Bill Harvey: 3ft high & rising

Bill Harvey
Refusal to see certain patient categories undermines our professional standing

Even though statistics show we should expect coincidences, it is always a surprise when a few happen at once.

Recently, I was thinking about how many trainee optometrists are uncomfortable with binocular vision. When faced with a case of a suspected pre-school tropia, the default action seems to be referral to orthoptics. As I considered this, a call came through from a niece who was worried that her 12-month infant looked as if his eye was, on occasion, turning in. I asked for a photo (taken with flash) and noticed that, as well as obvious and marked epicanthal folds, there was some suspicion of asymmetric corneal reflexes so booked him in for a cyclo.

Then, my long-time friend and colleague Dr Jane MacNaughton told me of something she had just posted online telling of how, on one single day in paediatric clinic, three two-and-a-half-year-olds attended as new referrals from their GPs and were found to have an accommodative esotropia for which specs were prescribed. Each parent had been to one of a number of local ‘opticians’ to book a first eye examination for their child only to be told that they could not be seen until the child was over three years of age or, worse, when they could read their letters.

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