Brisbane’s Hilton Hotel was “packed to the rafters” in September when 500 delegates attended for the annual Specsavers Conference.
The 2015 Specsavers Clinical Conference was themed “Driving clinical excellence in optometry through partnership with ophthalmology” and without a doubt, that was where the focus of all presentations was concentrated this year.
Opening the event, Peter Larsen, Specsavers’ Director of Professional Services welcomed the group’s optometrist franchise partners and their optometry staff, along with independent optometrists, representatives from Optometry Australia, The Australian and NZ Optometry Boards, representatives from five Australian and NZ Optometry Schools, and media. He then got straight down to the business of encouraging increased collaboration between optometrists and ophthalmologists.
Mr. Larsen said despite the growth in optometry placements in universities, the ratio of optometrists to consumers had declined. In terms of ophthalmology, he said, there was “a complete shortage of ophthalmologists in Australia and New Zealand” which presented “enormous issues”.
Driving clinical excellence in optometry through partnership with ophthalmology
He said, “a collaborative workforce needs to happen… we need to work in concert to drive productivity”.
Mr. Larsen reported independent research (from Oculo) showed that 64 per cent of optometrists felt communication between optometrists and ophthalmologists sometimes affected patient pathways.
He said to close the loop in communication, Specsavers was proud to present and launch the Oculo System, a secure online platform developed by the Centre For Eye Research Australia (CERA) and supported by Specsavers and others to facilitate communication between optometry and ophthalmology.
“This is a platform that will hold communication of particular patients so when you start sending a referral the information is maintained up in the cloud, accessible to you and the ophthalmologist,” said Mr. Larsen.
He said the Oculo System improves efficiencies in several ways. “Currently 20 – 30 per cent of referrals going into ophthalmology are a waste,” said Mr. Larsen, explaining that the new system reduces this waste by enabling optometrists to request an opinion from an ophthalmologist before referring a patient on.
With its list of ophthalmologists and their specialities, the Oculo System also means optometrists can check they are sending their patients to the most appropriate specialist. A drop down menu providing data relevant to individual disease processes, and the ability to upload photos and scans, will also assist optometrists to provide ophthalmologists with greater detail about referred patients. The ability for both optometrists and ophthalmologists to add to a patient’s file enhances the two way reporting process and patient communication as well.
“We know there are tremendous inefficiencies when referring to private and public specialists in terms of content. This goes some way to standardising the process of providing referral data,” Mr. Larsen said.
He said that as well as closing the loop in the communication process, the Oculo System would facilitate further learning that over time will improve patient outcomes.
“In the UK, careful collaboration between optometry and ophthalmology has affected the improvement of decision making choices for optometrists by enabling the collection and analysis of data from many optometrists caring for multiple patients.
“By working closely together in Australia and New Zealand the Oculo platform should not only be a way of transmitting data but should provide the very best CPD that you can possibly have,” said Mr. Larsen.
Diverse Subject Matter
A host of specialists, just some of whom are mentioned here, addressed Specsavers’ delegates during the conference, providing their expertise on a diverse range of topics from Telehealth through to macular disease, paediatric glaucoma and neuro-ophthalmology.
Dr. Angus Turrner, Director of Lions Outback Vision, gave a fascinating presentation, reflecting on the rewards and challenges of delivering eye health services to people in remote and regional Australia. He spoke in detail about the potential for tele ophthalmology to facilitate collaborative patient care and management. He said the Telehealth system, which enables a “live” consultation between patient, optometrist and specialist using videolink e.g. Skype, was “perfect” for common pathology and makes outreach specialist visits more efficient as there is more time for surgery and interventions. He said when more complex cases present face-to-face assessment by the specialist is still needed.
“In most literature Telehealth refers to ‘store and forward retinal screening photos for diabetes’… But we have an opportunity to work and progress this field, to be leaders in this internationally and show how we can solve the workforce issue by working together,” said Dr. Turner.
Paediatric Eye Health
Auckland’s Dr. Justin Mora spoke on the topics of paediatric glaucoma and paediatric allergic eye disease, describing distinct clinical features, non-surgical and surgical treatment options.
Speaking of paediatric allergic eye disease, he said optometrists should be aware of the dangers of prescribing topical steroids in children. “Children (particularly under six) are at higher risk of IOP elevation with steroids; the response is usually faster (15 days) and more severe; it is dose dependent but can occur even with fluromethalone; the literature contains many case reports of children going from normal to 0.9 cup in six months,” he said.
Glaucoma specialist Dr. Stuart Graham from Macquarie University and Save Sight Institute spoke about the practical aspects of visual field testing. He emphasised the importance of establishing a good baseline; determining the pattern of loss; using progression software that is available; and determining not only if change has occurred but the rate of change. He said the need for intervention should be based on quality of life and life expectancy.
Queensland’s Dr. David Hilford spoke about a range of macular conditions, teasing out the complexities, and putting them into a framework that would enhance delegates’ diagnostic skills regarding macular conditions and OCT interpretation.
Dr. Hilford told delegates, “Don’t forget, disease at the vitreomacular interface can often be thought of as a continuum with patients presenting anywhere along that continuum. These macular conditions may be static, progressive or even sometimes spontaneously resolve. Remember there is a good slit lamp test – the Watzke-Allen test – which can also be used to help diagnose certain macular conditions, or at least detect that further investigation is needed.” Dr. Hilford said the current treatment outcomes are generally very good and also spoke about the advent of Ocriplasmin (Jetrea), a treatment option for certain macular conditions.
Clinical Education Sessions
A series of clinical education sessions was presented by speakers from five optometry schools, including the heads of the University of New South Wales School of Optometry and Vision Science and Deakin Optometry. Three hundred Specsavers optometrists attended two concurrent therapeutic and clinical skills tracks, both of which emphasised the broader theme of collaboration between optometry, ophthalmology and universities.