“The 9.30am virtual team meeting usually begins with a grainy 80’s tune emanating from Aberdeen ophthalmologist John Olson’s computer. The song of the day affectionately dedicated to an optometrist or ophthalmologist in our close-knit group of 40-ish. The meeting generally progresses to discuss the successes of the past day, and improvements required to be implemented for the next six hours for the benefit of our patients. This has been the routine for the past eight weeks, seven days a week, since all optical practices were required to close for face-to-face consultations in Scotland.
“I’m proud to be an optometrist working as part of the Emergency Eye Care Treatment Centre in Grampian, North-East Scotland. In the region there are five hubs of strategically located optometry practices. Every patient that calls an optical practice with an eye complaint is triaged by an optometrist. If deemed an emergency, their details are emailed to us in the centres. Our next steps consist of video conferencing with the patient, arranging a telephone consultation, or offering a face-to-face appointment as a last resort.
“We are able to video conference directly to an Aberdeen-based ophthalmologist at any time throughout the six hour shift we volunteer for, gaining instant prescribing advice and second opinions. This also includes the ability to share our OCT and optomap results in real-time, allowing ophthalmology and optometry to work together to deliver the best eye care possible.
“Just the other day my prescribing colleague Janet Renfrew and I had details emailed to us of a young lady with a two day history of a unilateral swollen, painful, red eye. We asked the patient to send us photographs using her iPhone. These images were then screen shared in real-time with the ophthalmology department - preseptal cellulitis was the consensus. Janet was then able to prescribe medication under the direction of the ophthalmologist, and email this directly to the patient’s nearest pharmacy for collection in one hour. A week later, she is now feeling much better.
“Another colleague in a centre based in the northernmost part of Grampian recently saw a gentleman with bilateral anterior uveitis whose condition was unresponsive to hourly steroid drops. She used a video slit lamp to examine him, which allowed an ophthalmologist to view her findings alongside her for a second opinion. Under direction, she was able to prescribe oral steroids among further medication for a faster resolution. Not only did this avoid a long drive to the hospital followed by a long wait time, it also minimised his potential exposure to the coronavirus. He is now much improved and very grateful.
“These cases of fast and effective treatment are not isolated. We’ve diagnosed and/or treated cases of foreign bodies, nerve palsies, retinal tears, retinal artery and vein occlusions and cellulitis. In fact, under new guidance, our prescribing optometrists can remotely prescribe for certain cases of herpes simplex keratitis, dry eye disease and recurrent anterior uveitis, meaning the patient can simply take one trip to their community pharmacist.
“The aim of all this? To minimise those in at-risk groups from entering the hospital building where patients with COVID-19 infections are being treated. The safety of everyone we treat is placed at the forefront of the system. We can now deliver faster and better eye care through reinforced interconnected optometry and ophthalmology services. Perhaps after lockdown has ended in Scotland, this way of working will become the new ‘normal’?”
Yasmine Sahraie MCOptom is an optometrist sharing time between a multiple and independent practice in Aberdeenshire.