Editorial: A varied issue covering relevant and interesting topics

18 April 2019
Volume 20, Issue 2

From ocular allergy, through cosmetics and genetic disorders of the anterior eye, to driving without spectacle correction.

From personal experience, the hayfever season seems to begin earlier each year. I am clearly not alone in coming to this conclusion as, last month, the College of Optometrists introduced a new patient factsheet advising sufferers to minimise the effects of hayfever by treating their allergy before their symptoms arise. Cognisant of the challenges practitioners will face managing their patients over the coming months, Optometry in Practice’s first paper, by Midlands academic and independent prescribing optometrist Dr Paramdeep Singh Bilkhu, focuses on the effective identification and treatment modalities for the most common subtype of ocular allergy: allergic conjunctivitis. Bilkhu notes that optometrists are ideally placed to manage such patients fully, and even help them maintain contact lens wear. He outlines that allergies are a common cause of red eyes, with patients typically presenting with symptoms of itchy and watery eyes. The paper states that a thorough case history is an important element in the differential diagnosis and management of these patients, whilst treatments should aim to prevent the allergic response by implementing avoidance measures based on the suspected allergen. The paper concludes by suggesting non-pharmacological treatments are helpful in relieving symptoms in acute episodes, but therapeutic interventions may be necessary for longer-term management.

The second paper, by Cardiff University academic Dr Katharine Evans, provides a detailed discourse of the legislation underpinning the use of cosmetics and the impact their use has on the physiology of a range of ocular structures. Evans notes that, whilst adverse ocular effects on comfort and the tear film have been observed in users of eye cosmetics, severe complications are rare and typically occur in isolation. The paper goes on to recommend that contact lens wearers should be reminded of the importance of washing their hands before lens handling to minimise contamination with cosmetic products. The paper suggests that use of cosmetics on the lid margin should be discouraged to minimise contamination and ideally waterproof mascara should be avoided, particularly in those wearing reusable contact lenses. Evans concludes by saying that patients should be instructed to apply make-up following lens insertion, but remove their lenses prior to removing their make-up, particularly if they use an oil-based make-up remover.

Genetic factors are involved in several of the most important diseases to affect the anterior segment of the eye, including several developmental disorders. Recent advances in genetic technology have had a considerable impact on the classification and diagnosis of anterior eye disease and will increasingly determine management and treatment. With this in mind, Professor Richard Armstrong, from Aston University, continues the anterior eye theme by providing optometrists with a review of genetic disorders of the anterior eye. The paper provides a current perspective of the topic and describes the genes associated with these disorders, how the presence of abnormal genes may cause disease and the advantages and disadvantages of genetic testing. Armstrong concludes by stating that detailed medical and family history and eye examination remain the most important first steps in the investigation of any genetic anterior eye disorder.

With at least one high-profile road traffic accident making the press in recent months, it seemed rather apposite to conclude the current issue of Optometry in Practice with an interesting paper by Amy Hughes, Joanne Wood, Fiona Fylan and David Elliott outlining the findings of a series of focus groups conducted with current drivers who admitted to driving without their spectacle correction. The authors provide optometrists with advice to help them counsel, challenge and influence patients positively to make safe decisions about wearing their spectacles to drive.


Professor Leon Davies PhD BSc(Hons) FCOptom Prof Cert Med Ret

Immediate Past President, Chair of the Board of Trustees, Council Member – West Midlands

Leon Davies is a registered optometrist and Professor of Optometry & Physiological Optics at Aston University. A Liveryman of the Worshipful Company of Spectacle Makers, Leon holds fellowships with the College of Optometrists, the American Academy of Optometry, and is a Senior Fellow of the Higher Education Academy. Leadership roles at Aston University include Director of Research (2010-17) and Head of the School of Optometry (2016-21). His clinical research is focused on presbyopia and the restoration of ocular accommodation to the ageing eye.

Related further reading

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The College of Optometrists is calling on the next Westminster government to establish optometrists as the first port of call for anyone with an eye care issue.