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Category Archive for: ‘Clinical’
The global pandemic introduces many difficulties to daily life and Optometry is no different!
Optometrists cannot perform any work at a distance greater than 2 metres – their arms are too short after all! As anyone who has had an eye exam will know, examination of the back of the eye is a very close procedure, with very little distance between the client and the optom.
Professional and regulatory guidance suggests that because Optometrists cannot work with the “self distancing” suggestions, we will have to attempt to go by the 15 minute rule. For the foreseeable, eye tests may need to be split into more than one session – the suggestions are that refractions and history and symptoms will be visit one and there will need to be another appointment for eye examination and (if necessary) collection of spectacles.
Obviously, depending on symptoms and issues, things may need to be done in a different order, depending on priority.
This is a not ideal situation, but in these circumstances, which are not ideal, we will have to roll with it.
We are going to have to instigate an appointment only visiting plan – no visitors without an appointment, at all. All appointments made by telephone will have to be screened, “triaged” to ensure you have no symptoms of COVID-19 and to determine why you require an appointment – if you have an emergency, such as loss of vision, we will see you no problem, but a red and/or sticky eye associated with a cough could be a sign – we will direct you elsewhere – best to call the HSE?
Routine eye examinations are the most likely to be disrupted – we plan to split those up as previously described, but, unfortunately, at this time do you really need your eyes tested? If you broke your specs and need a new pair, for the moment, if you could see OK with the previous pair, it might be better to go with the old prescription? We will absorb the costs involved here – should it later become “clear”, after a test down the line, that the correction was not ideal, we will change the spectacle lenses at no further charge to you. But maybe just wear your spare pair until this current crisis has passed?
Teaching clients how to apply and remove contact lenses is a time intensive and close proximity task which will have to be suspended until further notice.
For those folks who are past their contact lens prescription “in date time”, we will (as per recommendations) extend the contact lens prescription validity time, until things improve – no contact lens check mandatory at the moment!
For the same reasons, all home visit appointments are cancelled until further notice – there is no point in visiting a housebound person and exposing them to unnecessary risk!
Tough times for all of us – none of these measures are necessarily just to protect the staff of the practice, though that is of course an issue, but it is moreso to protect the wider community, to ensure we do not cause community spreading.
Pubs, Clubs and other venues, where large numbers may be in close proximity have been advised to close for two weeks by the government. We also see that certain local businesses have chosen to close for the next few weeks – that is their choice and we make no inference on whether that is the correct choice, but life goes on, as will COVID-19. It will still be in the wild in 2 weeks from now, likely more widespread, so we will hold off from even more drastic measures until absolutely necessary…..
Christmas Time, again.
As usual we are going to be closed between Christmas and New Year, our excuse being that we can get no deliveries until the New Year. Though that is actually true!
This is the only time I am personally guaranteed to get some time off, and that time at home is very precious, particularly this year.
We will be having a staff Christmas meal on Friday 21st in the afternoon, so we will be closing at 1pm, or perhaps shortly after? on that Friday, and we will be gone until January 3rd.
(Scottish people are genetically unable to work on January 2nd).
We may see you in the Bailie Hotel on Friday afternoon, but after that we will see you in 2019.
Wishing everyone a Very Merry Christmas, or Happy Holidays to be more politically correct?
Ho Ho Ho!
Happy Holidays from Ian, Neasa , Sandra and Victoria.
(once again, in alphabetical order!)
Many thanks to all of our clients – no business is anything without you, after all!
We wish you all a happy and healthy Christmas, and onwards to year 2019 and beyond!
Please, please remember to NOT sleep in your contact lenses- it may have been a great night out, but your next day or two in hospital may not be so great? It is not worth it – for more information in case of an emergency, please click this link.
Once again, it is national AMD Awareness Week – September 10th to 16th.
As members of the Association of Optometrists, we will be offering AMD (Age related Macular Degeneration) screening free of charge in practice next week. AMD used to be called ARMD, which given its actual meaning still makes more sense to me!
