Ian Cameron: “I want to be able to monitor the things that it can let me monitor”

He emphasised: “There’s a lot of stuff that goes on in the periphery of the retina and unless you look you won’t see it, and unless you see it, you can’t do anything about it. There is stuff in there that you need to monitor, and there is stuff in there that you need to detect – serious sight-threatening conditions appear in the periphery of the retina and so you have to find them if they are there, and the earlier you find them the better. The Optomap gives you the chance to find them earlier than you would otherwise.”

The optometrists’ view

As an optometrist with 20 years’ experience, much of which has been spent practising in Scotland, Cameron explained that he is used to performing a lot of peripheral retina tasks in daily practice. “I like to think we are pretty good at it as we are trained to do it, and it’s a big part of this standard GOS contract,” he told OT.

However, the optometrist admits that having an Optos California in practice has enabled him to realise, “I’m not as good at the periphery of the retina as I thought I was, and there is a load of stuff that I miss.”

“[The Optos California] really supports my clinical practice,” he highlighted.

Reflecting on when the device was first installed, Cameron said it was humbling to see how many things on patients who he had been seeing and dilating year-after-year that he had been missing – from “tears in the retina, lesions in the retina, abnormalities that I just simply didn’t know were there, despite doing what I thought were good quality dilated examinations,” he said.

The installation and the business

As owner and managing director of Cameron Optometry, Cameron believed when purchasing the device it would enhance the practice’s offering, but it was only after installation and rollout that he understood the full extent of its benefit.

“[We purchased the device] as we felt there were compelling reasons to add it to our offering. But actually, the value has increased since then as we have got used to using the device and learned its capabilities and seen what we were missing all these years,” he told OT, adding: “It’s in hindsight that you can really see the value.”

Cameron explained that much consideration was given before rolling out the device in practice, and key in these considerations was the patient experience. As a result of the purchase, the business introduced pre-screening and from the day of installation every patient received a scan as part of their eye exam.

Discussing the process changes that purchasing the device led to, Cameron said: “At the point that we decided we were going to do Optomap in addition to OCT as a standard of care, then we had to make the move to pre-screening which we didn’t do before. That took quite a lot of juggling around as you have to adapt all of your processes and systems to move patients through that patient journey.”

He advises: “Think carefully about that and really take the time to think about how you are going to integrate into the patient journey as this has meant that we have made the most of it. From the first day we got the Daytona, every patient was on it… it was getting maximum use from minute one.”

The patient and the ‘normal’ scan

Cameron shared that, of course, most scans do not show anything of concern, but he is keen to highlight both the importance and benefits of ‘normal’ scans.

“The value of taking so called normal scans is that you can then see changes that occur,” he told OT, adding: “If a patient doesn’t have any blemishes on their retina one year and suddenly there is a blemish the next year, if you never got the normal baseline how do you know that it is a new blemish and how do you know how much it has changed?”

For Cameron, monitoring, comparing and communicating about the scans with every patient is key. He spends time with every patient he sees going through the scan, explaining what he is seeing and importantly not finding too.

“I always spend time going through scans with patients – I think it is probably the most important feature of the eye exam,” he said, adding: “You really do need to carve out the time in your eye exams and make that a real priority in order to get the most out of these pieces of technology.”

“[The Optos device] has really great features for monitoring and comparing and contrasting – it’s got some really solid software for that,” he highlighted.

Cameron concluded that he could not live without the Optos California because he relies on it. “I’ve got such a strong database of information about patients that I just don’t want to not be without it, and I want to be able to monitor the things that it can let me monitor.”