona work I say go for it. Steve states he got a two year contract...I think mine was one...I need to talk to my rep!