I have practiced for many years working closely with local optometrists to provide high quality ophthalmic care. Patients who are referred to me for treatment will still remain under the care of their original optometrist for all refractive needs. The principles I abide by are: -
- All patients seen by me will have a medical report that is copied to the original referring optometrist and GP to ensure continuity of care
- Shortly after surgery I will contact the optometrist with advice regarding the optimum timing of post-op refraction
- For cataract patients I encourage all patients to see their referring optometrist in the period 1-2 months after surgery. At this point I would like to receive the final prescription that you recommend
- I usually see all patients approximately 6-9 months after surgery to ensure that they are entirely happy with their operation. Any changes e.g. PC opacity will be reported to the optometrist and GP
Patients who have surgery under our CESP fixed price package schemes have a built in allowance for post-operative refractive reports. With your report we are pleased to offer a reimbursement to you for co-management and this can be invoiced to our practice manager, Karen Ramsden, at CESP Glos.
notes on multifocal implants
More recently the Alcon +2.5 multifocal lens has been released. This lens offers patients good distance vision with excellent intermediate vision (e.g. computer distance) and the ability to read in good light. For very small print and dim surroundings reading glasses may still be needed. Most importantly the features of glare and haloes seem to be much reduced and I would be happy to discuss using these lenses for patients in certain circumstances. The ideal patient for this lens type is: -
- Usually slightly long –sighted i.e. currently requires glasses for distance and near correction
- Requires cataract surgery in both eyes – there is good evidence that use of this lens type in only 1 eye is not ideal. Usually surgery is carried out at 2-4 week intervals between eyes
- Does not expect to spend large amounts of time carrying out tiny detailed tasks
- Will be prepared to allow 3-6 months to allow adaptation to the new lenses – the brain requires time to adjust to the multifocal image
- May require a laser procedure to clear the posterior capsule behind the lens at 3 months. This allows for optimum focus and clarity of the image on the retina
I recognise that decisions about referral and surgery are not always clear-cut. I would encourage you to contact me for advice if you have concerns about a patient. I am happy to receive email enquiries and will look at images or scan that you wish to send me. This should not be used as a substitute for proper treatment since the advice will always be presented in a way that makes allowances for the lack of consultation.