Perhaps not surprisingly given the recent increased profile of CET in the eye care professions, this autumn has seen a number of new CET conferences on the circuit. optician reports on some of the best
Perhaps not surprisingly given the recent increased profile of CET in the eye care professions, this autumn has seen a number of new CET conferences on the circuit. optician reports on some of the bestA number of new companies have been established in recent months with the aim of developing CET programmes now that continuing education is a statutory requirement for remaining on the GOC register.
Northern Ireland
Two practitioners experienced in organising continuing education events are to launch a new CET provider in Northern Ireland.
Optometrists Janice McCrudden and Professor Jonathan Jackson, both based in Dromore, have set up Insight Optometric Education, a training company that aims to help practitioners gain essential CET points in the province.
Having already organised three CET evenings involving well known speakers, the aim is to continue to organise key evening events throughout next year at locations across the province.
It is hoped that the organisation may allow easy access to good quality CET for all of the 550 or so professionals in the area. For details of the events, contact info@insight-education.co.uk.
ClearView
The first of the proposed ClearView CET conferences was run in Loughborough in November. Delegates were treated to lectures from such luminaries as Dr Robert Harper, Gordon Carson and Nick Rumney.
We were delighted with the success of our first event, writes organiser and ClearView director Jane Macnaughton. The feedback from both our delegates and sponsors was terrific and very encouraging. We feel that we are now in a strong position to build our business over the coming year.
We are already planning a second event on May 7 at the Burleigh Court Centre, 'Spring into summer', addressing the clinical challenges and complications of sun, sea, sport and health, and a follow-up in late autumn next year called 'Paediatrics day' in which we shall address the challenges today of working with children, from both a clinical and non-clinical perspective.
We are also planning a two-day pre-registration conference in April, called 'Preparing for the final assessment.'
Replay Learning
Now well established as a major CET provider, Replay Learning continues to develop and presented a strong bill of CET events this autumn.
It was not possible to attend all available sessions, writes delegate John Duffy, but I found those that I did to be very informative. Starting off with a tour of the peripheral retina and the pathology to be found 'way out there' Simon Browning gave his usual excellent presentation.
With the benefit of Optomap images, retinal tears, schisis and holes, retinopathy of diabetes and leukaemia as well as naevi and melanoma were all demonstrated. Inevitably the discussion in this workshop gravitated towards the argument of clinical benefit versus cost, and how do we build this into a business model hog-tied by the GOS terms of service. It left those of us not equipped with the Optomap wondering just how much asymptomatic pathology we are missing.
While this was going on, Jonathan Walker was presenting a lecture on 'Contact lenses for presbyopia', a 'virtual lecture' by Claire O'Donnell on examining the diabetic patient was being shown and another workshop covering polycarbonate lenses and sports eyewear was being run by Andy Hepworth.
The day's second session saw the workshops being repeated and a virtual lecture on 'Pupils' by Keith Davey, while I listened to Shehzad Naroo discuss 'Bespoke contact lenses'. Greater awareness of higher order aberrations (driven by the refractive surgery industry) and the availability of precise surface topographical measurements now permits the production of bespoke contact lenses.
Designed to fit the corneal topography precisely, these RGP lenses correct not only the low-order aberrations we know as ametropia but also higher aberrations such as coma, with commensurate benefits in terms of visual acuity. It is stated that if aberration correction can be achieved then visual acuity should match, or perhaps surpass, that achieved in naturally emmetropic eyes.
Marvyn Elton,who holds pharmacist and optometrist qualifications, outlined how recent legislation has changed the drugs available to optometrists. All registered optometrists hold level 1 exemption, which allows use of and supply of certain [P] medicines without the previous caveat that supply should be in an emergency.
The new list includes certain antimicrobial agents (chloramphenicol and fusidic acid), anti-allergy products (opticrom and otrivine antistine) and dry eye products (artificial tears) which optometrists can now supply directly to patients or give patients a written order for a pharmacist to supply. Level 1 optometrists can still use diagnostic drugs such as cyclopentolate and local anaesthetics, but the right to use or supply atropine and pilocarpine has been removed.
