Author Archives: admin

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The Ultimate in Recycling!

Next time you are passing, bring in any pairs of glasses that you no longer use and we will pass them on to Vision Aid Overseas.  Trained staff refurbish the glasses, analyse the prescription and transport them to eye clinics within  developing countries.  The gift of sight is special and is yours to give.

Thank you to all our patients who have provided thousands of pairs of spectacles to this cause over the years.

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The Poor Dog

I had the immeasurable pleasure of examining my maternal great aunt Martha’s eyes at her own home recently and learned a bit of where I came from.

It all started when my great grandfather, his wife and houseful of six children were plunged into poverty at three o’clock one morning. The comment was made about the strangeness of hailstones on the window, which turned out to be cracking windowpanes from the heat of the fire. The young children upstairs in and amongst the upper half story of thatched roof – they had been burnt out of their home.

‘We go in together and we come out together,’ was whispered wife to husband, as they went back in to get their baby niece, who they had taken in when her mother died in childbirth. In any case they were to find out what poverty meant, when everything they owned was destroyed, their friends and neighbours helping them to get back on their feet in any way they could.

As the adolescent years came round, with little to do but hang around fecklessly, brother Willie, my grandfather took an interest in shooting which one way or another resulted in the next door neighbour’s dog being shot. The police were called and the fine, upstanding Sargent Pogue duly arrived on the doorstep to investigate matters.

Seven pairs of ears cocked, in the next room as the drama unfolded, events were noted between the good Sargent and my great grandfather. Whatever way it worked out, the long arm of the law acted in mysterious ways, clearly noting the need of the family, and suggesting that Willie and his brother James had the look about them of lads that would make upstanding officers.

Pogue went on to tutor and train them at his own home, in his own time, and sure indeed didn’t they go on to become fully fledged police constables. And to all accounts never was there a worse policeman than my grandfather Willie Dennison. There wasn’t a rule he didn’t break – once when reporting for duty, unshaven and minus his cap, he lifted the cap off the head of the colleague behind and placed it on his head as he addressed his commanding officer. My grandfather used this position as a springboard to progress in life one way or another, and went on to amass a significant group of local businesses.

Not only did the Sargent Pogue do all this for the family, but his eye was somewhat better tuned when he identified the skill and character necessary for the nursing profession in my great aunt Martha. She was duly packed up and put on the train to Dublin to the good sergeant’s sister to train as a nurse with her. I enjoyed Martha’s the aside about, ‘But how will we know each other when I get to Dublin?’ and it was instructed she wrap a handkerchief over one hand on disembarkation. Nowadays, the idea of upping sticks and moving away from home to stay with someone we have never even spoken to, is quite strange to me.

We skipped to the point where my aunt, who had become matron of the Samaritan Maternity Hospital, was advising the medic in charge of the hospital that she was ‘fed up delivering babies.’ The discussion developed that she had an interest in mental health, but into her forties and having risen to an admirable rank in maternity nursing, she was going to struggle to change her specialism. By hook or by crook, something of a secret year-long placement as a student nurse in Creighton Royal Hospital in Scotland was arranged. With express instruction from my aunt that no-one was to know that she was previously a matron, she endeavoured to work out what the medical, nursing, auxiliary and janitorial people on the ground really felt.

A few years down the line, the position of matron at Holywell Hospital near Antrim came up, barely a couple of miles down the road from where the nine of them had been burnt out of their home that night. Regarding Holywell, I believe the comment was, “All you could here was the jangling of keys, and the clinking on locks – 120 beds and every single occupant was committed and continually locked up.” This was the dark old days of the sanatorium, and great-aunt Martha felt it was most definitely not the place for her. She was encouraged to apply but repeatedly declined, until her boss at Creighton Royal whispered conspiratorially, “That place needs somebody like you – somebody to give it a good shake-up.”

And duly indeed did she shake it up, getting the patients into their own clothes, out of bed. She opened the doors, she opened hair salons and workshops inside the hospital, and people did indeed start to recover and actually go home. After a few years, her mentor from Creighton Royal along with her associated medical man, came over to inspect the works, and requested that they stay in the bungalow that was built for Martha in the hospital grounds. After four days the comments was, ‘Miss Dennison, tell me what you thought the real purpose of our visit was.’

