Change in Moorfields Policy on Contact Lens Solutions

[Sweet]

Well they could have a few optoms in the community then!!! We don't need to keep going back to Moorfields for them to sort out lenses for us. it would make waiting lists shorter for new patients coming in!!

Sweet X x X

[GarethB]

No need to get the hump with me missey

Such disruption will be delat with severly

Only joking

[Sweet]

LMAO!!!!

I was joking you hehehe

Gee you!! ROFL!!!

Sweet X x X

[John Smith]

Getting back on-topic...

Actually, I agree with Sweet here... I was originally sent to my local eye department, and after diagnosis at the hospital, I was sent to a local optician who specialised in "special" lenses.

And there I remained, getting very fast appointments when I needed them. Right up until I needed a scleral lens... at which point I was told that I needed to see Ken.

The trouble is, that everyone knows Ken, and there's only one of him.

Can we invent a clone-Ken machine?

[Sweet]

Yes the whole Ken thing is a problem and he needs to train more optoms. The thing is i was waiting months in Moorfields to see any optom when really i could have been seen somewhere else but it would have had to be privately if i did it.

Sweet X x X

[GarethB]

John,

Now you are moving off topic

Cloning Ken is easy, just find the discussion on the Star Trek transportation system for beaming about the place in the chit chat area

[Ali Akay]

There's a lot of merit in what you're saying Sweet,but having an efficient specialist contact lens fitting service in primary care ie high street optoms with accreditation has one big drawback: increased cost! It's a sad fact but this is the reality, the number of appointments available in a hospital clinic limits the cost, if clinic sessions are doubled, the waiting list would halve, but the cost would double as well! In some areas where the local hospital does not have an in-house contact lens clinic they sub-contract to a high street optom they know and trust as you had in Wales, and that can work very well.If you have a problem your friendly high street optom would often be able to see you at short notice which is not easy for an optom doing one session a week at a hospital. If all fittings were sub-contracted to community optoms it would have cost implications to PCTs as, apart from anything else, waiting list would be a lot shorter and hence more fittings carried out in a financial year! As you know KC fittings can be quite time consuming, hence a high street optom would only be interested in the work if he received sufficient remuneration for it to cover his chair time and overheads.

The best way forward probably is to somehow incease the profile of KC. As you know as a nurse most things in NHS are unfortunately target-driven and if there were targets for fitting keratoconics with lenses, PCTs would soon find a way to shorten the waiting lists!

[Sweet]

Thanks Ali for a nice informed reply!

Yes i can see how this is all money led. If it all changed and we go to a high street optometrist it would be better for us hehe maybe i should ask my optometrist back home what he gets in being sub contracted with the hospital! I'm not actually joking here!! If he finds it a good deal i'm sure more optometrists would as well!

Every surgeon and opthalmologist has an optometrist they know and trust. My private surgeon very happily gave me details of someone for lenses post graft. This would work the same way with hospitals giving work to high street optometrists and while creating more work in reduced waiting times and there being more patients, it would even out with optometrists competing with prices in getting patients! Sorry to you guys i think here ...

I think the whole thing on targets is very very complex but a good way to go! If there are targets which have to be met suddenly a lot of stops get pulled and it happens!

Like in 'A and E' where i work. Since we have had the four hour rule where patients have to be seen and treated or discharged in this time suddenly the times of patients waiting on hospital trolleys all night lowers considerably. It is only when there are matters out of human control where it falls apart.

Am thinking on this but any ideas to make KC targets would be brilliant!! As there are more people getting diagnosed with KC and this group is getting more notice surely something could come of this. We need to be more pro-active and inform important people who could change things for us. Maybe some figures on increasing numbers of patients with KC and those needing lenses etc would help councillors take notice.

Thinking ... Sweet X x X

[Ali Akay]

Hi Sweet
If you talk to your optom in Wales, I feel he'd probably tell you he does the work because it's interesting, and makes a nice change from routine sight tests and fitting disposable contacts, but he probably couldnt afford to do it on full-time basis! I think it's also fair to point out that there are some benefits in having a hospital-based system as well in the sense that it's easier for the consultant and the contact lens fitter to discuss patient management strategies, and manage problems. But, nevertheless, most patients would probably prefer to see a high street optom if the service was equally good

[Mike Oliver]

Seems to me that however treatment or management of KC is dealt with, we will never be cost effective. That means we will be towards the back of most queues when it comes to funding. I accept the arguments over what the various tiers of the NHS will see as economic, but I also accept Ali's comment that raising KC's and our profile is the way forward.

We don't want clones of Ken - he is of course unique! What I think (for what it is worth) is we should get behind the sort of training that he provides whenever he can, try to help fund and promote this and other ways of raising awareness of the condition itself and management/treatment options.

Since I was diagnosed in the early 60s those options, in terms of lens and surgery have advanced immeasurably. I don't see any real indication of those options being available outside a few centres of excellence and one or two enlightened practitioners. That has got to be unacceptable.

I think I have become a grumpy old man, but have changed my view of the way to deal with this. Keratoconics have often been described as "vocal" for a fairly small group. I think there is a range of issues which require us in as effective a way as possible to scream, shout and generally stamp our collective feet to draw maximum attention, Slowly Slowly which I have advocated before just is not, in my humble opinion doing the job.
Mike Oliver