Level 2 requires optometrists to have undertaken additional training, but then allows an extended range of pharmaceuticals to be supplied. This list includes atropine and pilocarpine together with two more antihistamines, the NSAID diclofenac and the combination antibiotic polyfax. Elton also gave an outline of the clinical manifestation of allergic conjunctivitis, bacterial conjunctivitis, adenoviral conjunctivitis and chlamydial conjunctivitis, and indicated where optometrists might be able to help patients within the formulary available.
I attended a workshop on 'Therapeutic agents for the management of dry eye' presented by Jim Farrell. Jim covered the classification and causes of dry eye and described scoring systems that allow the practitioner to judge the degree of dryness and any subsequent change with greater objectivity.
He also outlined the different types of topical ocular lubricants classifying their characteristics as 'aqueous' artificial tears with low viscosity, eg hypromellose or liquifilm tears; 'Ocular lubricants' with high viscosity, eg lacrilube or simple eye ointments; and 'viscoelastic' or thixotropic agents that exhibit both liquid and gel properties eg voscotears and systane, all of which are suitable for relief of symptoms of evaporative dry eye and as [P] meds are now available to optometrists to use and supply to patients.
Optometrists should remember that the goal of treatment is not only to reduce subjective symptoms but also to permit regeneration of corneal epithelial cells.
The final lecture of the day was an interesting update on 'New techniques in corneal surgery' by consultant ophthalmologist Jeremy Prydale. Development of scleral transplants to repair small corneal penetrating injuries, together with the use of super glues and amniotic membranes were all discussed.
He also described the surgical techniques developed for keratoconus which permits the dissection of 95-99 per cent of the stroma while leaving the endothelium intact. The ability to perform such deep anterior lamellar keratoplasty reduces the risks of subsequent endothelial cell loss and graft failure and provides better postoperative visual acuity through reduction of interface scarring.
Prydale also described the management of high astigmatism following corneal graft surgery, and described the use of cylindrical Artisan iris claw lenses. These anterior chamber implants clip to the iris, and are suitable for correction of residual refractive error following graft or cataract surgery and can even be used for phakic patients with high refractive error.
The day was very well organised with good handouts and plenty of time between lectures and workshops to allow delegates to move between seminar rooms. The recording of attendance at lectures or workshops by the use of bar codes and scanners seemed effortless. Because of the amount of sponsorship provided by various companies this was a very inexpensive day yet provided a very high quality of CET. Overall excellent value.
Boots' CET Days
On the back of last year's successful day at the Royal Society of Medicine, Boots Opticians repeated the event this November and indeed expanded this to include a second day in Leeds a fortnight later. Overall, nearly 400 delegates attended and were able to enjoy a variety of workshops and lectures.
Interesting highlights included a lecture on 'Falls and the elderly' by Professor David Elliott of Bradford University. He outlined how the ageing eye contributes to general healthcare issues and, interestingly, added that all optometrists really should consider offering education and training to community-based educational and care service centres.
'They will always appreciate this and you will always enjoy it,' he added.
Professor David Thomson summarised the range of tropical diseases currently still leaving much of the world with disabling sight problems. He emphasised that many, such as xerophthalmia, are preventable by simple means, such as simple dietary advice.
The aim is to run similar events next year and to ensure all professionals (not just Boots staff) can benefit.
EyeCare 3000
The annual EyeCare 3000 event is now established as one of the key CET events of the year. It was interesting to note therefore that organiser Dr Scott Mackie was able to arrange a similarly impressive line up of speakers and presenters at the new EyeCare 3000 events run this autumn in Cardiff and London.
Highlights for Wales included an excellent BCLA address from Dr James Wolffsohn who highlighted how current legislative changes have affected contact lens practice recently. This was the talk he had been unable, through illness, to present at the BCLA conference itself so it was good to see him having made a full recovery.
