What are the important diagnostic technologies for glaucoma care in the optometric office?
The most important diagnostic tools are the tonometer, slit lamp, goniolens, fundus lens, retinal camera, perimeter, and OCT. Each of these tools has its own level of importance. One must examine the optic nerve and retina as part of the comprehensive eye examination to be suspicious that glaucoma may be present. If there is a question as to whether or not glaucoma is present, other tools are needed, such as the perimeter or OCT. Retinal photographs provide a great deal of information, and their role in diagnosing glaucoma and other ocular diseases cannot be underestimated. Photographs are not going to become obsolete with changes in equipment or software that has occurred with OCT.
What do you think are the biggest challenges facing optometry in the future?
One challenge is how we educate our new graduates so that they can become important members of the eye care community. The new graduates will create the template for how optometry integrates into the evolving health care model. With the changes going on, recent graduates are optometry’s future.
You Are a founding member and former president of the Optometric Glaucoma Society; tell us about the goals and accomplishments of the society.
I believe the main accomplishment of the Optometric Glaucoma Society is that it has served—and continues to serve—as a role model for other optometric societies, demonstrating how a clinically oriented society can be scientifically oriented at the same time. Although the American Academy of Optometry is optometry’s academic institution, it is a large group that meets and covers a wide range of subjects. The Optometric Glaucoma Society concentrates on one clinical topic and brings to an optometric audience the world’s thought leaders. We have always felt that educating the educators is an efficient means of bringing learning to a small group who will then go on to educate a larger group.
In your experience, what are three important things a medically minded OD can do to maintain loyal patients?
Be empathetic, be honest with the patient about his or her condition, and recognize one’s limitations.
How do you optimize the OD-MD relationship when caring for patients?
Work with an individual whom you respect and who respects you, and be open to receiving advice. Communicate everything you can about the patient. If there are areas where you would do something differently, don’t be afraid to discuss them with the comanaging physician.
How has primary care of patients with glaucoma changed over the years? Where do you see it going?
Optometrists are becoming more sophisticated in their knowledge of glaucoma and their ability to treat it. This broadening knowledge allows them to continue monitoring patients further into their course of therapy. It wasn’t all that long ago that optometrists were only comfortable treating ocular hypertension and mild glaucoma. Now, many are comfortable managing patients with glaucoma who require several medications and/or laser, and some optometrists are managing patients whose condition is worsening. Optometrists are going to continue to become more skilled over time, which will afford them growing responsibility in managing patients with glaucoma.
What is a good first step for ODs considering adopting the medical model? Where should they start?
Find a mentor, either an OD or an MD, whom you can present cases to and seek advice from. Start slow. Your first patient should be someone with ocular hypertension or early glaucoma so that you can see how the process of managing patients works. You can slowly take on more challenging cases as you become comfortable with the process.
Ready to Claim Your Credits?
You have attempts to pass this post-test. Take your time and review carefully before submitting.
Good luck!
