Despite the challenges of the pandemic, the need for acquiring the latest in hi-tech instrumentation, and having to overcome restrictions in flying over a number of experts from the US, renowned therapeutic optometrists Dr Michael Johnson and Dr Deacon Harle managed to run the first ever UK-based course in advanced therapeutic techniques for optometrists.
The result was a complete success. To quote the organisers: ‘We now have 25 UK-based optometrists who are certified to deliver such treatments as the removal of eyelid lesions using radiofrequency, the suturing of lacerations and the use of ophthalmic lasers to perform capsulotomies and selective laser trabeculoplasty.’
Opening Address
In introducing the first course, Dr Michael Johnson said: ‘Welcome to the inaugural advanced therapeutic techniques course for specialist optometrists, the first of its kind to be held in the UK. This is a relatively small meeting in London, but it is a hugely significant event in optometry and the wider national eyecare community. Even before today, the event has created ripples in the profession and is already broadening the imagination of what we and other optometrists believe to be achievable in our clinical scope of practice.
Delegates. Dr Deacon Harle (rear) and Dr Michael Johnson (front) are on the extreme right hand side
‘We are here because, as each day passes, we are witness to the sad reality that thousands of people in our communities are receiving poor eye care; or no eye care at all. As a direct consequence, many patients are anxious about their future and, tragically, some are losing their sight. It is not my place to ascribe fault or blame. Instead, I am calling this out because we have a responsibility to act in the best interests of our patients. It is no longer tenable for us to watch and do nothing. As a collective, we can make a positive difference and rectify this problem.
‘We can do this. We should do this. Surely, now the conversation to be had is how do we do this? How do we educate? How do we appropriately train and certify? How do we build clinical governance into the design of services?
Honing skills for peripheral iridotomy
‘Shortly after I qualified, the law evolved and it became possible for us, with further education and experience, to prescribe medication to manage eye disease. At the time, there was some valid concern about our ability to do this safely. This concern has been addressed and therapeutics is now an accepted part of optometric practice. To date, the number of fitness-to-practice hearings for optometrists with an independent prescribing specialty on clinical matters is zero. Not a sausage, nor a sweet Fanny Adams.
‘Of course, as a group we must remain open to external review or challenge, but some experts have shown themselves inclined to over-worry. The data is not duped by worry and does not lie. Actuarial tables tell us that the risk from optometrists with entry level registration failing to detect disease is greater than the risk of specialist optometrists mis-managing a disease. On the other side of the balance sheet, with an overwhelmed NHS, the risk of us not working to the safe limits of our capacity and competency is certain harm. This is harm that we can prevent. This is harm that we should prevent.
‘The advancement in our scope of practice, from detection to diagnosis and management, was achieved by the immense efforts of our professional predecessors. Now it is our turn, standing on the shoulders of giants, to push upwards. It is now our turn to do what is right for our patients, rather than what is easy for us.
Use of radiofrequency for the treatment of eyelid lesions
‘To this end, we are blessed to be supported by our brethren from across the Atlantic. Their willingness to help cannot be underestimated and should never be forgotten.
‘I always knew that running this course was going to be a flip of the coin venture; financially and professionally. There were so many uncertainties and I did have my doubts. Thankfully, Deacon convinced me that we could make it work and provided the nudge to get us across the line. Seeing you all here, a room full of the best optometrists in the country, gives me the confidence that this course will give our profession, currently wavering in uncertainty about its contemporary role, a similar nudge.
‘Let’s do this…’
- A full review of the course will appear in next week’s Optician.