Please call us to book a slot if you wish to avail, but please be aware that this is not a free eye examination, it is a free AMD screening. Also please remember that we are fitting these checks into our already busy diary, so you might not get the exact time that you would like. If you just arrive, please don’t be annoyed if we ask you to come back later – we are doing this as part of a national awareness campaign, which is more for your benefit than ours!
If you are entitled to a government funded full eye examination, either due to Medical Card or PRSI entitlement, you would be much better to get the full test done, rather than this “freebie”. By all means have this freebie too, but this is not a substitute for a full test, but given what I said here, even a full test is perhaps not enough, due to the speed of onset of the most devastating type of AMD?
Every year we have callers who have no particular interest in Age Related Macular Degeneration, but a very strong interest in getting something for nothing. We will happily accommodate them, but everyone, please understand that the staff will advise you to have a full test rather than the very reduced screening offered – if the full exam is still not going to cost you, why not avail of that instead?
If you have had a recent eye examination and everything was OK, and you have no issues now, you likely will not benefit from this screening, but do ensure that each eye is distortion free and seeing as well as you are used to – you should do this on a weekly or fortnightly basis. If not, you should get your eyes checked as soon as possible, ideally in the establishment you normally attend – they best know your eyes after all!
(And you do trust them, don’t you?)
AMD Awareness Week 2018 10 September 2018 – 16 September 2018
AMD Awareness Week 2018 ‘SightSee With Me’ will take place from the 10th-16th September. This year marks the beginning of a new decade for the awareness campaign, as we mark the 11th anniversary of the multi eye care stakeholder group initiative, supported by the Irish College of Ophthalmologists.
The aim of the awareness week is to create greater public awareness and understanding of AMD, and encourage those aged 50 and over to get their eyes tested regularly.
Further information on AMD Awareness Week 2018 activities and testing locations will feature shortly on the ICO website www.eyedoctors.ie and www.amd.ie.
There is a recent study which found that Diabetics who drank more than 4 glasses of “diet soda” in a week had a significantly increased risk of Diabetic Retinopathy – the diabetic eye disease which can cause blindness.
The study found that diet soda drinkers had a doubling of the likelihood of diabetic retinopathy, compared to non diet soda drinking diabetic peers.
Most everyone, me included, would have thought that sugar free drinks would be safer, but it seems that there may be other issues with diet sodas compared to naturally sweetened drinks.
There have always been mentions, and suggestions about diet drinks being bad for you, but there do seem to be other health issues, even in non diabetics associated with some artificial sweeteners. Some suggestions of cardiovascular issues?
As a fat bloke who honestly does prefer Diet Coke to Normal Coke, and even Coke Zero- which I assume is as bad, this is perturbing!
I do prefer the taste of Diet Coke over the other cola options, but maybe I need to just stop and drink water!
On behalf of the Board of the AOI can I thank you for completing the recent survey on Cataract and Children waiting list.
This forms a very important part of our strategy when dealing with the HSE and Department of Health.
Below is the press release that was issued to all National and Local media and we shall be meeting with members of the Oireachtas later today. The results can be found in the members section of the AOI website.
A Press release – Issued by the Association of Optometrists Ireland
Wednesday, May 16th, 2018.
Average wait for public cataract surgery is 28 months – Optometrists survey
Five year wait for Cataract Surgery in South West
Inconsistency and major gaps in children’s eye-care services
Half of country has no public eye-care scheme for 12-16 year olds
The average wait for cataract surgery across the country is 28 months – and up to five years in some parts of the country – according to a survey of eye-services carried out by Optometrists.
The nationwide survey of members carried out by the Association of Optometrists (AOI) found that the longest wait for public cataract surgery was in West Cork (60 months) with the shortest delay in Sligo and Leitrim (15 months) – where an award-winning scheme is in place involving greater co-working between Optometrists and the regional Hospital eye department.
