Sadly, I dont see the debate ending any time soon. But in the meantime, while the professions hash this out, what should the schools be teaching? What type of courses should be presented at CE meetings? What should be covered in magazines and journals, such as Review of Optometry? What is our obligation to the profession, and how do we serve both camps without taking sides and without discrimination?
A few weeks ago, I attended the Optometric Retina Society meeting in Boston. Wow! The education was a brilliant collection of advanced lectures that made me acutely aware of one simple fact: The eye is connected to the rest of the body. I know that seems rather elementary but, in fact, it implies a great deal of personal responsibility.
|"Are Your Patients Hurting Themselves?" See this special report by Leonid Skorin, O.D., D.O. In it, he discusses the differential diagnosis of self-inflicted psychiatric disorders that affect the eye.|
Consider this scenario: A mother brings her 13-year-old daughter to your office for contact lenses. Shes taken up a new sport at school, and glasses are getting in the way. No one would argue that this falls squarely within the domain of optometric scope of practice.
You immediately note that the patient exhibits bilateral superficial punctate keratopathy. Slit lamp examination reveals multiple episcleral capillary aneurysms and subconjunctival hemorrhages. She also has reduced mean tear production and moderate conjunctival squamous cell metaplasia. Now what?
Maybe you dont need to get involved. Obviously, the patient has a medical problem, namely an eating disorder. Youre not a psychiatrist, but thanks to your optometric training, you have the knowledge to intervene by making the parent aware of your findings and making the appropriate referrals.
Cases such as this dont fall neatly into the optometric domain, but they are unavoidable. Further-more, I would argue that it is not in the best interest of society as a whole, much less the profession, to limit knowledge for the sake of a personal or professional agenda. Ignorance does far more harm than education, particularly in a health-care environment.