1:30min
Optometrist Annie Tran has been named the winner of the 2025 Optometry Connection Case Report and Clinical Image Award, after receiving the highest number of votes from peers for her case report, ‘To dilate or not to dilate? Choroidal melanoma: obtaining appropriate baseline data’.
The annual award recognises the most meritorious case study or clinical image published in Optometry Connection, highlighting contributions that support the continuing professional development of optometrists across Australia and New Zealand.
Annie’s case report explores the detection and management considerations surrounding choroidal melanoma, emphasising the importance of establishing comprehensive baseline data and maintaining clinical vigilance.
Reflecting on the experience that inspired the article, Annie said the case was particularly impactful early in her career.
‘As a recent graduate at the time, I didn’t think I would encounter a melanoma in practice,’ she said.
‘My first thought when I saw the melanoma was the mnemonic I learnt in third year at university. My second thought was that this routine check-up was the beginning of a life-changing moment for my patient.’
She noted that while detecting serious pathology can be confronting, it highlights the responsibility optometrists carry as primary eye care providers.
‘As primary care providers, we can inherit lifelong patients, and our responsibility doesn’t stop after the initial detection. These patients often undergo significant treatment and require ongoing monitoring for potential sequelae.’
Establishing strong baseline data
Annie said the case also reinforced the importance of baseline dilation and comprehensive imaging in everyday practice.
‘I work in a practice that dilates routinely and usually all patients who have complex posterior conditions have a dilation annually,’ she said.
‘For new patients, I’m guided by their presenting symptoms, systemic conditions and any findings on my undilated examination to determine the appropriate timeframe for dilation.’
She added that many patients report never having had a dilated eye examination before attending the practice, highlighting an important gap in baseline data.
‘Baseline dilation is important to establish comprehensive data, and subsequent dilations can then be guided by any known ocular pathology, systemic conditions or symptoms,’ she said.
‘Providing colleagues with a detailed history benefits the patient’s continuum of care rather than starting from the beginning.’
Annie also emphasised the value of modern imaging technologies in building that baseline.
‘Many practices are well-equipped with technologies such as fundus photography, wide-field imaging, OCT and visual field machines,’ she said.
‘These tools provide robust baseline data, aid detection of subtle changes over time and help ensure new conditions aren’t confounded by existing pathology.’
Clinical vigilance and patient communication
Beyond the clinical insights, Annie hopes the case reminds optometrists that rare conditions do occur and that communication plays a critical role in patient care.
‘How we communicate with patients is just as important as the clinical work itself,’ she said.
‘Preparing patients for what to expect, explaining findings clearly and being transparent about management builds trust and helps them feel supported.’
She added that staying up to date with emerging research is essential, particularly when patients seek information about their condition or treatment options.
‘Combining clinical vigilance with effective communication ensures patients receive the best care, even in complex or uncommon situations.’
Encouraging others to share clinical insights
Annie encourages other clinicians to consider sharing their own experiences through case reports.
‘We encounter a wide range of cases in practice as primary eye care providers, and every case – whether routine, rare or complex – can offer valuable learning points,’ she said.
‘Writing a case report is a great opportunity to reflect on your clinical experience and share those insights with colleagues.’