The Blog

Changing to Avastin could save NHS £100m a year

The drug Avastin has been in the newscalling for its use in the UK in a bid to save millions each year.

eye-care

Popular in the US, Avastin is used for patients with age-related macular degeneration (AMD). It has been on the market for years, gone through all the testing and has been proven to be as effective as Lucentis, the NHS approved drug for the same condition. The difference is cost. Lucentis typically costs around £700 per treatment, compared to Avastin which is about £70. Yet red tape seems to be halting its use.

It is currently unlicensed in the UK so should anything go wrong with its use, the practitioner may not be legally covered. However, in times of austerity and it is perhaps time for the NHS to move forward and license its use.

Could watching TV provide an accurate glaucoma diagnosis?

Sounds fanciful but recent research has found that watching how the eyes move when someone is watching TV could give an accurate indication of glaucoma and other neurodegenerative conditions.

An article published earlier this month in Frontiers in Aging Neuroscience, highlights the findings of research by Moorfields Eye Hospital in London. The studymonitored patterns of movement while a person watched TV and resulted in about three-quarters of people with glaucoma receiving an accurate diagnosis.The researchers used their technology to observethe eye movementsof the test group and this information was then processed in to maps that contained a signature of vision loss. Through data gathered from the study, researchers were able to distinguish between those with age-related neurodegenerative eye disease, such as glaucoma and those without.
Contrary to reports in some national newspapers, watching TV will not prevent these conditions developing, however this study could lead to new, non-invasive screening procedures for glaucoma and other age-related eye conditions. If you read the headline “Fancy an episode of Dad’s Army? How watching TV and films can save your eyesight,” I hope you did so with a large pinch of salt! That said, it is an interesting development relating to diagnosis, although a larger sample (the sample was of 76 older people) would be required for real conclusions to be drawn.

Donald Cameron receives Lifetime Achievement Award

Cameron Optometry is delighted to announce that former managing director, Donald Cameron, has been awarded the 2014 Lifetime Achievement Award at the Association of Optometrists (AOP) Awards ceremony, which took place last night. Donald is only the third person to receive the award and the first Scot.

The AOP Awards’ Lifetime Achievement accolade was established in 2012 with the aim of recognising ‘a person who has dedicated their career to promoting and expanding the role of optics, or who has brought the benefits of optics to a wider audience’. The impact that Donald has made on the optometry profession in Scotland is remarkable.

Henrietta Alderman, AOP chief executive, said: “The AOP Awards gives us the opportunity to celebrate the extraordinary achievements of the individuals and organisations who give so much to the public and the profession. I would like to extend my congratulations to Donald in recognition of his drive and passion which has helped to transform the face of optometry in Scotland.”

With a career in optometry spanning over 35 years, Donald was a founding member of Optometry Scotland that aims to develop and represent the views of the optometry sector to the Scottish Government. The organisation has successfully lobbied the Government on a number of key issues resulting in a world-leading contract for eye examinations in 2006. Following on from that, the Scottish Government agreed to allocate £1m per annum to fund the development of an optometry education programme through NHS Education for Scotland, to which Donald was appointed programme director. He was also a founding director of Optometric Educators, an organisation that focused on high quality education in the profession and held the position of chairman of the AOP from 1999-2000.

On achieving this Lifetime Achievement Award Donald said, “It is a great honour to receive this award. I see it as recognition of not only the work I have done, but also the work of my colleagues and fellow professionals in Scotland, in particular Frank Munro and Hal Rollason, who have helped us move the industry on in the last 35 years.

“I have always felt strongly about the importance of education as the route to professional advancement and hope that the NHS Education for Scotland programme continues to thrive ensuring we carry on developing our expertise in optometry across Scotland. I believe this approach has helped change the way optometry professionals practise in Scotland to the benefit of the members of the public and their eye care.”

During his early years in the industry Donald developed a keen interest in contact lenses which went on to be his area of specialism. He worked closely with the Princess Alexandra Eye Pavilion in Edinburgh, taking referrals from them for patients requiring specialist contact lenses. Cameron Optometry, formerly McGrath and Cameron, is currently the largest independent optometry and contact lens practice in Scotland and is now run by Donald’s son Ian Cameron who is also revered in the industry. Last year Cameron Optometry was awarded the title of UK Practice of the Year at the same awards.

Ian Cameron added, “On a personal level, my dad has always been an inspiration and someone I have greatly admired. I’m delighted that through this award his impressive career has been acknowledged. I have learnt a huge amount from him and through the establishment of the NHS Education for Scotland programme, many others will also benefit from his work in education for years to come.”

