Editorial: That was the ‘year’ that was

11 December 2020
Volume 21, Issue 4

On behalf of the whole Optometry in Practice team, I would like to send you our best wishes and hopes for a happier and healthier 2021

What a year! Little did we know at the beginning of 2020 that, instead of celebrating the Year of Vision and Optometry in Practice’s 20th birthday, we would be battling with the consequences of a once-in-a-century pandemic.

I am conscious many readers will have experienced loss and hardship over the last eight months. With that in mind, and on behalf of the whole Optometry in Practice team, I would like to send you our best wishes and hopes for a happier and healthier 2021.

The whole profession has adapted swiftly to new ways of working, with the ubiquitous phrase ‘Covid-secure’ seemingly embedded in everything we do. I have been inspired by the skill and tenacity of practitioners, and the way colleagues have modified their practice to continue providing the best possible care for their patients. I congratulate you all on your hard work and resolve.

I have also been impressed by the way colleagues have taken advantage of these difficult and challenging circumstances to undertake further professional development and higher qualifications, which (with the addition of appropriate funding structures) will place optometry at the vanguard of eye care in the UK. Clearly, these advanced skills and qualifications can only be possible with considerable personal effort and a robust evidence base to underpin innovation. I am, therefore, delighted to share with you the peer-reviewed content of this month’s issue of Optometry in Practice.

The issue’s first paper by Rebecca Ford reviews the literature relating to thyroid eye disease (TED). This paper informs readers about TED, and in particular enables optometrists to recognise it, to advise patients and recommend supportive treatment, to make appropriate onward referrals and to identify some of the treatments patients may receive after specialist referral.

Our next paper, by Bertil Damato, senior clinical research fellow at the University of Oxford, and locum consultant ocular oncologist at Moorfields Eye Hospital, describes a new scoring system and protocol for managing patients with melanocytic choroidal tumours (MOLES).

Whilst recognising the impact of Covid-19 on patient care and the current and future roles of optometrists in the patient pathway, the paper considers whether the new MOLES algorithm could be used by optometrists to monitor low- and highrisk choroidal naevi in clinical practice. The author concludes by hoping optometrists and ophthalmologists will find the MOLES acronym, scoring system and referral form helpful in managing patients with melanocytic choroidal tumours, avoiding unnecessary referral of patients with naevi to hospital eye clinics while expediting specialist care for patients with melanoma.

Optometrists are well versed in the clinical manifestations of presbyopia and optical methods to alleviate its impact on near vision. However, despite over a century of research exploring factors that lead to decline in ocular accommodation, the exact aetiology of presbyopia remains elusive. It is perhaps for this reason that a successful method of either preventing or reversing the decline in accommodation with age is still out of reach. Hot on the heels of Acuity’s recent feature article on presbyopia, our third paper by University of Manchester academic Fiona Cruickshank (and yours truly) reviews the evidence underpinning our contemporary understanding of the mechanics of presbyopia by outlining the multifactorial nature of its progression with age.

Adults with learning disability are less likely to access regular eye examinations, despite being 10 times more likely to have serious sight problems compared to other adults. Commonly reported barriers to accessing eye care services include a lack of awareness of the importance of regular eye care, problems with communication, concerns regarding entering an unfamiliar environment and a lack of experience/ training for practitioners in examining people with learning disabilities. The final paper by Northern Ireland colleagues Shelley Black, Kathryn Saunders, Jenny Lindsay and Jonathan Jackson describes the common visual problems associated with learning disability in adult patients and provides evidence-based advice on how eye care professionals can reduce the barriers preventing equitable eye care.

However you occupy your time over the Christmas and new year period, I do hope you are able to reflect on and celebrate your achievements in 2020, spend time with your family (and hopefully friends), and look forward to a brighter 2021.


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.