My name is Yeghia Gharibian and I am a new member of the Young Optometrists subcommittee. I graduated from the University of New South Wales in 2020 and have been practicing full-scope optometry ever since, currently working in an independent practice in Northern Sydney. I am passionate about providing quality eye care services to patients and the wider community.
Tell us a bit about yourself and what made you want to be an optometrist?
I decided to pursue optometry as a career because I had a family member in the profession and was exposed to the industry early in my life. In high school, I decided to undertake my work experience at an optometry practice and really enjoyed and appreciated the time spent in clinic face-to-face with patients. Seeing the impact you can have on someone’s life by enabling them to see the world better was a truly unique and rewarding experience and I knew that was career path I wanted to take.
What are you other interests outside of optometry?
Outside of work hours, I spend a lot of time exercising which involves a lot of running, swimming, weightlifting and soccer. Specifically, I have played soccer since I was five years old for the same club and with childhood friends. This year, being an Australian-Armenian, I have the privilege of representing Australia with my club ‘Northern Homenetmen Football Club’ in playing soccer in Armenia. I am very excited for this opportunity and currently training very passionately.
Besides sporting activities, I also try to be an active Australian-Armenian by engaging in various community activities. In 2021, I was a part of the executive committee of the Northern Sydney chapter of the Armenian Youth Federation of Australia. In this role, I gained great fulfilment in improving the lives of others via providing educational activities, regularly volunteering and attending fundraising events and meetings.
The activities we have been involved in include “World’s Greatest Shave” for the leukaemia foundation and our group was ranked fifth in Australia for “The Push-Up Challenge” which is a great initiative that raised awareness for mental health. Furthermore, we participated in “Walk4Brain Cancer”, as well as raising awareness about the Armenian Genocide and Artsakh Humanitarian crisis through donating blood via the “Australian Red Cross Lifeblood” initiative.
In my downtime, I enjoy playing board and card games with my family, my favourites being chess, backgammon and UNO.
Tell us about the ACO course you have recently completed and what inspired you to undertake this?
Last year, I completed the ‘ACO Certificate in Public Health and Leadership in Eye Care’ online course. The reason I enrolled in this course was because I wanted to learn how the public health system works and the role that optometrists have in it.
The course helped me learn about different issues faced in the public health system, how to advocate in the profession of optometry and also about different leadership styles based on evidence-based guidance. My biggest takeaway from this course was from the final assignment which challenged us to address an area of concern in the public health system. The topic I chose for my project was to raise awareness about myopia and reducing screen time via facilitating virtual educational activities for local schools that at the time were home-schooling due to the “stay-at-home” protocol and lockdown in Sydney due to COVID. Through completing this assignment, I felt that I was able to really make a positive impact on my community as an eye care professional during a time of uncertainty.
Do you recommend our members do this course? How would it help our members?
Every Optometrist should have a basic understanding of how our health system works. We are not just eye professionals; we are health care professionals. We have a key role as leaders in protecting the safety and improving the health of our communities. Although this course is online, it challenges you to think outside the box and I encourage young optometrists to always be curious and work towards improving health and social outcomes for all.
The link to sign up for the course is https://www.aco.org.au/certificate-in-public-health-optometry/?utm_source=youngoptometrists and the commencement date is 16th May 2022.
Do you have any advice for young optometrists out there who would like to pursue their passion but haven’t quite gotten started?
I think it is important to initially take baby steps outside of your comfort zone because the beginning is always the most difficult part. Currently, I am taking steps towards improving my cooking skills and learning a third language by watching YouTube videos. The process has been challenging, but then again, small progress is better than none.
Do you find it easy to juggle your optometry career and your other passions?
I think it is easy because the other passions help me become a better optometrist as I find time away from optometry helps me be more energized to tackle stressful situations when they occur. It helps you not be fixated on one thing and at the same time helps diversify your skillset and mindset.
