After last week suggesting one way eye care practitioners might expand their roles by offering drug toxicity screening, a more obvious area for use of our skill set came to mind this week.

I have always thought that ECPs are ideally placed to offer advice on, and indeed to ‘prescribe’, lighting appliances appropriate to our patients needs. Any readers currently supervising pre-reg optometrists will be aware that they have to present a record card where they have advised upon and dispensed a low vision aid. Among the many examples I have recently reviewed of high reading adds, hand and stand magnifiers being offered to elderly people, there was little mention of lighting. This is a shame as I have found that improved lighting is often all that is needed in managing early sight loss with the commonest conditions. And if elderly people are told to ‘get better lighting,’ too few know where to access good and specific advice – surely this is an opportunity.

Now we have all (I hope) survived blue Monday, we might remember that this is a time when the incidence of seasonal affective disorder (SAD) peaks. Some GPs offer light therapy, and with a deal of success. As outlined in previous articles (see Optician 20.03.15 for example), light stimulation of some retinal ganglion cells is key in regulating metabolic processes and influencing both mental and physical health. Just as modern lifestyles have changed the prevalence of ocular surface and near binocular status problems, changes in diurnal light exposure is also affecting health. In this month’s Journal of Physiology, for example, there is a sobering report showing how ‘shift work during pregnancy can disrupt maternal circadian rhythms… and metabolism’ leading to reduced foetal growth and an increased risk of conditions like diabetes.

Now who might best able to offer therapeutic lighting and specialist advice…?