Community OptometryCommunity Optometry

Working Together with General Working Together with General Practice!Practice!

EYE UNITSEYE UNITS

OPTOMETRY PRACTICESOPTOMETRY PRACTICES

PRIMARY PRIMARY EXAMINATIONEXAMINATION

CoreCore ElementsElements

AdditionalAdditionalElementsElements

SupplementarySupplementaryProceduresProcedures

THE NEW GOS EYE EXAMINATIONTHE NEW GOS EYE EXAMINATION

FOR FOR ALLALL

? SIGNS ? SIGNS & &

SYMPSYMP

Ongoing care Ongoing care in the in the

communitycommunityDirect referral to Direct referral to

acute sectoracute sector

Competency AccreditationCompetency Accreditation

Essential Equipment Essential Equipment

HistoryHistory Refraction Refraction

Internal ExamInternal Exam

EYE EXAMINATIONEYE EXAMINATION

PerimetryPerimetry

Digital ImagingDigital Imaging

AdviceAdvice

External ExamExternal Exam

OptometryOptometryNetworksNetworks

Acute PresentationsAcute Presentations

Red EyeRed EyeVisual LossVisual Loss

Inappropriate Inappropriate ReferralsReferrals

GIES 77%GIES 77%Grampian 70%Grampian 70%LENS 50% ?LENS 50% ?

Top 10 – Eye Casualty!Top 10 – Eye Casualty!

1.1. Seasonal allergic conjunctivitisSeasonal allergic conjunctivitis2.2. Anterior UveitisAnterior Uveitis3.3. Infective ConjunctivitisInfective Conjunctivitis4.4. Corneal AbrasionCorneal Abrasion5.5. Dry EyeDry Eye6.6. EpiscleritisEpiscleritis7.7. Corneal FBCorneal FB8.8. HSKHSK9.9. Marginal KeratitisMarginal Keratitis10.10.PVDPVD11.11.TrichiasisTrichiasis

Referral Guidance - EmergenciesReferral Guidance - EmergenciesSAME DAY

Penetrating InjuryPenetrating Injury

Sudden loss of visionSudden loss of vision

Chemical injuryChemical injury

Preseptal/orbital cellulitisPreseptal/orbital cellulitis

Post-operative complications eg endophthalmitisPost-operative complications eg endophthalmitis

Suspected temporal arteritisSuspected temporal arteritis

Intraocualr foreign bodyIntraocualr foreign body

3rd cranial nerve palsy3rd cranial nerve palsy

ANTERIOR SEGMENT ANTERIOR SEGMENT

Microbial keratitis Microbial keratitis

Herpetic keratitis Herpetic keratitis

Herpes Zoster with suspected ocular involvementHerpes Zoster with suspected ocular involvement

Acute Angle closure glaucomaAcute Angle closure glaucoma

UveitisUveitis

Corneal abrasionCorneal abrasion

Corneal foreign bodyCorneal foreign body

HyphaemaHyphaema

HypopyonHypopyon

POSTERIOR SEGMENTPOSTERIOR SEGMENT

Retinal detachment/holeRetinal detachment/hole

Vitreous haemorrhageVitreous haemorrhage

UveitisUveitis

URGENT (Within 24-48hrs) 

Scleritis

Newly diagnosed Wet AMD (if rapid access clinic not available)

Amaurosis fugaxPapilloedema

Acute onset diplopia RubeosisProptosis

Horner's syndromeAcute flashing lights/floaters

Blunt ocular trauma (if no penetrating injury)

The Future?The Future?

IT Integration ? 2013/14IT Integration ? 2013/14

Optometry Linked to NHS NetOptometry Linked to NHS Net

ReferralsReferrals

Inter communication between optometry, GPs and the Inter communication between optometry, GPs and the HESHES

Optometric Prescribing – PGDs / IPOptometric Prescribing – PGDs / IP

Work together – We all win!Work together – We all win!