Sure enough, Miss Dennison went on to become matron of Creighton Royal the largest mental health hospital in the UK, and bring her own brand of hard work, determination, reform and professionalism to that establishment too.

Auntie Martha and I howled with laughter with the parting comment, ‘And all because your brother shot the next door neighbour’s dog.’

collie


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Blindfulness

Category : Uncategorized

I spent a very enjoyable, challenging, entertaining couple of hours with a rather inspirational patient of ours this month. She is developing a project to help people with vision difficulties and the sighted community understand each other better through the medium of dance. Now, anyone who knows me will not automatically associate me with interpretive dance, indeed I have previous for enjoying this medium but proving subsequently for it to have been more ‘misinterpretive dance’. Prior to this we spent an hour together in the practice for me to help her by explaining common forms of vision loss and what the person might possibly experience.

When I rocked up at the dance studio, I met our director as well as two professional dancers who had just been rendered temporarily completely blind for three hours beforehand. They demonstrated the piece of work they had been working on that day, and then we sat down so they could ask me whatever questions they had about the visual system and how it can malfunction. It turns out that I had as many questions for them as they did for me. Amongst a bunch of other stuff, I learned two really interesting things regarding human beings experiencing a lack of visual stimulus.

Firstly, the engaging, young, capable male dancer seemed to cope quite well for a number of hours amongst other techniques, using the way his voice bounced off the objects around him to determine the proximity of walls etc. That is, until he indeed hit something of a psychological wall, and became acutely agitated and frustrated. It was the acuteness of it that he finds he found deeply strange. 

The second interesting insight I got was from the direct, challenging, insightful young female dancer about when the blindfold was removed. She described beautifully, feeling almost inexplicably overwhelmed an emotion she could not quite describe – what’s more, she didn’t seem like the type of person who would be prone to this.

I am so excited about this project, and really interested as to how these guys are going to take this forward – I can’t wait for the next instalment. Indeed, I will most definitely be buying tickets for the front row and enjoy misinterpreting it.

Andrew, Optometrist.


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Our Facebook

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Great fun at Rory's Ringhaddy Challenge this weekend. Turns out that Rory wasn't the only one to take a dip... ...

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Back to the Future! Charles Stone 2017 versus NHS 1950s (courtesy of Frank's roof space). ...

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Andrew has got his car packed already for Rory's Ringhaddy Challenge this weekend. ...

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We’re increasing our opening hours – finally

Category : Uncategorized

In our heart of hearts, we have known for some time that opticians really need to be open when our patients are not working, but in uniquely human form, sub-consciously we did quite a lot to put this off.

We did customer feedback surveys, we performed a resource needs analysis, we analysed our supplier availability, we did an HR impact analysis, and generally pushed this one around the plate for a good while – and then somebody said we should just try it for six months. Common sense isn’t that common.

We are now open until 8pm on a Thursday evening to give you time to get to us after work, even if you have a little distance to travel. Also, we are now open from 8am until 12 midday on a Saturday, if work from Monday to Friday renders an appointment a bit tricky during those days.

We hope this helps – and indeed would love any feedback you can give us.


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Why is my child’s squint worse since wearing glasses? Accommodative esotropias and the mechanism behind them.

Category : Uncategorized

This question and the question, ‘Will glasses fix the turn in my child’s eye?’ are two of the most common questions I get in practice. The hospital does a fantastic job, but often we can fill in a few gaps regarding young children’s care.

Before we can understand why it goes wrong, often it is helpful to get an idea of how it works. I liken in the human eye to a projector and a screen. There are two lenses in the eye, the cornea, and the crystalline lens inside the eye. The combination of these two lenses and a variable aperture in the form of the pupil, forms a projector, projecting an image of the real world onto the lining of the eye. The lining of the eye (the retina) samples the image changing it from light information into electrical information. The image is then sent out of the eye via the optic nerve to the brain; actually to the primary visual cortex at the very back of the head, where we perceive the visual information. Bizarrely none of what we see happens in the eye, it all happened in the brain.

