“It’s like looking at the moon”

How is optical coherence tomography (OCT) used at Amar Shah Optometrist?

Amar Shah (AS): We’ve had it for five years now. It’s been brilliant diagnostically, for marketing the practice and in terms of interest for my patients and me. Patients love being able to see the pictures and we’ve been able to spot things that we are not able to by any other means.

Most patients aren’t aware of what’s going on with their eyes – they think they’re just going to come in and have a refraction. It’s been really interesting looking at the pictures with patients. ‘It’s like looking at the moon,’ is a common thing that patients say. We have people coming back year after year to get reviewed. It has also improved recommendations as we have top of the range technology.

I think my referral rate to hospitals has gone down. Things like unexplained acuity drops, I can now explain and some of them don’t require referral. I’m very fortunate that I have a great relationship with a local ophthalmologist, so I can send them copies of images, we can triage things and I can monitor them rather than referring for something that there’s no treatment for. 

Why did you decide to attend Topcon’s National OCT Conference last year?

AS: I’ve had an OCT for quite a few years and it’s been a steep learning curve on how to use it clinically. I wanted to improve my skills and it was held locally. I also know and respect some of the local ophthalmologists who were speakers at the event and thought it would be an interesting opportunity to improve my knowledge.

How did you benefit from attending?

AS: It was very interactive. I got the chance to talk to colleagues and exchange opinions on how to manage different things. It reinforced that what I was doing was correct. A lot of the time when you go to these meetings, it is about affirmation of what you’re doing as much as learning new things. There was information on how to use certain elements of the instrument to get better quality scans that I hadn’t appreciated before.

Why is it important for practitioners to continue their education on the technology?

AS: It’s important to keep your interest up. My patients come and see me because I have the most up-to-date technology and knowledge. I’m duty bound to try and do that. I enjoy giving my patients the benefit of that. It also helps me grow my business. I don’t think I would like to practise without one. 

I got the chance to talk to colleagues and exchange opinions on how to manage different things

What was the purpose of Topcon’s National OCT Conference?

Graham Trevor (GT): The idea behind the conference was to provide our existing users with a more in-depth set of educational experiences and workshops. For Topcon, it is a key part of selling an OCT device. There’s no real benefit to the practitioner if they do not know exactly what the OCT will give them and how to interpret what they are seeing; that has to come from Topcon. The education sessions were for beginners, intermediate and advanced users. We used ophthalmologists, optometrists and our own clinical trainers to deliver this.

How was the event set up?

GT: In a day, there were keynote speakers on specific topics from ophthalmology or optometry. Then we separated attendees into different workshops; some of those were hands-on, and some covered topics where OCT plays a key part, such as glaucoma, disc analysis, macular, the use of OCT and referral pathways. There were also peer discussion groups and quick-fire question and answer sessions. More recently, we’ve introduced hands-on sessions where you can have a conversation with a trainer on specific areas where the practitioner feels they are not very competent. For example, I can’t use my OCT this way and I’d like to know how to take that scan.

Delegates listen to a lecture at Topcon’s National OCT Conference

What should a practitioner be considering in order to get as much out of their OCT as possible?

GT: Practitioners should be thinking about the types of scan they should be taking with different types of patients. It’s really important to match up the type of scan with the condition. If you have a glaucoma patient who comes in, make sure you select the right type of scan that will give accurate information on what the glaucoma may or may not be doing to the back of their eye. When they’ve taken the scan, it’s important to know how to look at the report because there is a huge amount of data that OCT generates. Practitioners need to know where to look and how to understand it.

Why is it important for practitioners to keep up-to-date with technological advances?

GT: Technology is changing all the time. OCT is the biggest advance in the diagnostic side of optometry. We are getting better resolution, more in-depth data and more studies are being done, so we know more about what the data is telling us. It’s really important that optometrists inform themselves but also that we inform them of new information and trends that may lead them down a different decision path, for example. 

Technology is changing all the time. OCT is the biggest advance in the diagnostic side of optometry

What feedback did you receive from practitioners who attended the event?

GT: It was very good. Feedback allows us to tweak the content, adjust the way the day runs, change the type of speakers and target different subjects. The feedback is invaluable because it allows us to assess if we are doing it right, whether we are partially right or not right at all. It allows us to completely change the agenda if there are certain sections that are not appropriate. The feedback drives the content of the day. We’ve tended to adjust as we go. In 2018, we did eight roadshows, but have previously held just one event.

Why is it important for Topcon to support optometrists with education?

GT: Practitioners expect to be educated. That’s the biggest change I’ve noticed in the last five to 10 years. Before, you’d sell an instrument, teach them how to use it and we wouldn’t need to get too much more involved. Their expectations are different now. The pressure on practitioners to be more clinical has grown hugely. The more clinical a practitioner is, the wider their education needs to be. That has to be driven by us.