Tips from the witness box

Muriel Glenn reports from another successful hospital optometrists conference

Congratulations to the Hospital Optometry Committee who once again organised and delivered another hugely successful, high quality Hospital Optometry Annual Conference; this time their 31st.

Dr Charles Cottriall (Oxford Eye Hospital) has been working for the past 10 years to find a clinically effective drug to treat myopia. Significant research has endeavoured to identify why eyes become myopic and what can reduce its rate of progression. Atropine has been shown to be effective, but unfortunately isn't a viable option due to its associated side effects.

Another more selective muscarinic antagonist, pirenzepine, has been identified - a drug more commonly known for its treatment of stomach ulcers. Clinical trials have been carried out and a pleasing 50 per cent reduction in myopia occurred.

However, the drug appeared not to be as effective in the second year of usage, suggesting an adaptation effect. Before this drug can be used as a therapeutic treatment, further research is required.

For the past three years, optometrists have been running YAG clinics in the Royal Victoria Infirmary, explained Kevin Gales. YAG laser is used to treat the most common complication of extracapsular cataract extraction - opacification of the posterior capsule.

This technique has been traditionally performed by medical staff, therefore, ongoing audit is required to prove that there is no increased risk in patient care when the procedure is performed by an optometrist.

The most common complication that can occur is damage to the intraocular lens (pitting) which happens if the laser is not correctly focused on the capsule. Rarer complications include cystoid macular oedema, retinal breaks and raised IOP. So far, things are going well and 1,500 patients have passed through the optometry led YAG service.

Posters

The winning poster was titled 'Visual Acuity beyond Snellen', authored by LK Lim, DG Frazer and AJ Jackson (Royal Victoria Hospital, Belfast). This poster highlighted that, functionally, the majority of patients are not totally 'blind'. Varying levels of defocus were used to show three fingers alongside a Snellen letter, illustrating that fingers are easier to detect and are not standardised. The clinical message included: