Editorial: All change

12 June 2020
Volume 21, Issue 2

One thing is certain: I wasn’t expecting the events of the last 10 weeks to take place when I wrote my last Optometry in Practice editorial in February this year.

Firstly, I do hope that our readers and their families are safe and well, and are managing their way through the myriad of challenges we all face both personally and professionally. 

Whilst the future remains opaque, the easing of the UK Government’s lockdown measures reveals green shoots for our profession. Since lockdown began in our four nations, many colleagues have had to close their practice doors to patients, whilst others have been able to undertake essential, urgent and emergency clinics with a skeleton staff in either primary or secondary care settings. Given the nature of our profession, it will take time to return to any sense of ‘normal’, but as we transition from the red to amber phase of the pandemic, we must innovate and seize all opportunities to advance our profession to provide the best possible care for our patients. I encourage readers to access the College of Optometrists’ Covid-19 guidance. Updated regularly, the College provides current guidance for practitioners in each nation on how to adapt working practices as we move into the next phase of the pandemic.

Despite this recent turbulence, and through the tenacity and hard work of our authors and editorial team (huge personal thanks from me), I am pleased to say that this month’s issue of Optometry in Practice brings you four more evidence-based articles on a diverse range of topics.

We begin with a timely review article by Claire Mc Donnell and colleagues from BUCCLE (British and Irish University and College Contact Lens Educators) on the use of lissamine green in clinical practice. Following the General Optical Council’s recent statement clarifying the legal position for eye care practitioners wishing to use lissamine green dye for anterior-eye examination, the article outlines the advantages of using lissamine green in conjunction with sodium fluorescein as part of an anterior-eye examination. The authors conclude the evidence indicates that lissamine green plays a valuable role in aiding the evaluation and understanding of ocular surface damage and, as such, it should be viewed as in the patient’s best interest to utilise such techniques.  

Our next review article by Neema Ghorbani Mojarrad and Louise Terry tackles the age-old question of whether myopia is a genetic or environmentally induced problem. Their paper outlines the evidence used to demonstrate the complex aetiology of myopia development, and discusses how the supposed opposing influences of genetic factors and environmental influences can be used together in a complementary manner to further our understanding of the refractive state. The authors hope that their review will help clinicians further understand the modifiable and unmodifiable risk factors for myopia, to better advise their patients in clinical practice.

Our penultimate paper in this month’s issue considers how the ocular surface microbiome may influence clinical optometric practice. Arthur Okonkwo and Hema Radhakrishnan of Manchester Royal Eye Hospital and the University of Manchester, respectively, remind readers that exposed surfaces of the human body are covered in bacteria that play a vital role in preventing infection, and that an infection can occur when the quantities and variety of these bacteria are altered. Consequently, the authors conclude that understanding the homeostatic balance of these single-celled organisms is of relevance to optometry and, in particular, patient management in contact lens practice.

Returning to the need for optometry to innovate and advance following the Covid pandemic, our final paper by Nita Odedra and colleagues at the University Hospitals of Leicester NHS Trust outlines a case study of the evolving role of optometrists in emergency eye care. The authors present data comparing a cohort of patients attending eye casualty over a 1-week period to an audit carried out in 2010. The main categories audited included the source and mode of referrals, diagnosis, appropriateness of the referral, evidence-based management and attending professionals. In conclusion, the authors suggest that the introduction of multidisciplinary teams, including optometrists, helps to reduce demand within emergency eye care, and is also a platform for the training and development of community optometrists, facilitating communication and practice between primary and secondary care settings.


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.

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