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We are seeing more patients with eye problems. This is partly because Covid 19 has made people too scared to go to the Eye Hospital and some are finding it difficult to get an appointment with their GP.
Happily, eye examination technology is advancing all the time and we have always been at the forefront of using this technology to carry out comprehensive eye health screenings for patients at a safe distance of two metres.
Our latest addition is the Wave Analyser Medica 500 (WAM) from Essilor which we installed in mid-June 2020. We were the first Optician in the UK to start using this kit for eye health screenings including prescription change, topography, glaucoma, cataracts, and keratoconus testing.
When we first came across the WAM we were really interested in the enormous amount of data it provides in under two minutes. When Covid-19 swept the nation we made the decision to install the kit quickly because we knew it would help us keep socially distanced in practice and make our staff and patients feel safer.
During the first wave of the pandemic we were very limited in the services that we could offer based on guidance from our professional bodies against using slit lamps and the ophthalmoscope or anything that involved invading the patient’s space. We agreed that the WAM was a safe way to help navigate this new way of working.
Initially, we trialled the kit, but it soon became apparent that we needed to keep it in practice indefinitely. It was lovely to watch patients sit back and relax at what’s been a very anxious time, while we carried out the screening at a distance with minimal contact.
We’re now using the WAM on all patients to examine the front of the eye and an Optomap fundus camera for the back of the eye. This process picks up any problems first, before going on to do an eye examination at 1.5m via an electronic phoropter. So far, we’ve found that the WAM gives astonishingly accurate prescriptions and usually just needs a little adjustment for perfection.
Patient experience
Most patients found it really easy to get “WAMed” because it’s very comfortable and quick.
It really does help boost their experience and they like to pull themselves up to the large patient facing screen and enjoy an explanation of what and why we’ve collected this data. It also helps us demonstrate why we’re doing these tests and the importance of regular eye examinations for eye health too. For example, we get a good estimate of the eye’s anterior angle and can show how its closure can cause glaucoma and why it changes as the lens inside the eye grows with age. Try explaining that without a handy WAM!
Our patients are fascinated at seeing pictures of their cataracts because it’s not a part of the eye they’ve ever really seen before. The images are also a fantastic tool to help us explain to patients why they’re having difficulty seeing, which helps them understand our next step treatment recommendations.
The glaucoma pressure test is quick and painless with the whole experience usually completed in under 2 minutes for both eyes.
Cleaning the equipment is quick and easy too, which, given all the other sanitising measures in place right now, is a huge benefit. This helps the flow of patients and keeps appointments on time.
Helping with diagnosis and treatment
There have been a few instances where something has looked abnormal during a WAM screening and we have double checked it using our slit lamp to confirm that the initial abnormal indication had been correct. On one occasion this was spots on the cornea.
Black spots on the cornea
Usually the WAM photograph of your lens shows a plain, light grey but in this picture you can see lots of black spots. This indicates Fuchs endothelial dystrophy, a common cause of blurred vision. It’s hard to spot in the early stages and the drop in vision is usually put down to early cataracts. There are a number of treatments that can help clear the vision and make it clearer or more comfortable.
The first picture above shows normal corneal topography (map of the bit the contact lens rests on). But a few weeks later the patient returned with blurred vision.
In the second pictures above you can see the shape and numbers have changed. This was caused by a large chalazion (common sore lump) in the centre of the upper lid rubbing on the cornea and deforming it. The patient was reassured that this would settle over the next few weeks and should clear completely. A hot compress such as the Eyebag can help speed the process up. If it doesn’t clear completely and the vision stays blurred the chalazion can be removed but it usually isn’t done through the NHS unless it’s causing vision problems lasting months.
Ortho-K treatment
Ortho-K lenses are custom designed by us for patients to wear for the temporary correction of myopia (short sightedness). While you sleep, the gentle, harmless pressure from your eyelid on the lens is transferred to your tear layer changing the shape of your cornea which improves your vision overnight.
We have always specialised in Ortho-K treatment and wanted a more accurate way of testing. After researching the WAM, and learning that America and Australia were using the previous model successfully for Ortho-K, it was clear that it could help with this.
The eye topography data is easy to acquire using the WAM and makes the Ortho-K treatment process more seamless and fluid. Overall, having all this information delivered in just under two minutes at a distance of over two meters has been a huge help in both keeping patients and staff safe and reducing time spent in an enclosed space.
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