It is the challenges that make any job more interesting.

Like most newly qualified optometrists, I remember my first few days, working on my own without supervision, as both exciting and somewhat scary. I will now confess that, yes, I felt relief if there was a ‘no-show’. The patients I felt least confident about seeing were also the ones where I could probably do the most good; namely, very young children and the elderly.

If you undertake a dilated examination of everyone over 70 years old, you will always find something of interest. Most eye disease is age-related, and readers of Optician should have no qualms identifying these. The real challenge is how best to communicate any findings with a patient who, even if yet to suffer any significant cognitive impairment, is likely to have a whole range of eye care beliefs and ingrained views that might need modification.

I recently received an email reminding me that September is World Alzheimer’s Month. The email also included a link to a list of NHS memory clinics throughout England, which specialise in diagnosis and interventions in Alzheimer’s disease. As eye care professionals (ECPs) deal with elderly people regularly, we are very often the first to suspect a cognitive loss, and may also be more likely to detect mental problems linked with sight loss, such as depression or Charles Bonnet.

So, may I again make a plea to those looking at new curricula for teaching ECPs to think about including some formal training in screening and identifying common mental illnesses. Patients might benefit from a more specific care pathway, such as to a dedicated memory clinic, and GPs might feel less put upon.

Finally, a non-political point. It was only after the Queen took the initiative and had her first Covid-19 vaccine that I was able to persuade my mom and her friends to follow her lead.

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