Optometry student question??

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cmcerlean
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Optometry student question??

Postby cmcerlean » Thu 26 Feb 2009 8:34 pm

Good evening Ladies, Gents, Boys and Girls

I am a 4th Year Optometry student at Glasgow Caledonian University, who had the pleasure of meeting Andrew and Elizabeth (apologies if I got the names wrong) last night at the Scottish CL Society 'Dry Eye' meeting. They said you wouldn't mind if I poked my nose into the forum.

I am currently undertaking a module called 'Shared Care of Ocular Disease'. One aspect of this subject relates ocular diseases, how they are managed within the optometry practice and/or if they require referral to GP and Ophthalmologist.

I would be interested to find out if many/any of the forum members go to the optician on the high street for the management of KC or, if you attend the ophthalmologist/hospital, how long did the high street optom provide treatment?

I do realise that every case is different and the severity of the condition/confidence of the practicioner will have a massive effect on individual experiences, however any feedback would be greatly appreciated.

Thanks
Conor McErlean FBDO

private104

Re: Optometry student question??

Postby private104 » Thu 26 Feb 2009 8:58 pm

hello Connor.

I was told by my high street optician that I had keratoconus. I had gone for a routine eye test. The optician lady told me to go to my GP and ask for a referral to the ophthalmology clinic in Manchester. They confirmed that I had KC. In those days I could cope okay with glasses but then my sight got worse. I am now away from home and go to a local hospital where I attend both a contact lens clinic and the ophthalmologist. The opticians here have given me lenses for both eyes. At first I only needed one lens but now I have two. RGP in each eye. I also have dry eyes and use clinitas and an eye bag.

Is that the sort of information you wanted?

AJ

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Re: Optometry student question??

Postby GarethB » Thu 26 Feb 2009 8:59 pm

I have experiecn of care through both the highstreet and hospital.

When I was first diagnosed in the late eighties there was now contact lens clinic at my local hospital in Darlington. The optician who noticed the KC referred me to my GP who reffered me to the opthalmologist for diagnoses. I then went back to my highstreet optician for lens fitting and he was very good. There were alos regular reviews with the opthalmologist who perfomed the grfats when we were at the point my KC was changing quicker than lenses could be made plus the lenses would no longer physically stay in my eye.

Post grfat I dropped out of the system and just had care through the highstreet optometrist for glasses just like any one else needing glasses.

In 2004 it was a different highstreet optician who has since retired was very knowledgable regarding KC but by his own admission lacked experience in fitting lenses so he refferd me to my GP who did the referal to the hospital. After seeing the optomotrist I saw the opthalmologist who said KC had returned in the host tissue of my right grafted eye. Since then I have been reciving an extremely high standard of care through the hospital contact lens clinic.

Plus a high standard of care through a contact lens manufacturer through the developemnt of a lens for KC.

An recently as I needed some information on how a lens was performing I went to the highstreet optican who bought the practice my old optom retired from and they were extremely helpful and appear to be as knowledgable about KC and lens fitting as my hospital in Coventry.
Gareth

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Re: Optometry student question??

Postby cmcerlean » Thu 26 Feb 2009 9:07 pm

Thanks AJ and Gareth, this is exactly the kind of information I'm after.

AJ do you by any chance know the name of the RGP lenses you are wearing, ie, are they KC specific or modified 'regular' lenses?

Thanks again
Con

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Re: Optometry student question??