Professor Sudi Patel gave an excellent review of tear-based problems including practical sessions in punctal plugging and lacrimal drainage assessment.
London had the estimable Jack Kanski as a key speaker who spoke about his pet subject of uveitis and, in particular, its links with arthritis. The event was well organised and, as always, included speakers pushing the boundaries of 'competency-based' optometry. It is hoped the Eyecare 3000 progress will continue.
Local events
It should not be forgotten that local optometric committees have and continue to provide excellent quality CET in most areas of the country. These are generally well organised and often offer a full day of CET to 100 or more delegates. Less and less should they be viewed as a small 'evening social' for a handful of attendees.
Every two years Cambridgeshire LOC runs a one-day conference, which is subsidised by the LOC, writes course organiser Wendy Newsom. We aim to cover a broad range of topics to include core competencies and other areas of interest to optometrists. This year we had 90 optometrists from across our region in attendance and we were treated to a feast of fabulous talks.
Russ Watkins, former optometrist, ophthalmologist and now a pathology specialist registrar, gave us a clear and thorough talk on systemic hypertension. He defined hypertension and described national guidelines for its grading and treatment. He discussed risk factors, epidemiology and pathology, accompanied by pictures of post mortem arteries, brain sections and heart muscle wall thickening. He stressed our important role in public health in helping to detect undiagnosed hypertensives.
This was followed by his wife, Jo Watkins, a psychiatrist. She gave us a fascinating insight into all aspects of mental illness. She covered a wide range of conditions that we may encounter in patients and helped to dispel myths and clarify misconceptions. She outlined treatments both medical and non medical, qualifying her points with clinical examples.
After coffee, Bill Harvey took to the stage with his video slit lamp, kindly brought along by Topcon. He reminded us all exactly how to perform all the slit-lamp techniques that we should be using day to day, but had possibly not been retrained on since university days.
The talk took the form of a demonstration in fantastic detail, made available by the modern video technology, which even the delegates in the back row claimed they could see. With speakers to follow including Judith Morris and David Stidwell, feedback was excellent. LOCs, when effectively run, should always be remembered as an excellent source of up to date CET.
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Northern Ireland
Two practitioners experienced in organising continuing education events are to launch a new CET provider in Northern Ireland.
Optometrists Janice McCrudden and Professor Jonathan Jackson, both based in Dromore, have set up Insight Optometric Education, a training company that aims to help practitioners gain essential CET points in the province.
Having already organised three CET evenings involving well known speakers, the aim is to continue to organise key evening events throughout next year at locations across the province.
It is hoped that the organisation may allow easy access to good quality CET for all of the 550 or so professionals in the area. For details of the events, contact info@insight-education.co.uk.
ClearView
The first of the proposed ClearView CET conferences was run in Loughborough in November. Delegates were treated to lectures from such luminaries as Dr Robert Harper, Gordon Carson and Nick Rumney.
We were delighted with the success of our first event, writes organiser and ClearView director Jane Macnaughton. The feedback from both our delegates and sponsors was terrific and very encouraging. We feel that we are now in a strong position to build our business over the coming year.
We are already planning a second event on May 7 at the Burleigh Court Centre, 'Spring into summer', addressing the clinical challenges and complications of sun, sea, sport and health, and a follow-up in late autumn next year called 'Paediatrics day' in which we shall address the challenges today of working with children, from both a clinical and non-clinical perspective.
We are also planning a two-day pre-registration conference in April, called 'Preparing for the final assessment.'
Replay Learning
Now well established as a major CET provider, Replay Learning continues to develop and presented a strong bill of CET events this autumn.
It was not possible to attend all available sessions, writes delegate John Duffy, but I found those that I did to be very informative. Starting off with a tour of the peripheral retina and the pathology to be found 'way out there' Simon Browning gave his usual excellent presentation.
