Nihaama Narayanan wins 2024 Optometry Connection Case Report and Clinical Image Award

Victorian optometrist Dr Nihaama Narayanan has won the 2024 Optometry Connection Case Report and Clinical Image Award, receiving the $1000 prize after her peers voted for her standout case report ‘Unravelling Posner-Scholssman syndrome: Managing acute attacks and long-term control’, which appeared in the March 2024 issue of Optometry Connection.

A 2019 University of Melbourne graduate, Dr Narayanan also holds an Advanced Certificate in Glaucoma from the Australian College of Optometry (ACO). Reflecting on her work in regional practice over the past five years, she explains how this has exposed her to the opportunity to work with atypical and complex cases, reinforcing her belief that every patient encounter is a chance to learn and grow.

‘I am committed to knowledge dissemination, whether through mentoring graduate optometrists, clinical education or collaboration with colleagues to enhance patient outcomes,’ she said. ‘To me, optometry goes beyond just being a profession; it’s a lifelong journey of growth, learning and making a positive impact on others.’

Dr Narayanan recently sat down with Optometry Australia to share insights into her case report and the process behind her award-winning submission.

What does winning the award mean to you?

This award is incredibly meaningful to me in that it highlights the values driving me – excellence, perseverance and an unwavering commitment to patient care. To be recognised by peers for such dedication is humbling and highly inspiring.

To me, optometry is not just a job – it’s a responsibility. Practising in a regional location, where tough cases often present without the prospect of immediate access to specialist treatment, I’ve learned to depend on clinical judgment, test my diagnostic skills and refine my decision-making. This award is not just the acknowledgment of an individual case report; it’s the culmination of the years, the many hours spent deliberating over difficult cases and the unwavering dedication to delivering the best possible care.

Personally, it is a reminder of the path that has brought me to where I am today. It’s a time of reflection of how far I’ve come, the challenges that I’ve conquered and the people that have assisted me throughout the journey. It motivates me to keep striving for excellence – to keep on growing, mentoring and to continue sharing information and giving back to the broader optometry community.

Can you talk us through your case report?

Certain cases ask more of us – not only clinically, but in terms of how we embrace the unknown. This was one of those cases.

This was a case of Posner-Schlossman Syndrome (PSS), a rare and often misdiagnosed syndrome that may lead to severe impairment of vision. The patient experienced intermittent pain in the eyes and blurred vision, which was first thought to be a straightforward case, but it turned out to be a difficult case where acute management had to be balanced with chronic care. Identifying it early on enabled us to move before it inflicted lasting harm. Moments like this remind me why I love what I do –because every decision we make has the power to change someone’s life. Good optometry isn’t simply viewing what’s in front of you, it’s seeing what to look for.

What motivated you to write and publish the case report?

In all honesty, I wrote this because I believe that every challenging case is an opportunity to learn and get better – not just for me, but for the entire profession. What made this case stand out was how unpredictable the condition was – it made me think outside the textbook and modify a plan that weighed acute management against long-term control. I wanted to document this experience so other optometrists could more confidently diagnose and manage PSS in their own practice.

Glaucoma and inflammatory eye disease diagnosis and management have always been areas of intense personal interest to me, and this case served as a reminder that early detection and collaborative care are essential. This case was the perfect illustration of how early treatment can be life changing. Writing this case report felt like the natural next step – not only to bring the situation to light but to prompt more discussion on complex case management within optometry.

Why do you think it’s a good idea to share case reports?

Because our profession thrives when we share. Optometry is not just about protocol; it’s about always adapting, improving, and refining our approach to patient care. Case reports bring real-life clinical decision-making into focus. They challenge our assumptions and cause us to look beyond the apparent. In regional optometry practice, I encounter unusual, complex cases that challenge me on a daily basis. These cases don’t just impact the patients – they impact the way we practice and enhance our knowledge of eye health. I strongly feel that when we have one clinician who is able to pass on their experience, the entire profession is strengthened. That is how we learn to do more and give best care possible to our patients.

Is there anything you’d like your optometry peers to know?

If there’s one thing that I want my peers to take away, it’s this: your work matters.

Every patient you see, every decision you make, every difficult case that stays with you long after your clinic has closed – every one of them counts. We are building the future of optometry with every diagnosis, every treatment, every conversation.

I hope my case report serves as a reminder that even rare conditions are within our scope and that with the right knowledge, confidence and collaboration, we can make a profound difference in people’s lives.

I have always believed that optometry is more than just a job – it is a craft, a calling and a lifelong journey of learning. I’m grateful for every lesson along the way, and I look forward to contributing even more to our profession in the years to come. I also strive to support and guide future clinicians while continuously evolving as a practitioner myself.