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Monthly Archive for: ‘January, 2014’
A previous colleague of mine, Linda McGivney-Nolan recently was quoted in Optometry Today, a UK magazine- she was highlighting the problems with children who might fail a school screening.
Apparently, there is nearly a 4 year waiting list to have a child seen in Kildare, up to 3 years in Dublin. In our area I recently enquired about the waiting time for a couple of children I wished to refer, both of whom had significant problems- Navan clinic quoted me 12 to 18 months, with a faxed referral, though they would try to get them a sooner cancellation if I insisted it could not wait that long. The other child would normally go to Cavan, because of where they live, the waiting list these is approximately the same I was advised.
These waiting lists are unacceptable – both my young patients will have permanent weak eyes if they cannot be seen before the age of 7, at the very latest. At the moment it looks like both will be seven before they are seen.
There is no point in doing the school screenings if there is no suitable referral pathway for those who fail.
Not every Optometrist in Ireland is comfortable seeing children, because it is something that we do less of here than in the UK – the HSE insists that any child who is going to be seen under the community scheme must be seen by the Community Ophthalmologist – in a clinic with a long waiting list. The other issue is that the community scheme entitles your child to eye examinations free of charge, and a contribution towards spectacles, but if you go private, to an Optometrist or an Ophthalmologist, you get no help.
Those of us who have either a specialist interest in Paediatric Optometry, or those who have worked in the UK will probably be more confident.
We are more than happy testing children – it adds variety to the day! Parents are welcome to sit in on the test to observe, as long as they don’t inappropriately try to help their child – many point out the correct letters or give clues, which really does not help us establish what the child can see! Children are well able for an eye test usually by 3 to 4 years of age, and though the test would be different to that of an adult it is no less important.
A recent study has found that young myopic (shortsighted) contact lens wearers who were fitted with a specific type of multifocal contact lenses progressed at a slower rate than age matched peers. Although it was a small study, the results were still found to be statistically significant, meaning that there is very little likelihood that the results were different by chance alone. They found that the shortsight developed at half the rate of the control group.
This is a very interesting finding – 50% is quite a lot! at last there may be a way to slow down those children who seem to get worse, more shortsighted, at every visit.
Researchers believe that by making the peripheral vision slightly blurred using bifocal contact lenses (initially designer to help older people read with their lenses), the eye somehow knows to stop growing. This peripheral blurring will not affect the wearer’s vision significantly- peripheral vision is really only useful for movement detection.
Another study from a couple of years ago, in Australia used a lens design which was later licenced to CibaVision. Though Ciba have not yet released a contact lens specifically aimed at myopia control, there is mounting evidence that it can be effective at slowing those patients who seem to be constantly slipping.
Google has released details of a new contact lens which they hope will be able to monitor wearers’ blood sugar levels- Diabetics need to test their blood sugar regularly, which at the moment most likely means a finger prick with a needle.
The lens can apparently test glucose levels in the wearers tears, and is then be able to transmit the information wirelessly to a device- a dedicated receiver or perhaps even a smartphone, but in future they are looking into the possibility of incorporating tiny LED lights, which could flash if the sugar levels are too high or too low.
There are a few issues to overcome before the lens can go into production- they need to find a manufacturing partner, but also, research needs to be done into the glucose levels in the tears of diabetic patients- it is well known that tears do contain glucose, to nourish the cornea which has no blood supply, but how it fluctuates with blood sugar levels and perhaps tear evporation is not so well understood at the moment.
This contact lens is one of many projects Google is investigating in its new healthcare division called Calico, launched in September 2013.