Overview

Eye care in the 21st century is a team affair. The interdependence of optometrist and ophthalmologist in the UK sets an example to the rest of the world where competition rather than co-operation is the norm. The ametropic patient now has options. Do they wear spectacles, which are usual during childhood and adolescence, or do they graduate to contact lens wear? Once mature, however, a permanent correction for ametropia becomes a reality in our new world of refractive surgery, which is the fastest growing subspeciality in the field of ophthalmic surgery. It takes many forms which include corneal laser surgery, providing the bulk of the possible treatments, and also utilises lenticular options through phakic lens implantations and refractive lens exchange. The indications for each potential application include the degree and type of refractive error, the age of the patient (presbyopia is a major issue), the physical dimensions of the eye and within the eye as well as the visual needs and expectations of the patient. I emphasise the distinction between eye and patient. It is so easy to concentrate efforts on an eye and its refraction before and after treatment, but it is the outcome for the patient which is all important. Ocular dominance, mild amblyopia, binocular function, near, intermediate and distance vision are all contributors to the decision making equation facing the refractive surgeon. The risks and benefits of interventions, sensible patient expectations and ability to cope with setbacks, however infrequently they may occur in the surgical population as a whole, are issues and potential burdens that the eye care team have to acknowledge. Geography plays a role also and makes shared care so important, which returns to the theme of a team concept for patient service and management. The optometrist's role is to recognise the indications for surgery as well as its happy outcomes and occasional complications. Patients' needs include the imparting of sensible and considered advice based on continuing education and awareness of what is possible whilst leaving the surgeon to finally advise the patient on what is appropriate for them as well as a consideration of risks and benefits. Too often in the past patients have received inadequate or inappropriate counselling to their detriment and, in the end, that of the advising optometrist. That is why this volume when carefully read and absorbed should help to avoid the pitfalls in the management of patient counselling both pre-operation and postoperation. It should help to avoid alarmist comments for patients tend to dwell on professional advice as though it is the last word which of course it is until they receive the specialist's opinion. The point is that once ideas enter the heads of some patients they are hard to be dissuaded of the notion even though it may be incorrect. Continuing professional development, progressive education, advancement of knowledge, appraisal, revalidation, litigation, malpractice; just some words that describe the burden of modern professional life. Thus any written contribution that eases those burdens is most welcome. I am sure this volume will be appreciated by the optometric profession and am honoured to be invited to introduce it. Emanuel Rosen Bsc MD FRCSE FRCOphth FRPS MAE Visiting Professor, Department of Optometry and Vision Sciences at the University of Manchester Institute of Science and Technology. Director Rosen Eye Clinic, Co-editor Journal of Cataract & Refractive Surgery. Optometry is now a diverse profession and many optometrists are becoming involved with shared care schemes in both the private and public sector. Although there are certified training courses for some glaucoma and diabetic schemes within the NHS, it is up to individual laser refractive surgery providers to ensure that appointed optometrists are adequately trained to co-manage their patients. The aim of this book is to complement any existing training by providing a comprehensive guide and on-going reference source for optometrists who are working within the field of laser refractive surgery. It will also provide some insight for optometrists not involved in any co-management schemes, but who want to learn more about laser in situ keratomileusis (LASIK). The optometrist's role throughout the patient journey is described in detail with chapters dedicated to the interpretation of clinical data, patient management and postoperative care. A typical treatment procedure is also included for those who want to provide more information about the procedure to patients who are interested in having LASIK. Refractive surgery is a continuously evolving field with new techniques emerging that may eventually supercede existing ones. The final chapter discusses whether the surface ablation technique laser epithelial keratomileusis (LASEK) will become the treatment of choice in the future. Used in routine practice, this handbook will enable optometrists to discuss laser refractive surgery so that the patient can be better informed about all possible options for vision correction. In co-management, the handbook will serve as a reference tool to ensure that patients continue to receive appropriate postoperative care from the co-managing optometrist.

Full Product Details

9780750688093

Table of Contents

Reviews

Author Information

Tab Content 6

Customer Reviews

Recent Reviews

Countries Available