Postby rosemary johnson » Fri 27 Feb 2009 1:38 am

Hi Connor!
TO answer your questions - I've had experience of both hospitals/hospital CL clinics and of being "contracted out" to a Hig St CL centre for CL fitting - never been to opticians as walk in person paying them since I was a little kid in glasses pre-diagnosis.
Fuller description follows.
First, to pick up on something else (with apologies for a bit of digression - but have recently been so annoyed by this have included the point in a formal complaint letter - a very long other story......)
I like the name and idea of "shared care". WIsh it were more widely used.
Totally reject the idea or terminology of any medic (or anyone else for that matter) as "managing" my health. There's only one person who manages my health and that's me. The "pro's" give me their expert advice based on all that professional training and experience; it's me who decides what to do about it, cos, bottom line, it's my health, my body, my life....
But agree it should be a partnership - they have that store of theoretical learning and experience of what's worked (or not) elsewhere; I know myself and what tends to work or not with me and exactly what the problem seems to be.
Wish a few more, particularly th emedics, took this line!
Lots more long stories here.....!
I digress.
First diagnosed as needing glasses for shortsightedness at age (I think) 8 by the team who in those days came round primary schools. NOt a great surprise as lots of shortsighted and astigmatic glasses wearers in our family. Dreaded it though, felt like I@d failed to be "good" and would be punished by parents, never mind bullyingetc at school for being the kid in the NHS glasses (and would my dad ever agree we could afford anyting else? - noway Jose! Several years later, when I'd left glasses long behind and my sister had her chosen non-NHS frames, he was making out he'd no idea kids in NHS glasses got pbullied or picked on. My mum and I gave him very short sfrigt of the "Where have you been all these years?" stuff.
This was late 60s. GOt glasses first from school health clinic - right load of patronising gits!!!!! - and later when my mum managed to get out of their clutches by local optician she got her (also NHS_ glasses from. Still atronising and I still ahted the very idea.
This was in - well, Cheshire in those days, later Merseyside. The WIrral. "Over the water" from Liverpool.
In 3rd form of grammar school, went to have annual eye test and got prescribed new glasses. WHen they came, I couldn't see any better out of them than I culd the old ones. Got dragged back to opticians.
APparently - this bit I have gleaned from my mum in the last few months only! - youn gwoman in optician's saw something not quite normal (!) and told my parents (not me) to take me to the GP but refused to say why.
My parents, for reasons best known to themselves, immediately assumed she'd seen something cancerous at the back of m eye and their darling saughter (!) was about to die of retina cancer.
SO I got rapidly dragged off to GP's by BOTH parents at once. My mum reports taht encounter as being where (youngish junior partner) GP told them it wasn't cancer it was only somethign called KC which normally just means wearing cntact lenses and got them to calm down. I, who had no idea at all that the C-word had ever been dreamt of, remember it as being long and tedious and the cdoctor extremely patronising and not interested. Eventually he passed me one of those cards with examples of different sized types, and read somem of it. Then he took it off me, held it further away and told it properly and now how much can you read?
"Oh, nothing," I said. "It's all just a grey blur at that distance" - which was rather an exaggeration, but by that I was very bored and fed up and pee'd off being patronised.
At this his face changed and he decided he'd better refer me.... and then started a long and even more tedious round of being dragged off to this hospital and that hospital and the other hospital, then back to the first one again.... to be peered at down different machines all with painfully bright lights, patronised rotten by yet ore NHS staff, and made to spend hours and hours waiting around, all being made to sit in dark gloomy corridors where it was too dark to read any book or magazine comfortably, let alone succeed in trying to keep up with my schoolwork seeing how much I was missing.
The purpose or results of all this, let alone what they were looking for, no-one ever told me. Eventually they must ahve decided something or other, because I was then passed on to the contact lens man.
At this time, I was living just outside Liverpool - over te water on the Wirral, and the main hospital, nOw, I gather, largely shut down and everyone moved. The other ones I got sent to because they had special machines.
And the eye dept contracted out all their contact lens work to a "high street" (Well, town centre Square) optician/CL centre.
Pleasant place to go, friendly reception and other staff, light waiting room to sit and read, and generally pretty punctual. And SOOOO civilised - they called me "Miss Johnson" and my mother "Ann" - I was 14.
He took one look at me when I first arrived, said "We won't put a lens in and send you out to walk round the Square for 45 minutes to see if you can wear them. You're going to have to, so we'll assume you can."
And I got y first sight of a scleral lens.
I do not know WHY he put me straight into sclerals at age 14 - by then I'd given up wearing the glasses as they made no different to how well I (couldn't) see. At the time I thought all people with KC had to wear these jumba sized things as the little ones didn't work for us.
SO I got sorted out with lenses, and went back as and when required, including slotting in visits during vacations when I went away to college. Still had to go back to the hospital for an annual check-up, which I thought a complete waste of time as nothing ever resulted other than a long time sitting in dark gloomy corridors.
Also got ontot he "books" of the eye Hospital in Oxford, as got hydrops twice, once in each eye, jsut at the end of two vacations so got passed there via GP in Oxford (who I never otherwise saw) to look at the hydrops. Had no idea atthe time how CL work was handled by Radcliffe as was still goingback to Keith Nelson in the vac.
Then I left college, got a job in London and moved up to the smoke. Saw no-one about eyes or lenses for some time; eye healing from second hydrops, seemed to be doing it OK. Didn't bother till four years later, when lenses getting itchy and i thought they needed polishing again, Which RKN used to get done regularly. WIgned on with London GP, went to see him, got set up with prescription for what i'd mainly come about, got put onto asthma inhalers almost as an aside, and then asked if I could be referred on to the equivalent in London because I was having a few problems with the lenses....
He'd never seen a scleral lens before either and was stunned - took it to show his colleague.
Came back and said "WHy don't we jsut refer youto... >?" - a certian well known Eye Hospital which, in view of saga recounted on other threads will be nameless......
THought "OH no!" not more bloody hospitals. Want to see someone about lenses not more patronising git medics."
Then followed orund of long waits, appointkent cards arriving, hours sitting in waiting rooms, patronising medics and worse nurses.......
..... eventually got told to follow the rainbow along the wall and over the road to the Contact Lens centre (then in separate building).
Where met the legendary Ken for the first time.
Rest, as they say, is history.
Been seeing XXX regularly for, well, must be nearly 23 years now.
Hadn't seen a medic there for years - till one apptmt XX was otherwise occupied and one of his deputies called me in - and responded to my complaints about how light sensitive I was by arranging to refer me round to the mdeical side - who I eventually got to go and see, talked all about the light sensitivity and what a nuisance it was, plus about history of KC etc, to consultant's deputy. Big Bloke swans aong, has brief briefing from deputy in hushed tones I can't hear let alone be asked to chip in to, sits down at slit lamp, says "May I look?", peers at my eyes for about 30 seconds, sits back and says "Both your eyes are now at the state with a corneal graft would be indicated. We're happy to offer you one or both, if you wish. Let us know if you want to go ahead and which eye you want done first" - and I practically fall through the floor in shock!
The story of how that went disastrously wrong is elsewhere..... suffice it to say I'm now stuck back with seeing medics again (nt that one, though!), for how much longer, I don't know.
COmparison of expereinces: given the choice, and assuming either option would give the right skills and resources, Id go for a set up like the Wirral one of outsourcing over the hospital CL clinic any day and every time! - just so much more civilised and human.
Having said that, I generally find the CL people are far more human,a nd prepared to work with you as partners, thant he medics, and not only the eye ones!
If money, time and distance were no object, I - like I guess many of his patients - would have given teh hospital the heave-ho long since and be going privately in Hertford. One of these days, when my boat comes in.......!
He that's useful, and what you wanted and sorry for what's probably length though can't tell in this browser till I've saved and sent.
Rosemary

