My dad tells a great story about the time he decided to go and have an eye examination in Covent Garden in London. In a nutshell the conversation goes along the lines of, ‘So Sir, what do you do for a living?’ FJP replies, ‘Well, I do a bit of farming,’ which is not altogether untrue. To which the optometrists replies, ‘Well why are you wearing an Association of Optometrists tie then?’
In any case, this sowed the seed of thought in my mind for me to go and have an eye examination to see how it should be done. So, I found myself, through my role as President of the Northern Ireland Optometric Society (I really do feel like an imposter), in London for a luncheon at the Worshipful Company of Spectacle Makers. I had a bit of time to kill, so I chose a top end practice and made an appointment – I have been to a bottom end practice and I thought it only fair to mix things up a bit.
So, I arrived and gave my details, or in other words completely lied about what I do for a living and had a quick chat to the optical assistant. She asked me whether I was having any trouble with my eyes and I explained that I was fine, apart from slightly gritty uncomfortable eyes with intermittent blurred vision, when I am tired. Without a moment’s hesitation, she immediately determined that I needed a pair of glasses. I don’t know why I bothered booking an appointment with a highly trained, highly regulated eye care health professional when her assistant was able to diagnose my problem there and then.
With utterly indecent haste, I had a £200 pair of Pradas on my nose which I of course would need ‘all the coatings’ on (an extra £99). Oh, and not only did I need glasses, but I was literally booked in for a contact lens assessment also. Had I been a poor patient, I think I would have been truly sorry I ever darkened their door.
After trying on about a million pairs of glasses (which was actually really good fun), I was invited through by a smiley faced 40-ish impossibly attractive female optometrist and shown downstairs to the consulting room. My optometrist really was entirely lovely and she did spend a lot of time with me explaining how dehydration and computer use can cause dry eye which would explain my symptoms.
As it happens, as a specimen of human beinghood I am more than a little sub-standard. If I were a pet, I would be put out of my misery. I have a slight eyelid gland problem, I have a neurological anomaly which causes one of my eyelids to droop quite a bit, for the same reason one of my pupils is quite a lot bigger than the other one, my eye pressures are a bit high and my optic nerves are more than a little bit dodgy looking. When I go to trade fares and have a demo on fancy £50,000 scanners, the machines alarm bells start ringing whilst sales executives shift on the feet and adjust their ties, trying to figure out how to tell me I have glaucoma. I also have a significant amount of astigmatism.
Not that my utterly charming optometrist actually picked up any of this. Not a single one. Not a single one. I sometimes have to really force myself to find a positive slant to things. Put it this way, I am incredibly lucky that I have enough control over my own clinical practice that I have enough time, training, equipment and motivation to do the necessary tests to look after our patients in a way I can be proud of.
The bit that is way out of left field is that she did not measure my reading vision at all and at no stage used any test that would detect my astigmatism (there are about 4 different ways she could have done it). Even my great granddaddy boasted in his shop in Lisburn in the early 1900s, that he ‘tested for astigmatism’ with a big sign in the window. And for the unforgiveable bit, went on to ‘recommend’ a pair of reading glasses to reduce ‘tiredness’ at the computer, having got entirely the wrong prescription and not even tested my reading vision at all.
A patient of mine said to me the other day, ‘Andrew, the secret to a happy life is to not be around negative people!’ I can’t help but feel that this is all getting a bit negative. Something really good did come out of all of this. I am so proud of what we are doing in our practice. So proud that as soon as I got out, I picked up the phone and spoke to Ann and Ali at our practice and told them what an good thing we are doing. We wouldn’t know how good it is unless I had had my eyes tested.
We will continue to have no ‘conversion rate targets’ for conversion of eye examinations to spectacle sales. We will continue to examine eyes in a way that would be most likely to pick up any abnormality. We will continue to give advice that has a sound scientific basis and most importantly, we will continue to have our patient’s best interests at heart. I play a little trick in my head when I am testing eyes – I pretend that the patient in front of me is a family member. I think of them as my son or daughter, my dad or granddad, brother or sister. When I think about how I would want them looked after when they get their eyes tested, I re-double my efforts to do a really good job for the patient in front of me. It really focuses the mind!
I’m in serious danger of sounding like I have a good going superiority complex going on here. I remind myself regularly that, in a parallel universe, I could have found myself working as an optometrist in a practice that has 15 minute test times, relentless sales targets and a manager breathing down my neck tell me to test faster and see more patients. I am just lucky that I have been born into the family I have.