A couple of things to report this week.

I have been doing a few domiciliaries recently, mostly to elderly or learning disabled patients with visual impairment. One aspect of home visits that I have always felt uneasy about has been the challenge in assessing visual fields. As we reported in Optician 12.10.18, the Domiciliary Eyecare Committee issued guidance on this matter, recommending that ‘the safest requirement for domiciliary patients is for all mobile providers to ensure that a portable means for testing visual fields, either manual or electronic, is routinely available (in addition to confrontation targets) for all patients.’ Those of you with back strain from lugging around an Easyfield or similar might be interested in how I get on with a recently acquired and very portable laptop screener from Thomson Software Solutions – watch this space.

That said, I often remind pre-reg optometrists not to throw away their bead on a stick. Too many case records concerning patients with learning or cognitive impairment have simply ‘fields not possible’ written on them. Surely these patients, more than most, should have at least some form of fields assessment capable of detecting pathway damage?

There was another reminder this week of the need for careful analysis of data. When last year there was a report suggesting that neonatal survival rates were declining in the UK, there was uproar. In fact, the data was showing medical interventions at earlier and earlier birth ages. A report in last month’s Eye Journal has highlighted an increase in retinopathy of prematurity, a condition previously in decline. As the paper states, however, ‘this may in part be due to the increased need for ROP treatment in extremely preterm babies, whose survival has increased in the same period.’ This may have some impact on sight loss in the future.