Increasing the scope of clinical practice

The optical team at Specsavers in Cambridge are now even more focused on detecting signs of glaucoma in customers, with three of their optometrists achieving the post-graduate Professional Certificate in Glaucoma.

Optometrist and store director Kam Dhillon explained why he and two other optometrists, all with extensive clinical experience, decided to increase their clinical scope: ‘As glaucoma is the second biggest cause of blindness in the world but with no symptoms in the early stages, and many people unaware that they have it, I felt it important for myself, and our optometrists Chloe Ford and Claire Morris to continue to upskill’.

The qualification is the first level on the higher education path for glaucoma accreditation awarded by the College of Optometrists.

Improving detection

The course prepared the Cambridge optometrists, who already had clinical experience of glaucoma, for local NHS glaucoma referral refinement schemes. It provided additional specialist knowledge and skills for monitoring patients with diagnosed OHT and suspect COAG or stable glaucoma who have an established management plan, within the confines of locally agreed protocols, in a primary care setting.

The further training involved a suite of online audio-visual lectures, self study, peer discussions, a face to face tutorial session, in-depth experience with Goldmann applanation tonometers as well as practical and written assessments.

‘It makes the role more varied and you use your knowledge rather than just do the day-to-day eye test – which keeps your enthusiasm levels high too.’

Kam continued: ‘While all of our optometrists are qualified to detect the early signs of the disease, we are always keen to extend our knowledge and increase our skills. The post-graduate course provided theoretical and practical ways to improve detection and management of the varying types of glaucoma, which we are integrating into our eye examinations.’

All employees were sponsored to do the qualification by Kam: ‘I am happy to support our optometrists to do post-graduate qualifications as it further equips them for the opportunities in enhanced eye health services and pushes the highest standards of professionalism forward’.

In between their appointments, we caught up with optometrists Claire Morris (right) and Chloe Ford (left) – who, despite having 20 years experience between them, felt the jangle of nerves awaiting exam results this summer.

‘We began studying in January this year and as well as online learning, we attended face to face lectures and practical workshops at the division of optometry and visual sciences department at City university. Five months later, we think we have passed but we are just waiting for our final graded results,’ said Chloe.

‘I wanted to do the qualification as it’s a clear way for practitioners to demonstrate skills to patients. It was really fascinating. It’s amazing how interesting the clinical information is when it’s extra to your daily case load’.

Senior optometrist Claire added: ‘While I’ve been a qualified optometrist for 17 years, the course gives me more specialist skills. For me, it’s about enhancing and increasing the scope of clinical practice.’

What did you gain from the course?

Chloe: ‘We covered referral and treatment pathways, with an emphasis on optical coherence tomography (OCT) interpretation. I think it enhanced our knowledge of how glaucoma affects the eye, to analyse patient’s conditions better.

Improved referrals.
‘We hope to make better referrals too and generally be more confident that what you are doing is correct. It was useful to get feedback on what ophthalmology consultants would ideally like to know about the patient in the referral letter as there is not normally feedback. The lectures also talked about cases they would see in hospitals which we would not normally see in high street practice and it was also really useful to learn about the patient journey after they have been referred to the hospital.

Claire: The course was a good recap of knowledge for me, reaffirming things that have changed since I qualified. It was good to be able to practise things that we don’t normally do much in practice like pachymetry readings used to manage glaucoma patients (or glaucoma suspects) to determine the correlation between the patient’s corneal thickness and intraocular pressure. We also had access to the latest research findings on glaucoma.’

Claire and Chloe both attended the course together to give each other learning support.

Claire: ‘Everyone was quite friendly when were in different study groups. I got a lot out of the peer discussion and think it benefitted us to talk through the practical skills. As well as being able to go on the course together, there were other optometrists that I knew previously as well.’

How are you using the course now?

Chloe: I have already used the skills and knowledge that we learned on the course.

Claire: I definitely look at a patient’s presenting symptoms differently when looking at their eyes, at the fundus photographs and looking at the OCT image as now as a result of the course teachings.

Do patients like OCT?

It’s clear that the patients appreciate having a 3D eye scan done as they tell us that it’s really amazing to have such good technology in store. They are really impressed with the technology and gadgets that we have. I find it helps us have better clinical conversations where we help give them a better understanding of their condition and I have also seen that using technology gives the patient more confidence in us as optometrists – that we know what we are doing.

Chloe: I began my career at Specsavers six years ago in 2011, which was my second year studying optometry at university and then I started my career as a qualified optometrist in 2013, I have been four years qualified now.

Why did you choose Specsavers?

I liked the idea of having a choice of location for my pre-reg year as well as a good development programme. I stayed here as I liked the atmosphere in the store. The store director Kam has a great balance – as a WOPEC assessor he’s at the cutting edge of and always wanting to do new things but he looks after his staff well too and wants to make sure that we’re happy in our roles.

Claire: I worked previously as an optometrist at Boots, six years in independent practice, briefly at Tesco Opticians and then moved down to Cambridge and came to Specsavers as a senior optometrist. I love it here as I have an opportunity to get involved in all the enhanced optical services contracts. Seeing patients with minor eye conditions keeps things interesting and hopefully now that we have got our post-grad qualification we are going to be able to provide better glaucoma shared care.

‘It’s great to have access to extremely modern equipment as well. We’re really looked after here, and encouraged to think long-term about our careers too. Having access to the WOPEC glaucoma and MECs training for free and having access to glaucoma certificate just makes everything more interesting.

‘It makes the role more varied and you use your knowledge rather than just doing day-to-day sight tests – which keeps your enthusiasm levels high too.’

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