With the benefit of Optomap images, retinal tears, schisis and holes, retinopathy of diabetes and leukaemia as well as naevi and melanoma were all demonstrated. Inevitably the discussion in this workshop gravitated towards the argument of clinical benefit versus cost, and how do we build this into a business model hog-tied by the GOS terms of service. It left those of us not equipped with the Optomap wondering just how much asymptomatic pathology we are missing.
While this was going on, Jonathan Walker was presenting a lecture on 'Contact lenses for presbyopia', a 'virtual lecture' by Claire O'Donnell on examining the diabetic patient was being shown and another workshop covering polycarbonate lenses and sports eyewear was being run by Andy Hepworth.
The day's second session saw the workshops being repeated and a virtual lecture on 'Pupils' by Keith Davey, while I listened to Shehzad Naroo discuss 'Bespoke contact lenses'. Greater awareness of higher order aberrations (driven by the refractive surgery industry) and the availability of precise surface topographical measurements now permits the production of bespoke contact lenses.
Designed to fit the corneal topography precisely, these RGP lenses correct not only the low-order aberrations we know as ametropia but also higher aberrations such as coma, with commensurate benefits in terms of visual acuity. It is stated that if aberration correction can be achieved then visual acuity should match, or perhaps surpass, that achieved in naturally emmetropic eyes.
Marvyn Elton,who holds pharmacist and optometrist qualifications, outlined how recent legislation has changed the drugs available to optometrists. All registered optometrists hold level 1 exemption, which allows use of and supply of certain [P] medicines without the previous caveat that supply should be in an emergency.
The new list includes certain antimicrobial agents (chloramphenicol and fusidic acid), anti-allergy products (opticrom and otrivine antistine) and dry eye products (artificial tears) which optometrists can now supply directly to patients or give patients a written order for a pharmacist to supply. Level 1 optometrists can still use diagnostic drugs such as cyclopentolate and local anaesthetics, but the right to use or supply atropine and pilocarpine has been removed.
Level 2 requires optometrists to have undertaken additional training, but then allows an extended range of pharmaceuticals to be supplied. This list includes atropine and pilocarpine together with two more antihistamines, the NSAID diclofenac and the combination antibiotic polyfax. Elton also gave an outline of the clinical manifestation of allergic conjunctivitis, bacterial conjunctivitis, adenoviral conjunctivitis and chlamydial conjunctivitis, and indicated where optometrists might be able to help patients within the formulary available.
I attended a workshop on 'Therapeutic agents for the management of dry eye' presented by Jim Farrell. Jim covered the classification and causes of dry eye and described scoring systems that allow the practitioner to judge the degree of dryness and any subsequent change with greater objectivity.
He also outlined the different types of topical ocular lubricants classifying their characteristics as 'aqueous' artificial tears with low viscosity, eg hypromellose or liquifilm tears; 'Ocular lubricants' with high viscosity, eg lacrilube or simple eye ointments; and 'viscoelastic' or thixotropic agents that exhibit both liquid and gel properties eg voscotears and systane, all of which are suitable for relief of symptoms of evaporative dry eye and as [P] meds are now available to optometrists to use and supply to patients.
Optometrists should remember that the goal of treatment is not only to reduce subjective symptoms but also to permit regeneration of corneal epithelial cells.
The final lecture of the day was an interesting update on 'New techniques in corneal surgery' by consultant ophthalmologist Jeremy Prydale. Development of scleral transplants to repair small corneal penetrating injuries, together with the use of super glues and amniotic membranes were all discussed.
He also described the surgical techniques developed for keratoconus which permits the dissection of 95-99 per cent of the stroma while leaving the endothelium intact. The ability to perform such deep anterior lamellar keratoplasty reduces the risks of subsequent endothelial cell loss and graft failure and provides better postoperative visual acuity through reduction of interface scarring.
Prydale also described the management of high astigmatism following corneal graft surgery, and described the use of cylindrical Artisan iris claw lenses. These anterior chamber implants clip to the iris, and are suitable for correction of residual refractive error following graft or cataract surgery and can even be used for phakic patients with high refractive error.