In contrast the survey found that the average wait for private cataract surgery across the country was three months.
The survey of hundreds of practising Optometrists broke down responses per constituency and also looked at children’s eye-care, where major inconsistency and gaps in services were identified.
The survey found an average wait of 15 months for children’s public eye-care (under twelves) ranging from 24 months in East Cork to five months in Cavan and Monaghan.
The survey found that in 36 of 40 constituencies, the sixth-class vision screening service had been ceased and an alternative local arrangement had been put in place in just a quarter (9) of those constituencies. (In 2016 the HSE wrote to local health offices recommending the ending of the sixth-class service and that alternative local arrangements for children would be developed.)
For 12-16 year olds the survey found that local HSE Offices will not authorise public eye-care in 19 of the 40 constituencies for children who have their own medical cards, while local arrangements are in place in 21 constituencies.
AOI President Triona Culliton said the survey showed the urgent need for the Minister for Health to intervene and affect an overhaul of eye-care services.
She said the problem in Ireland was an over reliance HSE Eye Clinics and Hospital Ophthalmology departments to provide almost all public care, including even the most basic and routine care. These services are overwhelmed and far short of capacity.
“Optometrists can provide routine care such as eye examinations, glasses fitting, pre and post-surgery check-ups in the community. Only more complex cases need be referred to our colleagues in HSE Eye Clinics or hospital eye Departments.
“The findings from the AOI survey are very clear: With regard to cataract surgery, the Sligo Leitrim constituency has the shortest waiting time and is the core region where the award-winning Sligo Cataract Scheme is in operation. AOI has estimated that rolling out the scheme nationwide could save up to 20,000 hospital appointments per annum and reduce system costs.
We are calling on the Minister for Health to intervene and sanction the HSE to roll out this scheme nationwide immediately.
Ms Culliton also said that the survey showed children’s eye-care services to be inconsistent across the country, very limited and ad hoc.
“AOI is calling for the introduction of a national eye-care scheme for all children up to 16. Optometrists in the community should deliver eye examination and spectacles fittings, while medical cases requiring surgical management are referred to eye Doctors as necessary,” she said.
The capacity crisis identified by the survey is also reflected in the latest National Treatment Purchase Fund waiting list figures which show that those waiting longer that 18 months for outpatient eye appointments (which would be significantly comprised of those requiring cataract surgery) has more than doubled from 4,300 at the end of March 2017 to almost 9,000 at the end of March 2018.
Overall there are 41,000 patients on the Ophthalmology outpatient waiting list, an 18% increase since the end of March 2017.
In terms of inpatient eye-care waiting lists, there are 11,000 of the list for Ophthalmology the second largest in any medical area.
The survey also asked AOI members if they would be willing to contribute towards relieving pressure on the overburdened hospitals and clinics.
97% said they were immediately available to deliver the Sligo Cataract Scheme model and 87% said that they would support the non-medical and non-surgical elements of a national children’s eye-care programme.
“It is time that we stopped tolerating these terrible delays and take action to make services better for patients,” Ms. Culliton said.
“We need all eye-care providers to work together better by providing basic and routines care in the community via Optometry, with specialised care referred as appropriate to Eye Clinics and Ophthalmology Departments.”
AOI stressed that they have 650 trained Optometrists working in 350 locations across the country who could meet all clinical requirements necessary and most already have the necessary equipment in situ. They can also offer local access for patients in all cities, towns and many villages across the country.
AOI said it is 50% cheaper for a patient to be seen at their Optometrist than at a HSE Clinic or Hospital and has estimated that annual savings of €32.3m can be made by reforming eye-care services.
“In Scotland Optometrists are utilised as the front line for public eye-care which helps deliver ready access for patients and affordability for the taxpayer. They do not have any significant waiting list problems there, as Clinics and Hospitals are freed up to carry out specialised medical and surgical care.
“AOI is calling on the HSE, under the leadership of the Minister for Health Simon Harris, to reform Irish eye-care, to tackle the waiting list crisis – and better serve the interest of patients.”
