Advances In Eyecare

Electronic devices and adapted software are increasingly being sought out by patients with visual impairment. It is becoming more important that optometrists have a good understanding of the technology available so that the best advice is given. To understand the emerging technologies, Dr Michael Crossland explains how the OrCam and the OxSight devices can be used to help visually impaired individuals in their everyday lives.

Last year, it was announced that Optos were teaming up with the company Amydis in developing retinal screening for Alzheimer’s disease. Amydis have developed a technique that allows the visualisation of amyloid build up in the retina. Amyloid is a useful biomarker which is found in increasing amounts as the disease progresses. In this interview, we speak to Anne-Marie Cairns to find out more about the technique and the possible future role that optometrists might have in the early detection of Alzheimer’s disease.

Diabetic retinopathy is emerging as a leading cause of preventable blindness globally. The use of artificial intelligence and machine learning is set to revolutionise the way clinicians gather and analyse clinical data. One of the recent trends has been the increasing use of portable systems to gather and transmit clinical data. In this interview we speak to Dr Jorge Cuadros, Santa Cruz based optometrist and co-founder of EyePACS, to find out more about the web-based application that allows for remote diagnosis of patients by off-site optometrists.

The eyelids are an essential component of maintaining a healthy tear film and treatment of eyelids is often part of a management strategy for dry eye disease. One long-established technique for dry eye disease treatment involves the use of warm compression, although more recently, controlled abrasion has also been used as part of a management strategy. To understand the importance of a more recent treatment option, Dr Keyur Patel explains how the use of very high energy impulses on the eyelids can help treat dry eye disease.

Macular pigments absorb shorter wavelength visible light, act as anti-oxidants and reduce degenerative processes. They may also play a role in vision: specifically contrast sensitivity and glare reduction. Accurate measurement of the pigments is useful clinically as a means of assessing macular protection, especially in those susceptible to degeneration. In this interview, we speak to Dr Shelby Temple about a new macular pigment screening tool that has been recently developed at Bristol University.

The lowering of intraocular pressure (IOP) is the mainstay treatment for primary open angle-glaucoma and slows down further progression of the disease. Many patients present with raised IOP but without optic nerve damage and this is termed ocular hypertension. Many ocular hypertensives convert to glaucoma, and so lowering their IOP helps reduce the risk of the disease establishing. Recently published LiGHT study suggests that the use of a laser treatment, selective laser trabeculoplasty (SLT), may replace the need for on-going use of IOP-lowering drops. In this interview, we speak to Dr Deacon Harle and Patrick Gunn to find out more about the SLT technique, and what it means for optometrists.

Prof Jenny Read, Principal Investigator on the ASTEROID project and ‘Man, mantis and machine: the computation of 3D vision’, talks virtual reality and 3D displays, and the potential impact of prolonged use of virtual reality displays upon the visual system.

Dr Vivek Nityananda offers a unique insight into how we may better understand human stereo vision through his research into the stereo vision of praying mantises as part of the ‘Man, mantis and machine: the computation of 3D vision’ project.

Dr Kathleen Vancleef discusses the ASTEROID project’s new technology, and how its new methodology promises to make the assessment of younger patients easier.

Prof John Flanagan talks about a potential new treatment for glaucoma and explains the neuroprotective role of lipoxin around ganglion cells and how maintenance of this may offer new options in management of the disease.

In 2018, the RCO released new guidelines on screening for hydroxychloroquine and chloroquine retinopathy. This was in response to an increase in the use of the drugs, drugs that for a long time have been known to have significant ocular side effects. The new guidelines make specific recommendations on the techniques and timing of baseline and follow-up screening tests. To understand the importance of these drugs, dermatologist Dr Sharon Blackford provides a background summary on their clinical use. Following this, ophthalmologist Dr Tariq Aslam explains the new guidelines and how they will work in practice.

Myopia is a cause of sight loss reaching epidemic proportions around the globe. For most people with low to moderate myopia the main implications are refractive, but for those classed as having high myopia (-6.00DS or more) there is an increased risk of ocular pathology. For these patients, a number of possible interventions have been looked at, including the use of low-dose atropine. In this interview, Abeeda Khatoon speaks to Professor Niall Strang at Glasgow Caledonian University to find out how this intervention works and its availability in the UK.

Acanthamoeba keratitis is a rare eye infection caused by a water-borne microorganism, Acanthamoeba, which infects the cornea. The disease is rare but has a strong association with soft contact lens wear. Since 2011, there has been a threefold increase of the infection in South-East England. In this interview, David Cartwright speaks to Dr Nicole Carnt, at the University of New South Wales Sydney, to find out what the reasons are for the increased incidence in the UK and what this means for optometrists.

Geoff Roberson summarises the essentials to bear in mind regarding documentation of any referral process.

We discuss how primary open angle glaucoma is now referred via referral refinement schemes using the example of the scheme established with Manchester Royal Eye Hospital and how this has significantly improved accuracy of referral and resource usage.

Simon Frankiewitz explains when referral for orthoptic assessment might be appropriate.

Geoff Roberson uses the example of a cataract referral to clarify the concept of routine referral followed by a discussion of the Gloucestershire cataract referral scheme.

Raymond Curren discusses the situation regarding referral routes in Northern Ireland.

Stephen McPherson and Dr Nik Sheen look at the regional variation in schemes for referral in Scotland and Wales respectively.

Dr Robert Petrarca explains urgent referrals and Geoff Roberson looks at the best practice for optometrists.