The day was very well organised with good handouts and plenty of time between lectures and workshops to allow delegates to move between seminar rooms. The recording of attendance at lectures or workshops by the use of bar codes and scanners seemed effortless. Because of the amount of sponsorship provided by various companies this was a very inexpensive day yet provided a very high quality of CET. Overall excellent value.
Boots' CET Days
On the back of last year's successful day at the Royal Society of Medicine, Boots Opticians repeated the event this November and indeed expanded this to include a second day in Leeds a fortnight later. Overall, nearly 400 delegates attended and were able to enjoy a variety of workshops and lectures.
Interesting highlights included a lecture on 'Falls and the elderly' by Professor David Elliott of Bradford University. He outlined how the ageing eye contributes to general healthcare issues and, interestingly, added that all optometrists really should consider offering education and training to community-based educational and care service centres.
'They will always appreciate this and you will always enjoy it,' he added.
Professor David Thomson summarised the range of tropical diseases currently still leaving much of the world with disabling sight problems. He emphasised that many, such as xerophthalmia, are preventable by simple means, such as simple dietary advice.
The aim is to run similar events next year and to ensure all professionals (not just Boots staff) can benefit.
EyeCare 3000
The annual EyeCare 3000 event is now established as one of the key CET events of the year. It was interesting to note therefore that organiser Dr Scott Mackie was able to arrange a similarly impressive line up of speakers and presenters at the new EyeCare 3000 events run this autumn in Cardiff and London.
Highlights for Wales included an excellent BCLA address from Dr James Wolffsohn who highlighted how current legislative changes have affected contact lens practice recently. This was the talk he had been unable, through illness, to present at the BCLA conference itself so it was good to see him having made a full recovery.
Professor Sudi Patel gave an excellent review of tear-based problems including practical sessions in punctal plugging and lacrimal drainage assessment.
London had the estimable Jack Kanski as a key speaker who spoke about his pet subject of uveitis and, in particular, its links with arthritis. The event was well organised and, as always, included speakers pushing the boundaries of 'competency-based' optometry. It is hoped the Eyecare 3000 progress will continue.
Local events
It should not be forgotten that local optometric committees have and continue to provide excellent quality CET in most areas of the country. These are generally well organised and often offer a full day of CET to 100 or more delegates. Less and less should they be viewed as a small 'evening social' for a handful of attendees.
Every two years Cambridgeshire LOC runs a one-day conference, which is subsidised by the LOC, writes course organiser Wendy Newsom. We aim to cover a broad range of topics to include core competencies and other areas of interest to optometrists. This year we had 90 optometrists from across our region in attendance and we were treated to a feast of fabulous talks.
Russ Watkins, former optometrist, ophthalmologist and now a pathology specialist registrar, gave us a clear and thorough talk on systemic hypertension. He defined hypertension and described national guidelines for its grading and treatment. He discussed risk factors, epidemiology and pathology, accompanied by pictures of post mortem arteries, brain sections and heart muscle wall thickening. He stressed our important role in public health in helping to detect undiagnosed hypertensives.
This was followed by his wife, Jo Watkins, a psychiatrist. She gave us a fascinating insight into all aspects of mental illness. She covered a wide range of conditions that we may encounter in patients and helped to dispel myths and clarify misconceptions. She outlined treatments both medical and non medical, qualifying her points with clinical examples.
After coffee, Bill Harvey took to the stage with his video slit lamp, kindly brought along by Topcon. He reminded us all exactly how to perform all the slit-lamp techniques that we should be using day to day, but had possibly not been retrained on since university days.
The talk took the form of a demonstration in fantastic detail, made available by the modern video technology, which even the delegates in the back row claimed they could see. With speakers to follow including Judith Morris and David Stidwell, feedback was excellent. LOCs, when effectively run, should always be remembered as an excellent source of up to date CET.