Information on the survey findings can be found at www.aoi.ie.
Ian’s opinion, and it is just my own opinion!
Personally and very cynically – I have become a very cynical person! But which parent in all honesty would abide by this waiting list if they could scrape together a hundred or so Euro to “skip” the queue? Any parent who could get the money together would likely wish to bypass the queue to have their child seen (privately), if they could manage to.
It is annoying how many times we have had a child’s prescription written out on an HSE authorisation to dispense, when the child was actually seen privately, and therefore should not be entitled to any help toward spectacles, but the HSE staff do not seem to mind this “anomaly”. ?Look after you own? – now maybe the ophthalmologist is trying to save the parents a few Euro, but private tests should absolutely preclude a public dispense, as we were advised! The ophthalmologist is not even able to supply his own paper to write the prescription on!
Where is the incentive within the Medical Professionals to reduce these waiting times? There are none, at all, for the reason stated in the two paragraphs above.
Given that cataract problems require surgical intervention, which Optometrists obviously cannot do, where would the harm be to allow Optometrists to work out which child failed their visual screening in school because they were not paying attention, or did not feel good on the day, or didn’t really understand what they were supposed to do? Or didn’t know their letters?
Many visual screenings at school result in an appointment in the community clinic, and most appointments in the community clinic result in a prescription for spectacles. 7, 8 or 9 out of 10 of those prescriptions, had I found that prescription, I would have said that no spectacles were required. But without knowing all of the details and testing their eyes myself, I have no other option but to “sell” the parent spectacles for their child. “When do they need to wear them?” I don’t actually know when (or even if) they need to!
I once worked in the Cumbria NHS area. In the UK, all children under 16 are entitled to free eye examinations, and Cumbria NHS Trust used to send them a Birthday Card on their third Birthday, stating that now that they were a BIG three, they should go for an eye test. Under this scheme I once saw a boy who was so “long sighted” -Hyperopic, that he had never been able to see a clear world – he did not realise that there was any more “world” out there than that he could see! At an age of 40 months (ish), this lad had the vision of a newly born baby, because he didn’t learn, and couldn’t know that better vision was available! Had this boy been left until he was in junior or senior infants, it is likely that he would have been left partially sighted!
I felt so sorry for his mother on the day, as she was immediately beating herself up with mentions that he constantly runs into things, constantly bumps his head and other things, such as being unable to find things. I had to say that in my experience, that is just what children were like, having had a few of similar ages at that time.
My son was wearing spectacles for over 2 years before he had a screening at school (in Ireland) – in senior infants I recall, but that is not because I am an optometrist, it is because he couldn’t see! He may have missed the screening on the day, but not to my knowledge.. It was Victoria, my wife who realised he had an issue.
The hyperopic boy was seen within the hospital within a couple of months, and his mum came back to thank me – they had reduced his prescription a little bit, but in those few months his visual acuity had improved significantly. I never found out the end result, but to this day I hope that he was caught in time (I hope he was) and managed to catch up with his peers, but his peers had mostly a 32 month head start on what one should have been able to see. Had he had to wait to “go public” in the community clinic, or go “private” at the optician, I am certain that this boy, who would likely now be in his 20’s would be partially sighted? Here, in Ireland, exactly when would this lad have been picked up?
Humans learn to see for the first 7 to 8 years – yes you need to learn to see! Any interruptions to that process can have lifelong consequences – in Ireland you cannot trust your children’s eyesight to the state!
The state would argue, perhaps correctly that children’s allowance is better here than elsewhere – it sure is higher than in the UK! That is their “excuse” for poor children’s care ( and eye care) as best I can fathom! Pay for it yourself! Much like adults – isn’t it fabulous that many more adults are entitled to a “Government Funded” “Free” eye test? Well, it isn’t free – they took it out of your pay packet, in the hope you never try to use it?
The longest post ever, but most of it wasn’t mine!