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THE ALLIED NETWORK
SUCCESS THROUGH COLLABORATION
Inaugural Conference 6th April 2013
Amanda Griffiths BAppSc(Optom)(First Class Honours)
Founder
Optometrist
www.myhealthcareer.com.au
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PART ONE
What does an optometrist do?
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Initial consultation - an overview
1. Presenting complaint – what problems do they want addressed?
2. Visual tasks/goals – how do they use their eyes?
3. Past ocular history – may impact your management/treatment
4. Family ocular history – may have an increased
risk of some eye
Pupil reactions
Posterior segment health
Anteriorconditions
segment health
Intraocular pressure
Eye movements
Focussing
5. Medications and allergies – both of which can affect the eyes
Vision
3. 4.
–1.VISION
––OCULAR
& HISTORY
FOCUSSING
HEALTH
2. – PRELIMINARY
CASE
CONSULTATION
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Eye health
Retina
Lens
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Eye health - retinal photos
Macula
Optic nerve
Normal retinal appearance
You guessed it…. not normal….
Toxoplasmosis
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Results of the initial consultation
Glasses?
Referral to GP?
Contact lenses?
Referral to ophthalmologist?
Secondary consultation?
Referral to allied health?
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PART TWO
Who might an optometrist refer to?
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Referral to GP - mainly for blood tests
Eyelids uneven - upper lid retraction
Hyperthyroidism
Recent onset of blurred distance vision
Diabetes?
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Referral to an ophthalmologist
Cataract surgery
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Referral to an ophthalmologist
Wet macular
degeneration
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Referral to an allied health practitioner
LOW VISION CLINICS
Optometrist
Social worker
Occupational therapist
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Referral to an allied health practitioner
Diabetes – podiatrist,
dietitian, ex phys
Stroke – physio, speech pathologist, social
worker, psychologist, OT, dietitian
Cerebral palsy – OT, physio, psych, SW
Arthritis – OT, physio, ex phys
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PART THREE
Why might you refer to an optometrist?
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40%
asymptomatic
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of vision loss is treatable
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Children
Some childhood eye problems are, erm…. very subtle…..
Headaches during a 3D movie?
Didn’t see what all the fuss was about?
More clumsy than your average kid?
Hand-eye coordination?
Some eye problems are, erm…. obvious
…..and you only have until 8 years of age to get it sorted…..
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Teens and young adults
Blurred
vision?
Reading
too close?
Squinting?
Frontal headaches?
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40 to 45 years of age
I can still read….
I just need to hold it back further……
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Older adults
THE BIG THREE
Cataracts – surgery required – generally around 75-85 years of age in
Brisbane population
Macular degeneration – loss of detailed central vision, two forms
called wet and dry, wet is treatable with injections
Glaucoma – due to an increase in the intra-ocular pressure,
asymptomatic in the early stages, generally simple to manage with eye
drops if diagnosed early, blinding if left untreated, if presenting with noticed
vision loss – generally a raging glaucoma
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Any time
Refer ASAP for these symptoms
Scary possible cause
Flashes of light – like lightening bolts
Retinal detachment (RD)
Recent onset of spots in the vision – especially red
Retinal detachment
Double vision – seeing two of things – esp recent onset
Brain tumour, myasthenia gravis
Blacked out central vision
Macular degeneration
Known to cause eye problems
What can happen
Oral/injected steroids (and less commonly inhaled)
Glaucoma, cataracts
Parkinson’s Disease
Double vision
Marfan’s Syndrome
Turned eyes, focus problems, RD
Diabetes and high blood pressure (esp uncontrolled)
Retinal blood vessel haemorrhages
Stroke
Peripheral vision - driving
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PART FOUR
Areas of specialization in optometry
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Areas of specialisation in optometry
Behavioural
With ophthalmologists
Contact lenses
Low vision
Research
Therapeutics
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My area of specialization
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PART FIVE
Multiple choice questions
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1. A six year old child has a focusing problem in one
eye. This could go undetected because:
a.
The child never covers one eye to check if each eye has good
vision.
b.
Their parent doesn’t take them in for an eye test because the
child doesn’t complain.
c.
The child is labelled ‘uncoordinated’ and no further investigations
are done.
d.
The child mentions they have a headache at the cinema when
watching a 3D movie and the parent puts it down to the lollies!!
e.
All of the above.
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2. A person presenting to an optometrist has an eye
condition. What are the chances that it is (firstly)
asymptomatic and (secondly) treatable?
a.
30% asymptomatic and 75% treatable.
b.
40% asymptomatic and 30% treatable.
c.
10% asymptomatic and 30% treatable.
d.
40% asymptomatic and 75% treatable.
e.
75% asymptomatic and 40% treatable.
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3. A patient you are treating happens to mention that
they have blurred vision. Possible causes could be:
a.
Undiagnosed diabetes
b.
Cataracts
c.
A focusing problem such as shortsightedness,
longsightedness or astigmatism.
d.
A pituitary tumour
e.
All of the above….. plus many more!!