Testing times

I would just like to add to my letter (June 17) regarding a patient who was not seen by an ophthalmologist after I had noticed lattice degeneration in the far periphery of the retina.

My main concern is for the patient. At present I use a 90D Volk lens to view the peripheral fundus and with dilation this will only allow me to see 60 per cent of the fundus. Does this mean I will have to attempt scleral indentation or order in a binocular indirect ophthalmoscope?

I do not really want this amount of responsibility. If I did, I would have trained to become an ophthalmologist. What is next on the agenda?

Treatment with Argon laser photocoagulation because it takes too long to see a NHS ophthalmologist?

Are we heading towards a system whereby optometrists will have to do all the tests an ophthalmologist is expected to perform, but also be responsible for the profitability of a practice by doing it all in 20 minutes. Come on, something has to give.

Prem Kora
Wolverhampton