Feast your eyes cookbook

As part of National Eye Health Week, which took place last month, the organisers created a cookbook containing a collection of recipes packed full of essential nutrients for good eye health. We have a pile of them in reception and it has been so popular I thought I’d share it. The super sight saver smoothie is a personal favourite and I’m looking forward to knocking up the sea trout with a crab cigar this weekend!

It is encouraging to see patients taking note of the fact that a good diet really can benefit not only your waistline, but your eyes too.

The recipes feature ingredients proven to help maintain good eye health including some of the following:

Dark green, leafy vegetables – Eating spinach and kale for example, could help avoid macular degeneration. They contain lutein and zeaxanthin; two important nutrients that have antioxidant functions in the body and help prevent cell damage. Lutein helps protect the retina, much like sunglasses.
Bright orange fruit and vegetables – The likes of sweet potatoes have a rich source of beta-carotene, a natural precursor to vitamin A, the vitamin most commonly associated with healthy eyes. And fruits like oranges and papaya are a great source of vitamin C which evidence has suggested may slow the affects of macular degeneration and the formation of cataracts.
Beans and eggs – Adding zinc to your diet by eating zinc-rich foods such as beans, lentils, eggs and turkey will help the liver release vitamin A.
Oily fish -Fish such as salmon and tuna are rich in source of omega-3, which studies have found may also help protect eyes from age-related macular degeneration and dry eyes.
Wheat germ, soy and sunflower seeds – Great sources of vitamin E, which can help protect the eyes from free radical, damage.

Please feel free to pop in to the practice to pick up a free hard copy of the cookbook before they are all gone.
As part of National Eye Health Week, a fellow independent optometrist who was a former Masterchef finalist, also created a range of recipes, from smoothies to fish dishes. Worth a watch if you’re looking for inspiration and a step-by-step guide.

World Sight Day calls for no more avoidable blindness

Thursday will mark World Sight Day, a global initiative co-ordinated by Vision 2020. This year the campaign will focus on avoidable blindness and the organisers have highlighted worrying statistics with approximately 285 million people worldwide living with low vision, 39 million of those are blind. Yet 80% of visual impairment is avoidable, meaning it is treatable or preventable.

World Sight Day 2014

Cataracts and trachoma are the two main causes of avoidable blindness in the world. Thankfully in the UK trachoma is very rare and a course of antibiotics usually deals with it, however this bacterial infection remains the leading cause of infectious blindness worldwide.

Cataracts, however, are a very real problem in the UK. A condition that usually develops in older age, cataracts affect millions of people in the UK. Blurred or clouded vision is the most common symptom of cataracts, however an optometrist has the technology available to identify the very early stages of the condition even before the early signs noticed by the individual. This is one of the reasons we are so keen that people make a point of having a regular eye test. Even if you think your eyes are fine and your vision hasn’t changed, we encourage all our patients to make sure they see us at least every two years, ideally every year for those over 65.

The treatment of cataracts is usually a very straightforward operation however if they are left untreated they can result in permanent loss of vision.

We are very fortunate that we live in a country with very advanced eye care. So many in poorer countries do not have the expertise, diagnosis and treatment available. In the UK it is available so we need to make sure awareness improves so preventable blindness is prevented.

Police Scotland relax ban on officers with colour deficiency

Ian Cameron was asked on to BBC Radio Scotland to discuss Police Scotland’s decision to reverse its ban on recruiting officers with colour deficiency. The change in policy was a result of a legal bid by one potential recruit. You can listen to the piece here.

Ian discussed the eye examination that anyone entering the police force can expect to go through, including a test of visual acuity: how far you can read down standard chart, a visual field: testing peripheral vision, as well as a colour vision test. Ian highlighted that colour deficiency was a very hard condition to quantify as the test is not very accurate and there are such varying degrees of the condition.

Putting it in the context of the police force, Ian discussed how officers with colour deficiency, may find it harder to pick out an individual in a crowd based on the colour of clothes he was wearing. Their judgment may also be put under more scrutiny, say under cross-examination.

It is certainly an area that would benefit from more research that could result in better testing to identify a scale for the condition rather than relying on a degree of subjectivity.

GPs lack confidence when dealing with major eye conditions

UK Vision Strategy in collaboration with the Royal College of General Practitioners has announced that it is working to improve GP knowledge of eye care after a survey found that GPs have low confidence in diagnosing major eye conditions. Our view is if you experience problems with your eyes, visit your optometrist.

The survey found that just one third of the GPs questioned were confident in diagnosing symptoms or signs of age-related macular degeneration and only half were confident in diagnosing diabetic retinopathy.

Worryingly only a quarter of respondents had been offered training on how to support patients who were blind and partially sighted. And although it is encouraging that the vast majority wished to enhance their knowledge through training, the experts on eyes will always be optometrists. GPs shouldn’t be expected to have the level of expertise in eye care that you will receive from your optometrist. They also don’t have the technology on hand to give your eyes a thorough examination to accurately diagnose an eye condition.