Often people think that we can see at more than one distance at one time, but if we focus on something up close, objects in the distance are blurry and if we focus on something in the distance, objects up close are blurry. It is actually a combination of a muscle and the crystalline lens inside the eye, which enables us to adjust focus to different distances – I call this our autofocus mechanism. In the human eye the autofocus mechanism, the convergence mechanism (which pulls the eyes in when we look at things up close), and parts of the pupil mechanism are all inherently linked.

Young patients who are longsighted need to use more autofocus when not wearing glasses, meaning that they sometimes coincidentally converge too much, causing their eye to turn in. By wearing glasses, we reduce the need for the eye to autofocus, allowing the eyes to stay straight. For this reason, often children who have an eye that turns in, a pair of glasses to correct their long sightedness can keep their eyes straight. Frequently, when they take their glasses off, the eye will turn in.

As we go through life the amount of autofocus we have reduces. Very young children have loads of autofocus, and people at the age of 55 have none. As the amount of autofocus reduces, the effort to autofocus through uncorrected longsightedness is greater. This means the eyes are more likely to turn in without glasses.

Understandably, parents are keen to see a reduction in the tendency for an eye to turn in when glasses have been prescribed – as you can see, sometimes the opposite is true. Unfortunately if we were to operate on the eye to reduce the chances of the eye turning in without glasses, it would increase the chance of the eye turning out with glasses. We also need to remember that the child will have an increased need for the glasses simply to correct their eyesight, as the amount of autofocus they have reduces. This means that they will need the glasses to be able to see, consequently rendering the need for the eye to stay straight without glasses irrelevant.

In conclusion, my rather blunt response to the question in the title is, having explained all this to understandably anxious parents, that it is the wrong question to ask. The best question to ask, is if their little one’s eyes are absolutely straight with glasses – that there is not a tiny, cosmetically invisible turn in one eye, even with glasses on. What we are really aiming for here with these patient’s care, is that both eyes are perfectly aligned with glasses on, which will give the small person the best chance of both eyes developing the very best level of vision.

Additionally, it will give them the best chance of becoming ‘binocular’ where their brain can properly combine and interpret the information coming from both eyes, in order to very accurately determine relative distance of objects and speed of travel. Often we would refer to this is ‘depth perception’ but if you think about it, everyone has depth perception – I don’t have any patients who live in a 2D world. Binocularity gives the gold standard in depth perception, enabling improved performance in sport, better enjoyment of 3D media, and opening up more career opportunities.

 

 


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Do you wear glasses? No, well, just for reading.

Category : Uncategorized

There is nothing like a continual reminder of a permanent age-related change to send us into denial. A number of you forty-somethings will look at the title of this column and see absolutely nothing amiss with it. The quality of print isn’t what it used to be? Why do they print things in such daft colours? Why is the lighting so poor in restaurants?

I used to inwardly see this phenomenon as vanity, but my own advancing years have encouraged me to take a more gentle approach. I have always personally struggled with permanently closing doors in my life. Realising that never again will I go out to certain establishments in Belfast without everyone thinking that I am someone’s dad, never again will I bend down to pick something up without groaning slightly. Underneath it all, we know that reducing near vision is a subtle reminder of the relentless march of time – it aint ever going the other way so ultimately it’s a reminder of our own mortality.

Unfortunately, denial doesn’t work. Somewhere in our deepest darkest psyche, our brain knows that our issue is under that carpet, exactly where we swept it. So what are the options? The only one I can find is to see the opportunity for what it is. Even if you only use your wife’s glasses, even if you only use them in poor lighting, even if you only wear pound shop glasses, you DO wear glasses.

We need to get you to see the opportunity. This may seem like a bit of a stretch, but until we get you there, it will continue to be a grudge purchase, you will continue to waste money on products that are half right and you will continue to feel a bit miserable about the whole thing.

And if you do wear glasses, why not love them? Educate yourself as to what is out there, get the thing that ticks all the boxes, develop your own look, have different pairs for different occasions, and get people saying, “Your glasses are awesome – where did you get them?” To find out more, why not check out our ‘What makes a good pair of glasses’ article at http://petticrewoptometrists.com/eye-write/what-makes-a-good-pair-of-glasses/


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Keratoconus – ever thought of getting a pair of glasses???

