Christmas and all the associated festivities seems so long ago now. All the decorations are packed away in lofts up and down the country, adding the extra layer of insulation that we may need in any ‘cold snap’ that is to come.
Attention has now turned to the year ahead and the resolutions that so many of us have made to become better people over the next 12 months. All will involve change in some way, whether it to change the way we look, eat or behave, all to hopefully improve our lives in some way. Patients in practice have certainly been enthusiastic and forthcoming about all their resolutions for the year ahead, although I didn’t quite know how to respond to the gentleman who said he was giving up his wife.
While I may have my own personal resolutions, in practice, mine isn’t so much to change, but to continue on listening more to what my patients are telling me and their description of their complaints rather than start to work things out from what they say at first (which we all know is pretty accurate 98% of the time). I like to think that I improve my practice by doing so.
It can be hard on a busy clinic to spend a little longer eliciting as much information from them as possible, when you know there are more waiting to be seen the other side of your door. However, so often, I have found that patients have the strangest descriptions of their conditions, with often the more serious conditions having the wilder presentations.
An unfortunate example of this was a seemingly healthy teenager who was brought into me on a busy Saturday afternoon clinic as a last resort by her mother. She had been complaining of headaches for a number of months and her GP had dismissed it as stress and worry over her upcoming GCSEs. She left her mum in the waiting area, who had bumped into a friend and was catching up on holiday stories. As I started to measure her acuity, she happened to remark that, yes, she could see the letters, but there was always a spot just over it that was in the way.
I immediately assumed she meant a floater and asked her to move her eyes around. However, she insisted it was still present which prompted me to examine the fundi prior to subjective refraction, which is usually my routine. Sure enough, it revealed extensive papilloedema in both eyes, with haemorrhages extending into the macula area in one, where there was a haemorrhage just inferior to the fovea, hence her ‘spot’. An urgent hospital referral followed which sadly revealed a brain tumour. This was a few years ago but I often think about her.
Optometry as a profession is certainly changing, as all careers do, and with a new CET year, we need to be thinking about how we further educate ourselves and future optometrists to embrace the full scope of primary eye care. We will need to make eye care more accessible for our increasingly aging population and to support our over-stretched ophthalmology and GP services. As optometrists, we will need to build ever-closer relationships with local ophthalmologists and work much more alongside the local eye hospitals and GPs.
No profession or career stands still; it is always evolving just as everything else in our lives. And the speed of change in optometry seems to accelerate each year with all the new advanced technology. Hopefully 2018 will be a successful year for all whatever our resolutions are.
Judy Lea is optometrist director of Specsavers, Longton, Staffordshire.
