In Australia, macular degeneration is the leading cause of blindness and severe vision loss, with one in seven Australians over 50 having some evidence of the disease.
While wet (neovascular) AMD is rarer, it can appear suddenly and rapidly worsen, leading to severe vision loss or blindness in patients.
Therefore, early detection of AMD is critical to saving sight in patients. A 2017 study surveying optometrists across Australia and New Zealand found that optometrists play a critical role in recognising the symptoms and signs of early and established AMD, as well as having a responsibility for appropriate management, whether that be regular recall for surveillance of progression, or immediate referral for ophthalmological care.
The use of OCT for every Specsavers patient as part of a standard eye test is ensuring optometrists are armed with a diagnostic tool providing greater confidence in detecting AMD.
Hear from Specsavers Optometrist Partner Marlene Boulos, from the Keilor Downs store, Victoria, about how the use of OCT and established relationships with local ophthalmologists helped save the sight of a patient.
“In December 2020, a 69-year-old male patient presented with vision loss in his left eye when covering his right eye. The vision loss had only been noticed a few days before and he had no pain or other visual symptoms except for blurriness when covering his right eye.
“He had no medical conditions and his last blood test in 2019 showed his BSL and BP were normal.
“The clinical examination showed:
VA R: 6/15 L: 6/60
IOP R: 26mmHG L: 18mmHg
Retinal examination R: normal L: severe macular oedema with sub macular haemorrhaging extending to near optic nerve.
“Analysing the OCT, I could see there was sub-retinal fluid at the macular with haemorrhaging over quite an extensive area, spreading to near the optic nerve. The patient had no family history of AMD, however I suspected severe and sudden onset wet AMD in the left eye requiring urgent treatment.
“I discussed with the patient there was fluid at the back of the eye and haemorrhaging that was causing vision loss, and he needed to see an ophthalmologist for treatment with anti-VEGF injections to reduce the fluid and avoid vision loss.
“Fortunately, I had an established relationship with the local ophthalmology clinic and was able to refer the patient the same day. He was subsequently assessed and received anti-VEGF injections in his left eye.
“The ophthalmologist report stated the vision loss was likely the result of a sudden retinal rupture, as opposed to wet AMD, however with bleeding at the macula and sub-retinal and intra-retinal fluids present, treatment was as per wet AMD. The patient received monthly injections over the next three months. A subsequent report from the ophthalmologist in March 2021 stated the patient’s vision had gone back to 6/6 in both eyes, a remarkable result from the initial 6/60 in the left eye when he presented three months prior.
“While the patient’s vision will likely fluctuate over time, the ophthalmologist has recommended monthly injections to maintain vision.
“The patient is on a six-month recall cycle with us and we will continue to monitor refraction moving forward, as well as adherence to treatment.”