Category : Uncategorized

We have become aware recently of quite a number of keratoconic patient who have been told that they can’t wear glasses, or are wearing spectacles that could be much much better.

I think many opticians feel that people with this cornea condition have to wear contact lenses when actually, with careful care even patients who have not been able to adapt to glasses previously, can get a pair which are really useful. The contact lens clinic at the hospital often seem very keen to fit with contact lenses, and are often not in the best position to give advice on glasses.

Firstly, the optician often finds the prescription is extremely difficult to find, often with conventional methods giving very confusing results. Additionally, there can be two wildly varying prescription which both work! On top of this, getting the old brain to install new software can be tricky, resulting in the walls not looking quite straight or the floor not being level.

We have had lots of success with temporary prescriptions recently, with us putting diagnostic spectacle lenses into a patients frame at no charge, in order to test adaptation and squeeze the very best vision out of the system – feedback has been fantastic so far.

If you have any corneal disorder and want to know if you can better glasses, email us at info@petticrewoptometrists.com to make an appointment.


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‘Diabetics’ or patients with diabetes

Category : Uncategorized

I had a very interesting conversation with a person recently regarding his diabetic general medical care.

It is interesting that our health care system is spending a lot of money in order to keep this gentleman in good health. He takes great care of himself, taking regular exercise, eating healthily, and generally making sure that his blood sugar levels are under good control.

His diabetic care to him seems that every slight symptom is reported to a healthcare professional, is jumped upon, and offered further investigation or further treatment. He feels that he is seen as ‘a diabetic’ resulting in every ache, pain or random ailment being attributed to some horrible consequence of the condition. Should be maybe be view as a person first and foremost? A person who will undoubtedly have all the aches and pains people have.

He realises that any further investigation and further treatment costs time and money, and means that he has to think about his condition more, and indeed to worry about his condition more. This adversely affects his quality of life as it results in his diabetes actually playing a much bigger part of his life than it should.

This all seems terribly ironic as in delivering health care, we are doing our best to make sure that we improve patient’s quality of life, rather than effectively reducing it.


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NEHW – I didn’t come to see you in case you told me I had a brain tumour

Category : Uncategorized

It’s National Eye Health Week this week and I thought I would mark it by showing the gulf between health care professionals and our patients! The title of this post polarises the views of my patients massively.

Some of my patients see health screening as an opportunity to detect disease early, ensuring early intervention. Early intervention means less treatment, less invasive treatment, shorter treatment and better treatment outcomes.

But human beings are not always motivated to apply rigour to their healthcare thinking. I meet patients every week who fail to report symptoms to the appropriate healthcare professional in case they get given bad news…and up until recently, I thought they were nuts!

These people are making an understandable but flawed assumption that any condition detected would be untreatable and therefore they are going to spoil what quality of life they do have, by worrying themselves sick. What you don’t know, can’t hurt you. Unfortunately, there is good reason to believe that these poor people are worrying themselves sick in any case and this is what leads them to their viewpoint.

There is indeed an interesting argument around untreatable conditions and whether patients are better off knowing or not. Some people would prefer not to know, and some will want to plan. Unfortunately, as patients it is impossible for us to advise our experts that you don’t want to know about that thing they’ve found…because you then know they’ve found a thing. Equally, it’s not ok for healthcare professionals to make the decision on behalf of patients that they do not want to know.

On balance, I still come firmly down on the side of assuming that I will be reassured by normal results coming back, that if I do have something it will be treatable, and if it isn’t, it will be managed better with active intervention. Indeed I would be able to plan my personal circumstances better if I know.

I liken it to crossing the road – if I look both ways I might still get run over, but it’s definitely less likely. We have the opportunity to manage the risk by taking pro-active positive steps with our health. So, have regular eye examinations…common things are common and rare things are rare. Don’t suffer permanent vision loss from a common, detectable, treatable condition, due to a fear of finding something statistically very unlikely.