Specialisms within practice
There are many things within practice that an Optometrist can be
trained in, and specialise in aside from the everyday refractions
and contact lens appointments. These can range from the occasional
Diabetic screening, through to Orthokeratology and Behavioural
optometry. Some of the main specialisms are outlined below, with
some information about each.
Glaucoma Screening
This is a scheme which differs between each PCT throughout the
UK and will be organised in association with Local eye hospitals
and Ophthalmologists. Optometrists individually, and as a practice
can opt in to the scheme and will be able to liaise with, and learn
from resident experts in the field, and refer patients
accordingly.
Diabetic Screening
The National Service Framework for diabetes covers the
prevention, identification and management of diabetes, together
with surveillance for and management of complications.
This includes complications of the eyes, kidneys, feet etc.,
along with rehabilitation and continuing care. There is an annex
specifically dealing with diabetic eye disease. The NSF for
diabetes was released in two parts and the first part, entitled
'National Service Framework Standards for Diabetes Services',
dealing with standards to improve the care of people with diabetes,
was published on 14 December 2001. The Diabetes NSF
Standards apply to England only. The final part of the Diabetes NSF
- the Delivery Strategy - was published in 2003.
It included the early milestones, service models, performance
indicators and details of local implementation and national support
for local action.
By 2006, a minimum of 80% of diabetics will have been offered
screening for the early detection (and treatment if needed) of
diabetic retinopathy as part of a systematic programme meeting
national standards. The aim is to have 100% coverage by the end of
2007.
Quality Assurance Numbers
An optometrist involved in the national screening programme must
grade a minimum of 500 patient episodes, whether these are actual
patients seen or just the stand-alone screening of images
doesn't matter. This is designed to
allow schemes more flexibility in the use they make of
community optometrists.
AMD Screening
Age-related macular degeneration (AMD) causes severe visual loss
and is the commonest cause of blindness in persons > 50years old
in the western world. Two main forms of AMD occur: dry and wet. The
dry form accounts for 90%, whilst the wet form occurs in 10% of all
AMD. The severe visual loss in 90% of cases is due to the wet form
of AMD which is characterized by choroidal neovascularisation
(CNV). The majority of CNVs occur subfoveally. There is evidence
that angiogenic factors, especially vascular endothelial growth
factor (VEGF) and fibroblastic growth factor (FGF) play a
significant role in the development and maintenance of CNV. High
levels of VEGF have been demonstrated in CNV surgically excised
from humans or animal experimental CNV It was previously estimated
by research commissioned by The Macular Disease Society (MDS) that
21,000 new cases of wet AMD occurred in the UK each year. Current
estimates by the Royal National Institute for the Blind (RNIB) and
the National Institute of Clinical Excellence (NICE) indicate there
may be 26,000 patients eligible for the new anti-VEGF treatments in
the UK each year (compared to 7,000 currently eligible for
photodynamic therapy [PDT]) The management of an individual patient
depends on the type of AMD present. Until recently, the management
of wet AMD has been limited to laser photocoagulation, and PDT
where applicable.
Similarly to diabetic screening, AMD screening is overseen on a
local level, and optometrists can opt in to the scheme in order to
support the local Eye hospitals, and can in some cases take part in
supplementary training for additional AMD testing and
treatment.
Colourimetry
Many children and adults who have reading or specific learning
difficulties have subtle visual problems, which may prevent them
from achieving their full potential at school or work. Often, these
problems will only be detected through a series of specialised
tests and techniques, which are outside the scope of a routine eye
examination. These visual problems may cause symptoms such as sore
eyes or headaches when reading, poor concentration or even avoiding
reading altogether.
Optometrists can get involved in Colourimetry within certain
practices where there is the need for the service in the community.
Links can be formed with local charities as well, in order to offer
another unique service to patients.
Contact us on
020 784 32410
Email: info@resourcing.uk.com