What Optometry Would Look Like in the Very Near Future!

Dr Kerry Ho, Eyecare Plus Optometrist

The Southern Regional Conference (SRC) was hosted in Melbourne for two days, offering a broad spectrum of educational programs to Australian optometrists.

Along with four other colleagues, I travelled down from Sydney, where we were not only able to gain an insight to the current developments in this field but also what the future of optometry may look like in several decades to come!

In this two-day conference, a plethora of topics such as glaucoma, dry eyes and children’s vision were discussed.

Here are the take-home messages and interesting topics I found during this visit:

The Future of Optometry

We had the pleasure of listening to two esteemed optometrists who practice in the USA—Dr Ben Gaddie and Dr Jim Thimons. In their presentations, they discussed the myriad of conditions which they have treated and great amount of treatment options they have available for their patients. These doctors had access to oral medication, were able to order MRI scans and overall had a more integrate health network with other health practitioners.

One of the interesting things I noted is how well versed they were with medical knowledge outside the eye, such as how allergies can be associated with buck teeth and breathing difficulties.

Whilst I certainly feel that the practice of optometry in the States are many years ahead compared to Australia, both these doctors stress that one should not always rely solely on their equipment and should correctly manage expectations. They discussed managing expectations in the treatment of dry eyes—a condition which I feel many optometrists will detect but perhaps will not always decide to treat.

Just as eye conditions can be caused by many different factors, the treatment plan can be varied and should be catered towards each individual patient. The doctors informed that telling the patient this will require long-term treatment will help with compliance. Although their presentations represent a small part of their overall clinical experience, it has certainly given me an insight into the new possibilities in clinical practice.

The Pressures of Glaucoma Management

Glaucoma seems to increasingly play an important part in the practice of optometry. Being primary practitioners, it is often optometrists who diagnose this condition or refer it for further assessment.

Over the past several decades, developments in medication, surgical techniques and equipment have allowed practitioners improved methods of reducing intraocular pressure and, thereby, reducing progression of this condition. More importantly, there has been an increasing demand for practitioners to detect this condition earlier and earlier, and one of the hot topics of the conference was looking at the cornea and blood pressure in relation to glaucoma detection.

Vision with glaucoma.

Measuring the biomechanics of the cornea, specifically the thickness and hysteresis, has been shown to help predict whether a patient may develop glaucoma in the future. Cornea hysteresis, which measures the elasticity of the cornea, has been proposed to be a factor in glaucoma. Given the continuity of the cornea tissue with the lamina cribosa, it has been suggested that cornea hysteresis may reflect how the optic nerve responds to glaucomatous changes.

Evidence has indicated that patients with glaucoma overall tend to have a lower hysteresis (less elastic), and as patients get older, hysteresis was found to be lower. Thus, it has been suggested that the optic nerve head’s reduced elasticity and inability to respond to various mechanical effects may lead to glaucoma.

Fun and Interactive! The Virtual Reality of Amblyopia Management

One of the new forms of strabismus and amblyopia treatment was showcased at the conference, which involves the use of the Oculus Rift virtual reality headset.

The basic principles of this headset involve projecting differing images on each eye, which in turn induces an artificial stereopsis. One company has made several videogame software using this principle, with the aim to treat strabismus or amblyopia.

In one videogame, the patient was tasked to fly a spaceship through various coloured rings in space. The image of the ship was projected through one eye and the coloured rings through the other.

Various changes in the software’s parameters can be adjusted according to the level of amblyopia such as amount of disparity and amount of blur. These techniques aim to treat amblyopia by encouraging both eyes to work together to perform the assigned game objective.

Whilst these games are frankly quite rudimentary in my opinion, they certainly pave a new way for optometrists to treat these conditions in a more interactive and immersive manner. Considering the recent interest and boom in virtual and augmented reality, I may expect this to become more widespread and economic in the future.

Conclusion

Aside from these 3 points which I found to be the most interesting in the conference, the greatest aspect about this conference is that it presented a wide variety of topics which were quite relatable to general practice for most optometrists. Overall, the conference and the presenters were very enjoyable, and I look forward to taking part in the next one!

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