Anterior eye disorders are the most common conditions encountered by optometrists. Technological innovations have allowed practitioners a wide variety of diagnostic and treatment options using highly sophisticated instruments. Since 1962, the Cornea and Contact Lens Society of Australia has been dedicated to promoting education, research and professional development among optometrists.
BScApp(Optom) GradCertOcTher BScApp(HMS) P/G BScHons FBCLA
Topcon CV-5000S Automated Vision Tester for contact lens fitting and refraction
I cannot live without my Topcon CV-5000S Automated Vision Tester, which provides 21-point refraction and features a one-dial controller.
The Topcon is linked to my Topcon TRK-1P autorefractor and it makes life so much easier because it acquires all the information from the refractor head. It makes refraction quicker. The CV-5000S is valuable for all patients but especially for refraction over scleral lenses, as you can do the refraction in 30 to 40 seconds before the ocular surface breaks up.
The CV-5000S provides a cylinder orientation to a single degree and is more accurate than manual refraction, which means better vision. It frees my time to deal with the complex side of contact lens fitting and ocular surface disease patient management.
If you can afford it, buy the full package including the TRK-1P, which has an auto-alignment system, autorefractometer, keratometer, non-contact tonometer and pachymeter.
Medmont E300 corneal topographer in the treatment of keratoconus, contact lens fitting and dry eye
I am the principal optometrist and co-owner of Custom Eyecare, Newcastle, and I have been treating anterior eye conditions for five years.
We see a lot of keratoconic patients and I can’t look after those patients properly without a corneal topographer. We use the Medmont E300 corneal topographer to diagnose, monitor for progression, help choose the most appropriate RGP design for that particular eye and help calculate the RGP parameters.
The E300 is involved in all my orthokeratology patients. Without it, I wouldn’t feel comfortable even fitting orthokeratology lenses. Without a topographer, you can’t troubleshoot what is actually going on if the ortho-K treatment doesn’t go exactly as planned.
What surprises me about the E300 is that it provides more information than just corneal contour. With the TFOS module, you can diagnose and more accurately monitor dry eye patients and get some objective data on how well your dry eye treatment is working.
I find it really nifty when you need to know if a patient’s RGP is warped as you can take topography maps on the front surface of the lens, and use it to work out whether a multifocal soft contact lens is centred.
It takes a bit of practice to take good maps quickly, but like anything, practice makes perfect. It’s an instrument that, with training, can easily be used well by your support staff, saving you time and money.
Antares topographer in the treatment of dry eye, corneal ectasia and contact lens fitting
I am the Practice partner and optometrist at theeyecarecompany. My skill in anterior eye care has developed over 16 years, driven by a desire to evolve in practice.
Wanting to continually learn more and consistently pursue further education to help our patients should be an essential part of what we do. Some of my patients have such complex ocular conditions that I feel honoured to be part of their seasoned and experienced eye-care ‘SWOT’ team.
Instruments such as the Antares topographer that can combine dry eye analysis and corneal topography are becoming essential tools in my practice. Manufacturers are becoming clever at addressing space constraints in consulting rooms, usually by having one instrument run multiple different functions.
The Antares is defined as a diagnostic dry eye device; it can assess meibomian gland function, perform tear film analysis and calculate tear film break up time. Additionally, the 24-ring Placido disc technology to perform these functions means it also has a very accurate corneal topographer for management of corneal ectasia and for speciality contact lens design.
As the scope of practice changes and we continue to learn more about complex conditions, the devices that give us useful data to aid diagnosis and optimal management will become more than just fancy new devices. They will be the staples of advanced clinical practices, giving us more meaningful information and allowing us to continue to improve patient care.
BAppSci(Hons)(Optom) PGOcTher CASA CO
BlephEx in the treatment of dry eye and blepharitis
When I began working with an anterior eye surgeon in 2001, I realised the anterior eye was an area of optometry where I could make a difference.
After integrating BlephEx into my practice, I was able to proactively treat blepharitis and demodex mites during consultations.
The BlephEx is a hand-held tool with a spinning probe made of medical grade micro-sponge, which exfoliates the eyelid and removes scurf and debris. The device is cost-effective and ensures that patients have ‘healthier, happier’ eyes when they leave the consulting room.
Blepharitis is diagnosed very well by optometrists and frequently they instigate management, but very few of us actually treat it in the chair. Where the BlephEx device is fantastic is that we can offer a cleaning service for the patient’s eyelids and lashes while they are in your practice. It adds a whole new element to optometry.
Many optometrists are happy to diagnose blepharitis but then often push it out the door. We should be more hands-on and treat blepharitis, rather than just sending patients on their way with their various foams and gels.
If you are a practitioner who wants to get into managing blepharitis aggressively, my advice is: do some research and make sure you’re using the best product for each individual case.