If you have toothache, you visit your dentist. If you have issues with your eyes, you should visit your optometrist.

Caring for your lenses

World renowned Moorfields Eye Hospital has recently launched a campaign to encourage contact lens wearers to ensure they take care of their eyes. The hospital has seen a marked increase in cases of eye infections relating to contact lens wear. Most worryingly an increase in an infection called acanthamoeba keratitis which can be extremely difficult to treat and in the most serious cases, can see the patient require a corneal transplant.

Tiny parasites called acanthamoeba can live in water so should your lenses come in contact with water the parasites can take up residence in your eye. If they aren’t killed through thorough cleaning, this serious infection can develop. This is a serious yet thankfully uncommon infection, however with cases of it on the increase, now is a good time to remind yourself of some basic guidance which applies to all lenses.

• Always wash and dry your hands thoroughly before handling your lenses.
• After removing your lenses, clean them immediately. Don’t store them without cleaning them first. Cleaning will remove mucus, protein, make up and debris that naturally build up on the surface during the day.
• Never use tap water (or saliva!) to rinse your lenses or case. Microorganisms can build up in water, even distilled water, and can cause infections or even sight damage.
• Ensure your lens case is kept clean. Replace your case every time you open a new bottle of solution.
• Use clean solution every time. Don’t reuse or top up.
• Do not sleep in your lenses unless advised by your optometrist.
• Ideally lenses shouldn’t be worn when swimming but if you do wear them make sure you wear goggles to reduce the chance of contact with pool water.
• Follow the cleaning guidelines you were given, using the recommended products. Doing this will reduce the chance of picking up a nasty eye infection.
• Insert your lenses before applying make up.
• Have an up to date pair of spectacles on hand should you pick up an infection. Many treatments require you to stop wearing your lenses for the duration of the treatment so don’t be caught without a backup.
• Don’t use any eye drops without advice from your optometrist.

Remember these three simple questions:

• Do my eyes feel good with my lenses? You have no discomfort.
• 
Do my eyes look good? You have no redness.
• 
Do I see well? You have no unusual blurring with either eye.

If the answer to any of these questions is no, take out your lenses and consult us straight away.

Here’s a helpful video produced by Moorfields to guide you through the process for soft contact lenses and one for gas permeable lenses

Lenses for occasional wear

We’re supplying a patient with free lenses ahead of their participation in the Spartan Race in Edinburgh later this month. She’s running, as well as tackling various obstacles and mud, in aid of Downs Syndrome Scotland so we’re delighted to help out. She’s a glasses wearer but obviously glasses and muddy, wet obstacle courses don’t go too well together. The point of this blog is to highlight that lenses don’t have to be a fulltime commitment. You can dip in and out as you please.

The great thing about most lenses on the market is they don’t actually take much getting used to, especially daily disposables which are what we usually recommend for occasional use. Sometimes there is a bit of trial and error before we find you the perfect pair, but because we know our patients’ eyes so well we almost always find them the right pair first time.

Participating in a sporting event is an obvious time where glasses wearers can struggle. Whether on the ski slopes, to partake in some holiday snorkeling or when running a marathon, glasses are just not the practical option. Or maybe it’s a vanity thing – nothing wrong with that! You perhaps don’t want to wear glasses to attend a stylish black tie do. Occasional contact lens wearing is perfectly possible. Once you’ve tried them, you won’t look back.

Cameron Optometry on BBC Scotland following research on vision and driving

In light of research by charity Brake encouraging drivers to get their eyesight examined regularly, I was asked on to BBC Radio Scotland’s John Beattie Show to discuss the lifecycle of the eyes. Listen here:

The research found that almost nine in 10 (87%) are in favour of drivers having to prove they have had a recent sight test every 10 years, when they renew their licence or photo card. The survey also shows that a quarter of drivers admitted they have not had their eyes tested in more than two years.  A worrying one in eight drivers (12%) who know they need glasses or lenses to drive have driven without them in the past year.

I discussed the four stages that most people experience in their vision lifecycle. The developmental phase from birth until late teens, where a prescription is developing, followed by the stable phase from early twenties until late forties. People then enter the period in their early sixties where their vision may experience some decline as the eyes lose the ability to focus making near tasks, like reading, difficult. This is then followed by a phase of continual decline where people may experience conditions such as cataracts, macular degeneration and glaucoma.

I finished off by highlighting that regular eye tests can also help avoid tricky discussions with loved ones! Rather than having to point out to a family member that perhaps they need to get their eyes tested as they strain to see the newspaper or don’t see a cyclist in the corner of their eye, an eye examination at least every two years, will pick up any signs of declining vision.

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