Establishment and review of educational programs to train optometrists in laser procedures and injections.

Current scope of practice for optometrists in many countries include topical and oral medication with injectable and lasers being added more recently to scope in the United States (US), Canada, the United Kingdom (UK) and New Zealand (NZ). This expanded scope of optometric practice improves access to eyecare and is critical since an ageing population with a higher prevalence of vision disorders and higher healthcare costs looms. Expanded scope has been shown alongside strong safety records.

Acute community ophthalmology services provided by independent prescribing optometrists supporting hospital eye services during the COVID-19 outbreak.

Background: Specialised Independent Prescribing (IP) community optometrists provided acute eye care during the COVID-19 crisis ensuring that over-stretched hospital emergency eye care was supported, therefore local overall urgent eye care provision was not affected.

Subjects/methods: Number of cases seen by hospital Rapid Access Clinic (RAC) between January 2020 and June 2020 were compared to number of cases seen by IP optometrists in community Acute Primary Care Ophthalmology Service (APCOS) during the same time period. Specifically, comparisons were made between the number of cases seen in RAC and the number of cases seen by APCOS during the period before COVID-19 emergency (January-March 2020) and for a similar timeframe thereafter (April-June 2020).

Standardized patient methodology to assess refractive error reproducibility.

Purpose: Standardized patient (SP) methodology is the gold standard for evaluating clinical practice. This approach was used to investigate the content of typical optometric eyecare in England and the reproducibility of refractive error measurement using prescriptions obtained by three SPs.

Methods: The three SPs were independently examined by three to four expert optometric clinicians to obtain "benchmark" estimates of refractive error.

The content of optometric eye examinations for a presbyopic patient presenting with symptoms of flashing lights.

Background: Standardised patients (SPs) are the gold standard methodology for evaluating clinical care. This approach was used to investigate the content of optometric eyecare for a presbyopic patient who presented with recent photopsia.

Methods: A total of 102 community optometrists consented to be visited by an actor for a recorded eye examination.

The content of optometric eye examinations for a young myope with headaches.

Background: A recent review found standardised patient (SP) methodology to be the gold standard methodology for evaluating clinical care. We used this to investigate the content of optometric eye care for a young myopic patient with headaches suggestive of migraine.

Methods: We recruited 100 community optometrists who consented to be visited by an unannounced actor for an eye examination and to have that eye examination recorded.

Technical Note: A comparison of a novel direct ophthalmoscope, the Optyse, to conventional direct ophthalmoscopes.

Despite the current popularity of binocular indirect ophthalmoscopy, direct ophthalmoscopes are still commonly used by clinicians for fundus examination. They are considered to be expensive, however, and it has been suggested that this cost can prevent their use by healthcare professionals in developing countries. The Optyse Lens Free Ophthalmoscope is a novel direct ophthalmoscope, without a lens focus system, that allows for comparatively inexpensive manufacture and supply.

Subtle binocular vision anomalies in migraine.

A literature review reveals old references to an association between migraine headache and binocular vision anomalies, but a lack of scientific evidence evaluating these claims. In a masked case control study, we investigated binocular vision using standard clinical tests in people with migraine and in controls. Some test results suggest that heterophoria and fixation disparity are more common in the migraine group.

Visual stimuli are common triggers of migraine and are associated with pattern glare.

Objective: To investigate the associations between interictal pattern glare, visual stress, and visual triggers of migraine.

Background: There has been relatively little research on the visual stimuli that can trigger migraine episodes. This is surprising, since if practitioners can obviate such triggers, then some attacks may be prevented.

The correlation between migraine headache and refractive errors.

Purpose: A literature review reveals historical references to an association between migraine headache and refractive errors, but a lack of scientific evidence relating to these claims.

Methods: In a masked case-controlled study, we investigated the four aspects of refractive errors that have been implicated in the literature as correlated with migraine: spherical refractive error, astigmatic refractive error, anisometropia, and uncorrected ametropia. We also compared the calculated scalar value of refractive error, aided and unaided visual acuity, and spectacle use in migraine and control groups.

The pupillary light reflex in migraine.

The literature suggests that there may be pupil size and response abnormalities in migraine headache sufferers. We used an infra-red pupillometer to measure dynamic pupil responses to light in 20 migraine sufferers (during non-headache periods) and 16 non-migraine age and gender matched controls. There was a significant increase in the absolute inter-ocular difference of the latency of the pupil light response in the migraine group compared with the controls (0.

Frequency doubling technology perimetry and standard automated perimetry in migraine.

The literature suggests that visual field defects may be more common in people who experience migraine. The Humphrey frequency doubling (FDT) visual field instrument selectively examines the magnocellular visual pathway, but has not previously been used to investigate visual function in migraine. In a masked controlled study we compared Humphrey FDT and Humphrey Swedish Interactive Threshold Algorithm fields of 25 migraine sufferers with 25 age- and gender-matched controls.

The optometric correlates of migraine.

Migraine is a common, chronic, multi-factorial, neuro-vascular disorder typically characterised by recurrent attacks of unilateral, pulsating headache and autonomic nervous system dysfunction. Migraine may additionally be associated with aura; those focal neurological symptoms that may precede or sometimes accompany the headache. This review describes the optometric aspects of migraine headache.