As Clinical Editor of Acuity, I am very pleased to welcome you to our first edition. We intend to use the clinical articles in every issue to tackle important and contentious topics for the profession. As most readers will be aware, NICE recently published new or updated guidance on age-related macular degeneration (AMD), cataract and glaucoma, some of the most common eye diseases which we can expect to see more of in the future.
The new cataract guidelines emphasise the importance of taking into account individual patient circumstances, and referring based on symptoms and clinical judgement, not a rigid protocol. This can only be a good thing, enabling the optometrist to refer for cataract surgery when they, and the patient, feel it is clinically necessary to refer, rather than basing the decision on visual acuity.
In this age of treatable wet AMD, correct diagnosis and management is more important than ever. Early treatment can prevent sight loss, but the number of patients with AMD can swamp hospital eye services (HES). Thus, the recommendation is not to refer patients with early dry AMD. With appropriate training, the correct interpretation of optical coherence tomography can help to prevent unnecessary referral, providing a better service to the patient in practice, and allowing more effective use of HES resources. Of course, if active wet AMD – referred to by NICE as ‘late AMD (wet active)’ – is suspected, urgently refer to facilitate prompt treatment.
In an informative article on the latest NICE guidelines, we highlight how the burden of these diseases is predicted to grow dramatically over the next few decades, and how the role of the optometrist in diagnosing and managing eye disease will inevitably evolve to combat it. Similarly, our timely overview of how independent prescribing has developed over the last few years suggests how it may benefit your career. The Scottish model is more mature than that found in the rest of the UK, but it is likely that optometrists will have more opportunities to become increasingly involved in managing medical eye problems in the coming years.
To provide the best-quality care, we often talk about evidence-based practice. However, not all evidence is the same, and as more and more studies are published, it is becoming ever more important to understand how to critically analyse evidence. This skill enables the optometrist to interpret results and incorporate them into clinical practice appropriately. In our cover feature, we discuss how to assess the evidence that supports treatment options, and how you should apply it in practice.
We hope you enjoy the new journal, and we look forward to providing you with more cutting-edge clinical content in issue two.
Kieran Loft MCOptom, Clinical Editor
kieran.loft@college-optometrists.org
Picture credit | Caroline Andrieu
