This week is Eye Health Week which aims to promote the importance of eye health and the need for regular eye tests for all. There are 1.8 million people in the UK living with sight loss and for 53% of these a simple sight test and new spectacles could really help.
Many people think a sight test is just about checking your vision and then correcting it with glasses or contact lenses. In fact, eye tests can reveal a number of underlying health conditions including high blood pressure or diabetes as well as checking the general health of the eye.
To highlight the important work that local opticians do across Cardiff and the Vale, local optometrist James Davies opens his doors and shares with us an insight into a typical day at a busy opticians practice in Penarth.
James has practiced for the last 16 years and sees around 75 patients in an average week.
The most common conditions James sees are long and short sightedness which requires glasses or contact lenses to correct vision but he also deals with eye diseases including cataracts, macular degeneration and glaucoma, more common in people aged over 50.
James said: “People often don’t realise how much their vision has changed over the years and can be amazed at the improvement that can be made with new glasses. Also, many eye diseases do not have symptoms in their early stages and can be quite advanced before you notice a problem. By having regular eye examinations, your optometrist can measure and look for subtle differences and changes to the eye so that the onset of any eye diseases is picked up early and monitored or treated.”
Here James shares a typical day with us to show the varied nature of an optometrist’s role and expertise.
9.00am Carry out an eye examination on a patient who felt their reading vision had got worse. I found a new reading prescription helped with this but also find some probable age related changes to patient’s macular (the part of the eye that gives the best vision). I offered a dilated examination to enlarge the pupils to allow me a better view of the inside of the eye as the patient was not driving. I administered the drops and the patient waits for them to take effect.
9.30am A teenager visits the practice who has previously been prescribed glasses for classroom use but is now finding most tasks a little blurred. Prescribed an increased strength pair of glasses which should now be worn full time and we also discussed contact lenses. We had a long discussion about the exciting field of myopia control which uses contact lenses to slow down the natural increase in shortsightedness through teenage years. I passed the patient to the dispensing optician for new glasses.
10:00 am Assessment of the first patient through dilated pupil and also using an Optical Coherence Tomography (OCT) scanner which creates a 3D view of the patient’s macular. I diagnosed drusen which can be a precursor to age related macular degeneration. We discussed the latest studies of age related eye disease and the potential benefits of using eye supplements following the AREDS 2 (Age Related Eye Disease Study) formula. I passed the patient on to the dispensing optician for new glasses.
10.20am I examined an elderly lady who was finding her vision to be more blurred particularly for reading. She said this comes and goes and is often associated with watery eyes. The examination revealed little change to her glasses prescription and her eyes were generally healthy except for mild blepharitis (where the edges of the eyelid become inflamed) and significant dry eye. The poor tear profile is the cause of the unstable vision and we discussed eyelid cleaning techniques to promote tear flow and also artificial tears.
11.00am A routine examination of a patient who works at a local chemical plant. New varifocal safety glasses are prescribed to be used on plant and also a pair of office specific degressive lenses to be used when in the office and just using the computer and doing paperwork.
11.30am Examination of a patient that was found a week ago to have raised pressure in the eyes. They returned today to have drops as they are unable to drive directly after drops due to blurred vision. Pressure was lower today and was measured using a different technique. Her peripheral vision (visual fields) and the inside of her eye were normal. An OCT scan allowed me to take very accurate measurements of the appearance and dimensions of her eye to monitor for any future changes which could suggest glaucoma. I also carried out a scan of the thickness of the front of the patient’s eyes which suggested the pressure was less of a concern. We arranged to assess again in a year.
12.00pm An elderly gentleman was examined who was struggling to see to drive. He was found to have cataract which warranted referral to hospital for an operation. I also prescribed glasses which brought him to within driving standards to allow him to drive whilst waiting on the waiting list.
12.30pm Patient didn’t turn up despite receiving a text reminder the day before. Opticians do not receive payments when patients do not turn up so we have to absorb all our staff costs and overheads for this period.
12.50pm Patient was referred from pharmacist with a red eye. I diagnosed a subconjunctival haemorrhage which is a small bleed which requires no treatment. We discussed potential causes, medications and general health.
1.00pm Lunch break. Here I take the opportunity to write all doctor and hospital letters from this morning’s appointments
2.00pm I carry out a private OCT scan of a lady who had been diagnosed with vitreomacular traction (a condition where the jelly within the eye tugs the retina). This was diagnosed at her regular eye test three months ago although she had excellent vision. There is no change to this and we will review again in six months but I stressed the symptoms to watch out for.
2.20pm Referral from a local GP of a patient that had noticed flashes and floaters in his right eye for last two days. I checked the patient’s vision and then dilated his pupils with drops as he was not driving. I sent for visual field analysis whilst drops work and the patient waits in the waiting room.
2.30pm A routine aftercare appointment for a patient who is happily wearing contact lenses but requires regular assessments to ensure the eyes remain healthy and the contact lens prescription valid. Patient is wearing an excellent quality high oxygen transmissibility lens on a daily disposable basis so no changes were made as the eyes were showing no adverse reactions.
3.00pm Assessment of 2.20pm patient’s retina shows no damage but a posterior vitreous detachment, where the membrane separates from the retina. I discussed with the patient that this condition can occasionally progress to a more serious retinal detachment and the symptoms to watch out for. Patient is booked in again for a check up in one month’s time.
3.40pm Patient in their mid 40s is struggling to read material up close. I explained presbyopia (long sightedness) and the need for reading glasses. The patient is a teacher so although they had excellent vision we decided to dispense varifocals to allow good vision at all classroom distances.
4.10pm I see a brother and sister who are in their last two years of primary school and both parents are shortsighted. Both children’s vision is excellent but we discussed the likelihood of development of shortsightedness and will review again in a year unless symptoms dictate sooner.
4.50pm I see a patient who has recently had a cataract extraction and needs a sight test to check his new prescription prior to his outpatient appointment next week.
5.15pm I complete all paperwork and letters from this afternoon.
