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HomeminewsPEACE 2015: Focus on Collaborative Care

PEACE 2015: Focus on Collaborative Care

More than 200 optometrists gathered in Sydney recently, for the one-day PEACE (Personal Eyes Annual Conference Event) conference.

This was the fifth year the conference organisers, PersonalEyes, has reached out to optometrists with its PEACE program, aimed at educating optometrists on the diagnosis of various ophthalmological conditions, the latest surgical procedures and treatments, and issues around patient referral. One of the highlights of the conference was collaborative care of glaucoma patients.

PersonalEyes Business Development Manager Shirin Amirbeaggi said the event, held in February this year in Sydney’s CBD, attracted optometrists from NSW and the ACT. She said feedback was positive with 21 therapeutic points available on the day.

Conference Keynotes

Clinical optometrist Dr. Anna Siu spoke about dry eye treatments; Phil Dang discussed how to manage patients who receive unexpected results; and Therese Consiglio spoke on therapeutic placements. But the program really belonged to the PersonalEyes team of ophthalmologists.

Dr. Kerrie Meades spoke on small incision lenticule extraction – more commonly known by its acronym: SMILE. As the Chief Medical Director of PersonalEyes, Dr. Meades is one of the pioneers of laser cataract surgery and is passionate about refractive surgery, including surface treatments, LASIK, phakic IOLs, customised cataract surgery, intracorneal rings, cross linking and presbyopia.

…there are simply not enough ophthalmologists to treat the increasing number of glaucoma patients

She said one of the advantages of SMILE technology was the possibility of less dry eyes and reduced risk of infection.

Disadvantages included that it could not be used to treat hyperopia (at this stage), low myopia (<-1.50D) an increased risk of lenticule tear/difficulty in revolve, and that retreatment must be done as a surface treatment.

Dr. Meades also discussed patient selection criteria, patient work-up, the post-operative regime and post-operative visual acuity.

Ms. Amirbeaggi said another highlight was Dr. Chandra Bala, who presented on two areas. His morning session was titled ‘Lentis

high add IOL clinical trials – case reviews’, and he was back in the afternoon to discuss Femtosecond Laser Capsulotomies.

Collaborative Care

Not surprisingly, with the recent reinstatement of collaborative care arrangements between ophthalmologists and optometrists for patients with glaucoma, the issue was one of the hot topics at PEACE 2015.

Dr. Andrew White spoke to conference attendees on ‘Glaucoma referral guidelines: the optometrists’ role in collaborative care of glaucoma’.

He told attendees that there are simply not enough ophthalmologists to treat the increasing number of glaucoma patients.

“Optometrists outnumber ophthalmologists more than 4:1 with a wider geographic distribution,” he said. “One of the implicit assumptions of the settled legal dispute between ASO/RANZCO and OBA was that collaborative care was the way forward.

“The key to effective collaborative care is that high risk people are seen in the most timely fashion. This likely means low risk patients will be seen less often by ophthalmologists. We have to ensure this is done safely with good communication and education,” Dr. White said.

He said everyone has a different idea about what collaborative care actually means but the guiding principles required: patient focused treatment; evidence-based health care; access to the most appropriate health care provider in a timely fashion; and clearly defined roles for health care providers and effective communication between them.

Guiding principles should also ensure a reduction in unnecessary duplication of tests, unnecessary health care provider visits, unnecessary treatment or overtreatment of patients and to ensure patients at risk of progression to visual loss from glaucoma are not undertreated and have access to the full range of treatment options.

As a glaucoma specialist, Dr. White has taken a lead role in the development of the collaborative care program. He outlined the advantages of the scheme, and how it would work in private practice.

He said a certification program developed by PersonalEyes would be available to optometrists wanting to diagnose, treat and manage glaucoma patients.