Tell us a bit about yourself and how you got into optometry?
My name is Austin and I am currently in my 3rd year of practice. I chose optometry out of an interest in helping people and also healthcare. I currently work at an independent practice in Dubbo, in Central Western NSW, having previously practised in Broken Hill in Far West NSW. Relocating to rural Australia has naturally allowed me to develop professionally as well as personally. It has provided me many unique opportunities, including doing visiting clinics in smaller towns in Central Western NSW, being able to carry out clinical duties in the public ophthalmology clinic, doing a nursing home visit, and also is carrying out optometry duties at the Macquarie Correctional Centre in Wellington, NSW. I’ve also rekindled some old hobbies through meeting like minded individuals in the rural towns that I have worked in. The article will focus on my work at the correctional centre and also more generally my experience of working regionally.
Tell us about your typical day testing at a prison? What do you find are the most challenging aspects and most rewarding?
A typical day testing at the Macquarie Correctional Centre starts with a check-in and equipment screening. Before entering the premises, I am required to run through a checklist of equipment being brought into the correctional centre’s clinic. As a visiting optometrist, the clinic is conducted with portable equipment, including a trial lens set, portable slit lamp, ret and DO, BIO, diagnostic drops and the spectacle frames. I am then equipped with a personal duress alarm to be worn onsite. Afterwards, I am escorted through the grounds to the clinic where I am met by the clinic staff and set up the room for my eye examinations.
I perform a typical eye test, with a history, refraction, ocular health check, some gross binocular vision tests and also do the dispensing in cases where glasses are required. Not having access to additional testing such as OCT, perimetry, fundus photography and wide field imaging can leave you feeling ‘handcuffed’ at times, especially when you suspect certain presentations such as glaucoma, visual field defects, macula changes or unexplained headaches. Inmates cannot simply attend a private practice externally to perform the indicated tests. In cases like these, clinical decision making is important and referral necessary.
I work closely with Justice Health and Forensic Mental Health Networkmedical and nursing staff, who facilitate ophthalmology care, including cataract surgery. The Network provides care to the 30,000 people who move through the NSW adult correctional system each year; with many experiencing higher rates of chronic and complex health conditions than the general community. Clinicians working in this setting are positioned with a unique opportunity to respond to the health needs of these individuals, who commonly have had minimal contact with mainstream health services in the community.
An inmate I saw for the first time towards the end of last year had a family history of glaucoma in his mother, large cupping in both eyes, and IOPs of 26mmHg in each eye. Based on the risk factors, I decided to commence him on Xalatan Eyedrops despite not having all the pieces of the clinical puzzle. I was fortunate to follow up this inmate on my subsequent visit and note a satisfactory pressure reduction. The most rewarding part is that inmates appreciate the eye examination service provided as many have been without glasses.
On leaving the clinic, I am escorted back to the check-in area and once again go through the equipment checklist before leaving the facility.
Do you have any goals for your optometry career?
Further experiences in optometry will allow me to formulate these goals, however the most fulfilment is gained in helping those who most need help. It is a matter of continuing to do so.
What keeps you sane outside of your work life? Do you have any hobbies or passions you pursue?
I do enjoy a few different hobbies; the two main ones are tennis and art, which allow me to channel my active and creative sides. I feel these hobbies have allowed me to form connections within the communities I’ve immersed myself into, and that this is a crucial component in the overall success and/or fulfilment in regional stints.I often get called upon to make the controversial line calls in tennis since “I’m the optometrist”.
Broken Hill Artwork and Tennis
Interactions with local artists in the Broken Hill and Dubbo regions.
What advice would you give to other optometrists who may be looking to venture beyond conventional optometry?
Have an open mind in trying new things as you can be pleasantly surprised by what new opportunities bring you.