1. 1 THE ALLIED NETWORK SUCCESS THROUGH COLLABORATION Inaugural Conference 6 th April 2013 Amanda Griffiths BAppSc(Optom)(First Class Honours) Optometrist Founder www.myhealthcareer.com.au

2. PART ONE What does an optometrist do? 2

3. 3 Eye movements Pupil reactions Vision Posterior segment health Anterior segment healthIntraocular pressure Initial consultation - an overview 2. – PRELIMINARY CONSULTATION 4. – OCULAR HEALTH3. – VISION & FOCUSSING Focussing 1. – CASE HISTORY 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 conditions 5.Medications and allergies – both of which can affect the eyes

4. 4 Eye health Retina Lens

5. 5 Eye health - retinal photos Normal retinal appearance You guessed it…. not normal…. Toxoplasmosis Optic nerveMacula

6. 6 Glasses? Contact lenses? Referral to ophthalmologist?Referral to GP? Secondary consultation? Referral to allied health? Results of the initial consultation

7. PART TWO Who might an optometrist refer to? 7

8. 8 Hyperthyroidism Eyelids uneven - upper lid retraction Referral to GP - mainly for blood tests Diabetes? Recent onset of blurred distance vision

9. 9 Cataract surgery Referral to an ophthalmologist

10. 10 Wet macular degeneration Referral to an ophthalmologist

11. 11 Referral to an allied health practitioner LOW VISION CLINICS Social worker Occupational therapist Optometrist

12. 12 Referral to an allied health practitioner Arthritis – OT, physio, ex phys Diabetes – podiatrist, dietitian, ex phys Stroke – physio, speech pathologist, social worker, psychologist, OT, dietitian Cerebral palsy – OT, physio, psych, SW

13. PART THREE Why might you refer to an optometrist? 13

14. 14

15. 15 of vision loss is treatable

16. 16 Children Some childhood eye problems are, erm…. very subtle….. …..and you only have until 8 years of age to get it sorted….. 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

17. 17 Teens and young adults Frontal headaches? Blurred vision? Squinting? Reading too close?

18. 18 40 to 45 years of age I can still read…. I just need to hold it back further…… Presbyopia often presents with denial

19. 19 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

20. 20 Any time Refer ASAP for these symptomsScary possible cause Flashes of light – like lightening boltsRetinal detachment (RD) Recent onset of spots in the vision – especially redRetinal detachment Double vision – seeing two of things – esp recent onsetBrain tumour, myasthenia gravis Blacked out central visionMacular degeneration Known to cause eye problemsWhat can happen Oral/injected steroids (and less commonly inhaled)Glaucoma, cataracts Parkinson’s DiseaseDouble vision Marfan’s SyndromeTurned eyes, focus problems, RD Diabetes and high blood pressure (esp uncontrolled)Retinal blood vessel haemorrhages StrokePeripheral vision - driving

21. PART FOUR Areas of specialization in optometry 21

22. 22 Areas of specialisation in optometry Behavioural Therapeutics Research With ophthalmologists Contact lenses Low vision

23. 23 My area of specialization SUBSCRIBE www.myhealthcareer.com.au SUBMIT A GUEST BLOG POST IN RETURN FOR A LINK TO YOUR WEBSITE!!

24. PART FIVE Multiple choice questions 24

25. 25 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.

26. 26 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.

27. 27 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!!