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Dr Thomas Pham (centre) demonstrates scleral indentation to early career optometrists

By Rhiannon Riches


Scleral indentation, a technique seldom performed, was the topic covered at the New South Wales Young Optometrists (YO) first event of the year.

YO hosted a workshop with vitreoretinal surgeon Dr Thomas Pham at his Marrickville Eye Specialists practice on 19 April.

YO member Rebecca Li said scleral indentation was an important technique for examining the peripheral retina.

‘Unfortunately, it is largely underused or overlooked by optometrists. Used in conjunction with the binocular indirect ophthalmoscope, it enables examination of the ora serrata and adjacent retina.

‘Optometrists have an obligation to indent suspect patients otherwise an anterior retinal tear may be missed,’ she said.

Ms Li said Dr Pham discussed the indications for scleral indentation such as the presence of Shaeffer’s sign, vitreous haemorrhage, existing peripheral retinal changes such as lattice degeneration, and symptoms of flashes or floaters.

‘Contraindications include hyphaema, recent ocular surgery or penetrating trauma and scleral thinning disorders such as scleromalacia perforans,’ she said.

‘Dr Pham recommended maximum pupil dilation to ensure a thorough examination of the peripheral retina. An additional drop of topical anaesthetic prior to examination may also be used to promote patient comfort. Binocular indirect ophthalmoscope with indentation is then performed as the patient looks through the nine directions of gaze.

‘The full workshop was able to give all 20 attendees a taster of the technique. Dr Pham emphasised that the key to mastering the technique is “practice, practice, practice”,’ Ms Li said.

The workshop was sponsored by CooperVision, which also recently sponsored a barbeque for UNSW Optometry students, which YO organised.

Yo scleral indentation group

Save the date

At their next event, NSW YO will be exploring the workforce balance of supply and demand.

Titled ‘Too many optometrists’, the event will be held on 14 June at Dove and Olive in Surry Hills from 11:00 am to 1:00 pm, followed by lunch.

‘This event will be addressing the very real issue of an impending oversupply of optometrists. How can individual optometrists and the profession tackle this problem?’ Ms Li said.

‘The event will be chaired by Optometry NSW/ACT CEO Andrew McKinnon, and we have organised a panel of optometrists from different parts of the industry to discuss how they forged a fulfilling career in optometry. It will hopefully inspire young optometrists to see new possibilities within our profession, and generate discussion, networking and brain storming.’

The event is sponsored by Optometry NSW/ACT and CooperVision. CPD points will be available. For information, contact YO at

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