100% Optical

On stage at 100% Optical: identifying ischaemic optic neuropathies

Lorcan Butler on his session around understanding clinical characteristics of ischaemic optic neuropathies and the essential skill of communication

In the lead-up to 100% Optical 2023 in February, OT reached out to a selection of speakers from the education programme to find out more about the sessions on offer, the topics that will be explored, and what visitors can expect. Find the full series, along with further content on 100% Optical on OT’s dedicated page.

What is the focus of your session?

The main focus is revisiting two separate but similar ocular conditions that can have a debilitating impact on the patient’s vision, their lifestyle and their physical and mental wellbeing. Treatment options have not changed much over the years, but further studies into these two eye conditions are showing more impact on the risk factors and ocular comorbidities which can increase a person’s overall risk of an occurrence.

What are some of the key messages you wish to highlight?

Educate, educate, educate.

Educate your patient on age-related changes that can occur, as preventative education is key. They may be at an age where they are already using a hearing aid, have dentures, or walking aids, so they can appreciate that there are natural age-related deteriorations and their eyes and their vision are not exempt.

Asking them to self-regulate and self-check their vision and come to you at the earliest opportunity of vision changes is paramount. A quick diagnosis and prompt intervention is vital. It’s much easier to deal with vision changes at the first encounter of something being different, rather than waiting for a cure when it is too late.

The British tradition of having a stiff upper lip and ‘just get on with it’ attitude can predispose this generation for attending when it is too late and where no remedial action can be facilitated.

Who is this topic for? Who might benefit the most from joining?

From pre-reg, newly-qualified, early career optometrists, all the way to the more mature registrants. Unfortunately it is a condition where there is very little change, unlike a topic such as dry eye or myopia control where it is changing daily.

I feel that the people who would benefit from this session the most are the younger generation, such as the early career practitioners who maybe didn’t see many patients during COVID-19 or have limited experience dealing with these difficult situations.

Why is this topic so important for optometrists to engage with?

As we have an increasing, ageing population, and a corresponding increase in vasculopathic risk factors associated with ageing, we need to be able to be prepared for these ocular manifestations and sight threatening conditions. Unfortunately, we can expect to see an increase in their presentations as the population continues to age.

What do you hope the top takeaway will be for attendees?

It can be a very stressful and trying time for the patient to come to terms with losing something they have had all their life – good vision. Like anything, you don’t really appreciate it until it is gone.

We have the clinical aspect in the detection, referral and management options to discuss. However one thing we are not taught is how to explain this loss of vision to the patient in an understanding and empathetic manner. They will have a multitude of questions at first, and over time, as they appreciate their vision may not be returning to the way it was. Effective communication skills are strongly needed in what can materialise in delicate, sensitive manners such as driving.

Having a more holistic approach to helping and managing the patient’s stress, anxiety, and possible depression because of the ocular condition can be challenging to the uninitiated, and this is where communication and breaking bad news are life skills that can never be replaced.

Improving our communication with other healthcare practitioners is an example of a shared care approach where we have multi-disciplinary investment in the continuing care of our patient.