A few weeks ago, I heard from a colleague a story that I found hard to believe at the time. I was told that one GP, not far from where I work, was ‘prescribing money’ to help some visually impaired patients to afford better lighting. This had arisen because the usual support services were so oversubscribed and underfunded that waiting times were becoming unwieldy. I now know that the story may actually be true, having read news reports today of how some GPs were planning to ‘prescribe heating’ to help their more vulnerable patients to survive the challenges of winter.

I was sad to hear about the loss of the excellent Professor Roger Buckley this week. As well as being a major player in anterior eye medicine, Roger was a great supporter of optometrists from way back before many of his surgical colleagues thought of us as anything other than spectacles salespeople. Indeed, those of us who use the College of Optometrists’ clinical management guidelines appreciate the constant reference to how solid the evidence is for any specific treatment. This is a testament to the solid scientific rigour Prof Buckley, who contributed to the guidelines, brought to eye care at all levels.

I was once interviewed by the great man when applying for a hospital job. I remember him quizzing me on how refraction might help in the monitoring of eye diseases. For example, hyperopic shifts and reduced pinhole acuity as indicators of macular oedema, myopic shifts due to refractive index shifts in the crystalline lenses of poorly controlled diabetics, and contrast changes with corneal oedematous responses. This reminded me that, while refractive data might be gathered by suitably trained colleagues, the results always need to be interpreted in context. Thank goodness no one is really considering separating the refraction measurements from a full eye examination. Or are they?

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