Wendy d’E.Vallancey and Mary Bramley
Aves Optometrists, a long-established Hertfordshire practice, which is soon to celebrate its 70th anniversary, takes pride in its independence. A passion for clinical excellence is matched by the freedom to select the very best products to meet their patients’ individual needs.
The three consulting rooms are busy with ten part-time optometrists, all of whom share the practice philosophy of “the patient comes first”. The Heidelberg Engineering Spectralis is positioned in a separate room, alongside a retinal camera. The consulting rooms are inter-connected to support the work ethos of sharing clinical findings in the interest of professional development and high quality patient care. Scanning is offered for an additional fee for both NHS and private patients, with the recommendation for this level of care made on a patient by patient basis by the individual optometrists.
Mary Bramley, Optometrist Partner –
“Working without an OCT would be like working in orthopaedics without access to X-ray; you just don’t have the full picture. I certainly would not want to work in a practice without an OCT now that I have seen the benefits of having that extra layer of clinical information. We have set protocols and all OCT patients are given single line, full and basic glaucoma disc scans. Different protocols are used where appropriate.
“When we introduced our OCT we invited many of the local GPs to come and have their eyes scanned. This proved to be very worthwhile in building relationships and we are one of the first points of referral for many local GP practices.
“Our referrals are far more accurate since we have been using the Spectralis and this has enhanced our relationship with the ophthalmologists and local hospitals. We provide OCT scans for both NHS and private patients, and they often see this as a great advantage in that they are not having to travel ten miles or more to the local hospital for scanning, when they can come to us and it is complete in 20 minutes.
“We are looking almost at a cellular level and it can be very useful in the information that it provides. We are able to manage patients’ expectations, particularly with cataract patients prior to surgery who may also have some macular degeneration.
“We were attracted to the Spectralis by its ease of use and the eye tracking which ensures that follow-on scans are very accurate. Now that we have it, we realise how amazing this capability is: if a patient blinks or moves, the scan just picks up again in the same place in a fraction of a second. The ability to have ongoing upgrades to the Spectralis is also a great advantage. We are now looking at the BluePeak autofluorescence module which will tell us if the macular degeneration is progressing and highlight any active changes.
“Heidelberg Engineering is a great company to work with – we really appreciate their high level of education and training, and the support is excellent. The international yearly symposium is amazing and we have been very privileged to attend two of these events to have such an insight into the most up-to-date research.”
Wendy d’E. Vallencey, Optometrist Partner –
“Through our GP and hospital links, plus word of mouth recommendation from patients, we have established a strong clinical reputation.
“We get a lot of recommendations because people like the way we have looked after them. OCT scanning makes possible the differentiation between dry and wet AMD so that we can make accurate referrals directly into the Princess Alexandra Hospital in Harlow and the Lister in Stevenage. The OCT scans indicate how urgently they need to be seen. The net result is that we have patients who choose to come to us each year from as far away as Hampshire, Dorset, France and even Dubai.
“OCT is now an essential part of what we offer, but we don’t screen all patients routinely. We recommend it to patients who we feel are at risk and need further investigation – certainly anyone who sees distortion on the Amsler chart,has sudden vision loss, routinely prior to cataract referral or to monitor known retinal disease. Sometimes patients balk at paying £45, however, once they see the scan and what it reveals they tend to appreciate its value and they can see what they have paid for. Where follow-on scans are indicated in the future they are usually readily accepted. For at-risk patients we may recommend six monthly re-scans, but for others it may be up to two years.
“We have screened some patients in their 30s with the symptoms of CSR (Central Serous Retinopathy). This has allowed us to reassure the patient and saves unnecessary referrals. Much of the benefit of the OCT comes from the fact that it refines the referrals, and prevents unnecessary hospital appointments, which builds better relationships with our local ophthalmologists.
“The investment has been very worthwhile in keeping our clinical skills up to date. It has been a significant investment but we worked out that we only need to scan one patient a day to cover the cost. Two thirds of our patients are NHS funded and yet the majority of our patients agree to OCT when we recommend it to them and explain the reasons.”
Wendy d’E.Vallancey and Mary Bramley, Optometrists, Practice Owners
SPECTRALIS owners since 2015