Opinion

Bill Harvey: Thinking about tomorrow

​I have had to bite my lip this week to stop myself saying something.

I have had to bite my lip this week to stop myself saying something.

It was an excellent hospital optometrists conference this year, held online last weekend (see a full review in next week’s issue). In between the lectures, there were moving tributes paid to Dr Paul Spry who, to our great shock and sadness, recently passed away. As well as his role as heading up hospital optometry in Bristol, readers may remember him as one of the two authors of Optician’s Essential Glaucoma Handbook. It was while editing this that I got to know Paul and I can confirm, without any sentimentality, that it was a pleasure. His amiability matched his accuracy of knowledge such that it must have been the easiest editing job ever undertaken. He will be missed.

Still stopping myself…

Since the conference, a presentation from Cardiff researcher Dr Tony Redmond has got me thinking (again) about the apparent demise of visual fields testing. In many practices I visit, fields is carried out less and less, often only when someone has already been confirmed with a glaucoma diagnosis. This has got to be partly due to the rise of OCT disc analysis. As Redmond reminded me, structure has to be lost before vision is lost. However, vision loss is more complex and fields still has a role in assessing disease impact on vision. The correlation between structure and function is not linear.

Still stopping myself…

I had a glimpse of the future this week when visiting Specsavers in Newport. This large practice has integrated a hospital outreach macular clinic and patients arrive for their anti-VEGF injections along with regular sight test and OCT assessment patients. Clinical staff are currently undergoing training in injectables and very soon will take over some of the roles currently undertaken by visiting ophthalmologists. Most impressive.

I can’t stop myself... Brexit was a good idea, wasn’t it?