Bill Harvey: Rock lobster
Author: Bill Harvey
I am sure some of you remember those simulation specs we were given to play with as students that aimed to demonstrate the impact upon vision of some common diseases. The AMD ones had a big dark splodge in the middle of the lenses, cataract had translucent lenses and the glaucoma ones had the periphery of the lenses blocked off. I am equally sure that, like me, you soon realised how poor these devices (which are still used) were, having met patients with the actual disease. Particularly so the glaucoma ones. Crabb Lab to the rescue.
One benefit of the lockdown has been the increase in online events of excellent quality. The lecture/webinar series offered by Heidelberg, Thea and the Royal Society of Medicine spring to mind and, based on previous experience, the BCLA virtual event in a fortnight should be well worth attending.
An evening lecture organised by Thea last week featured Professor David Crabb of City University. Professor Crabb has spent many years developing a massive database of field loss in glaucoma patients. He presented some impressive data showing how the progression of loss may vary between individuals, but in a manner that might be predicted and so could be useful in prioritising clinic appointments. In these times of great pressure upon secondary care, and perhaps with an eye on offloading more patients to the primary care sector, such arguments are powerful. I suspect even more so were objective OCT data to be included in any such ‘triaging’ algorithm.
Almost as a throwaway mention at the end of the lecture, Crabb mentioned an app that the Crabb Lab has produced and is free to download (iOS and Android). The Glaucoma in Perspective app is aimed squarely at patients and demonstrates the vision loss with glaucoma, often unnoticed and certainly different to the old demo specs, brilliantly. Well worth showing your patients.