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IP and me

“Our local GPs have not seen eyes for many years”

Susan Bowers, one of the first UK optometrists to become an independent prescriber, tells OT  about her most memorable cases

Susan Bowers

I became an IP optometrist because…

Doing so much contact lens work meant I did lots of anterior eye and dry eye work, so it was a natural progression.

My first prescription was…

So long ago, in 2009 – but was probably dry eye, as this is the most common problem I encounter.

My latest case was…

IP update

Coventry & Warwickshire LOC is part-funding some optometrists to do the basic certificate in glaucoma, starting in October 2022

A very naughty 75-year-old female patient, who was referred with suspected glaucoma after a domiciliary visit by Specsavers two or three years ago and did not take the referral letter to her GP. She presented for a Minor Eye Conditions Service (MECS) appointment with eye pain and discomfort. Her pressure was 27mmHg, with extensive visual field loss and optic nerve damage on optical coherence tomography scans.

After checking with a consultant colleague and because of the backlog, I put her on Latanoprost (as I have the professional diploma in glaucoma) and I will be referring her to the glaucoma clinic, where I also work, for a formal diagnosis of primary open angle glaucoma by the ophthalmologist.

After I told her that I suspected she had glaucoma she sheepishly admitted not progressing her previous referral, hoping the glaucoma would go away.

She has so much damage already, that with the COVID-19 waiting lists for the Hospital Eye Service I medicated her first. Without independent prescribing and the diploma in glaucoma I wouldn’t have been able to do that.

The case that kept me up at night was…

I have photography, so I can record exactly what each case looked like and review the following day – so I tend to be fairly confident whist treating patients.

My most memorable case was…

I really enjoyed treating a Thygeson's case, and saving patients trips to hospital and long waits in A&E. I would be reluctant to treat conditions where there is no one in clinic the next day to monitor, but luckily we have three IPs at our practice now so that is rarely the case.

My ambitions for the future of IP are…

I got my diploma in glaucoma in late 2019 and wanted to learn Selective Laser Trabeculoplasty and PIs in the hospital setting, but COVID-19 got in the way, and I also reduced my hospital hours to help cover a colleague’s maternity leave. Now at 68, I am looking forward to retirement.

My speciality is digging out embedded metal, and I have had a lot of practice – patients are often not quite as grateful when the anaesthetic wears off, though

 

Being IP-qualified has helped the reputation of my practice by…

All three of us have FP10 pads, and our local GPs have not seen eyes for many years. We take referrals from pharmacists, GPs, and local non-IP colleagues, and patients also walk in, especially if they have been before. We see quite a few patients each day.

The benefits IP brings to the business are…

Our kit is very comprehensive, to enable us to get accurate diagnoses. We even have Zeiss Forum software to do structural and functional loss in glaucoma. This means we see private patients, as well as MECS and those outside our catchment area.

Patient response to my IP skills has been…

My speciality is digging out embedded metal, and I have had a lot of practice – patients are often not quite as grateful when the anaesthetic wears off, though.

The implications of IP on other areas of optometry are…

If low dose atropine becomes available for myopia control in this country, you will need IP – but I am not keen to supply high doses due to the side effects. You can also get contact lenses with hay fever drugs in (from Johnson & Johnson Vision.)

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