private104

Re: Optometry student question??

Postby private104 » Fri 27 Feb 2009 10:51 am

Sorry Con. I don't know the name of my right lens but it is slightly bigger and paler in color than my left lens. I think the left one is called 'Rose K' but I may be wrong about that. Maybe the right one is Rose K and the other one is an ordinary RGP. :/. Aaaarghhhhhhh. Getting into panic mode. Straightforward answer is I think one if them is Rose K but I know for sure that the bigger lens of paler hue goes into my right eye.

What's the weather like in the wintry north?

AJ

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Re: Optometry student question??

Postby Anne Klepacz » Fri 27 Feb 2009 11:01 am

Hi Conor and welcome!
At our 2007 conference we had talks on contact lens provision for KC from both the hospital clinic and community practitioner perspectives, which led to some interesting discussion. If you'd like a copy of the DVD of the event, do e-mail me your postal address and I'll send you one anne@keratoconus-group.org.uk
For the record, I started off in rgp lenses with a High St optom, without knowing I had KC (I thought I was just very shortsighted). It wasn't until my vision in contact lenses had deteriorated sharply that the optom suggested I get myself referred to a hospital (still no mention of KC). That led to a diagnosis and constant changes of prescriptions until I ended up corneal transplants within a few years. I've stayed in the hospital system for lenses, but now go to a High St optom for glasses as I can also get reasonable vision with those now.
Anne

cmcerlean
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Re: Optometry student question??

Postby cmcerlean » Fri 27 Feb 2009 1:22 pm

Thanks for the replies everyone,

The weather in Glasgow is nae too bad, bout 25 degrees warmer than it was a fortnight ago.

AJ one possiblilty is that your lens has a tint so you can tell right from left, just a thought. Just doing a little bit of research on KC it seems that there are few hard and fast rules, really, whatever is best suited to an individual person at that particular time.

Cheers

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Re: Optometry student question??

Postby Lizb » Fri 27 Feb 2009 2:48 pm

Hi

I was diagnosed with KC in my left eye by a high street (independant) optician who had previously worked at Birmingham Eye Hospital. She gave me a letter to take to me GP and get a referral to go to my hospital. Once i got my referral I was under my then local hospital for both continous check ups and also CL fitting - without much success. During this time I moved house (2004) so got a referral to a more local hospital. Once i received the referral to a more local hospital I was seen and told that they outsource KC CL fitting to a high street (independant) opticians. Until 6 months ago I was on annual check ups at the hospital and numerous attempts (and visits to opticians) at wearing CL. I have been fortunate that i have been able to manage with glasses as i only had KC in my left eye. In the last 9-12 months i have been trying to wear CL (Synergise KC in the left and Synergise A in the right). Just prior to Christmas i have had numerous problems with my eyes, been diagnosed with KC in the right eye, diagnosed with Dry eye in both and have had minimal wear time (3 hours at best) out of CL. I due back at the hospital in April for my next eye check up and am back and forth regularly to the opticians for CL fittings/checks.
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private104

Re: Optometry student question??

Postby private104 » Fri 27 Feb 2009 6:48 pm

Con. That's what they said. Seemingly people with keratoconus are notoriously disorganized. Having lenses of different sizes and colours is an important service for KC suffereds. Helps me anyway. Big pale lens = right eye. Small dark = left eye!

I really am sorry I can't remember which one is the Rose K, at least I think that was what the optometrist said. Oops! Sorry again. How did you come to meet Andrew and Elizabeth (?). Don't think I know Elizabeth.

AJ


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