Tell us a bit about yourself and how you got into optometry
Hello, I'm Joanna! I’m a full time optometrist just starting my fourth year out at a practice in the inner city area. When I was about 15 years old, I had an eye test with an optometrist who was so friendly, helpful and welcoming that it completely changed my perception of the optical industry. From then on it opened my eyes to a wonderful career opportunity which I currently find myself in!
In my free time, I also bake cakes and macarons for all the sweet tooths in Sydney!
How did you get into what you’re doing in your time outside optometry?
It all started during the first COVID lockdown in 2020- everyone was doing a bit of iso-baking and iso-cooking back then. What I really found exciting was that there were so many different and new things I could bake and eat. Each baking experience was more challenging and more fun than the last.
Personally, I didn’t think my baking was too bad so I took it a step further and started an Instagram page for my bakes where people can order custom cakes and macarons.
Where can we follow you?
Tell us about your most memorable experiences
For Lunar New Year last year the design for my CNY macarons proved immensely popular and I may have bit off a bit more than I could chew. I spent 2 full days baking until 3am to get all my orders on time which I don't recommend for anyone haha. After baking 500 or so macaron shells I finally managed to get it all done. I was so happy with the final product so it made it worth it in the end!
It can be challenging juggling the logistics of baking cakes and macarons around full time work and getting them delivered on time. Luckily for me some of the baked goods can be done over several days so it gives me a bit of breathing space after a long day at work.
Does time away from optometry help you appreciate it more?
I would say so! Baking gives me that creative outlet that I need and optometry keeps me grounded and balanced.
Take that leap of faith and just do it! Be open minded and manifest your dreams. The best way to learn is through practice and experience :) Good luck!!
Student's Corner is a space which is designed to introduce some of the amazing Optometry Students - delving deep into their likes, dislikes, struggles and current mood. Introducing Karuna Darvesh!
Name: Karuna Darvesh
Student Year: 5th Year, Master of Clinical Optometry Student at UNSW
Favourite Disease: Retinal Detachment
What about Optometry really grinds your gears? (if any!): When patients do not take urgency of referrals seriously.
What drives your passion for Optometry? After learning about the intricate nature of the visual system I have learnt to appreciate my eyesight so much more and want to ensure that no one misses out on enjoying the beautiful gift of clear sight.
Something you discovered about the uni not everyone may know? There is a club and society for everyone. Through becoming involved in different clubs and programs you may learn more about yourself, meet new people and find your true passions.
What is your go to place for food at uni? Stellini Pasta Bar in lower campus has incredible pasta!
Something others may not know about you: I have obtained a Brown Belt in Karate and I will soon be having my graduation in Bharatnatyam - a major form of Indian Classical Dance which I have been learning for 9 years.
What song do you play that instantly lifts your mood? “A Whole New World” from Disney’s Aladdin.
In our day-to-day practice, we never know what eye disease is going to walk through the door. Whether you work in a small rural town or the hustle and bustle of the city, it is essential as an eye care practitioner to have a plan of action to be able to appropriately manage any eye emergencies that may arise. Without a triaging process in place for emergency cases, issues can arise in moments where time is of the essence.
Triaging can begin at the time of appointment booking and can start from before the patient even steps foot into the practice. Training staff who book appointments to ask relevant questions and identify red flags can help determine the urgency with which the patient is to be seen. Examples of red flags include moderate/severe eye pain, photophobia, redness of the eye, reduced vision and foreign body or penetrating eye traumas as well as flashes or floaters.
Once our patient is finally in the chair, where do we start?
A thorough history and symptoms-taking can go a long way, providing us with a working diagnosis as well as guiding our clinical investigation. In many cases, the aetiology can be determined based on symptoms and presentations as well as the patients’ experience. We can uncover risk factors, if current treatments are working, relevant medical histories, medications, and pre-existing conditions, all of which can also guide possible treatments to help patients. Important questions to ask include:
Is it unilateral or bilateral?Any discomfort or pain? Is it getting better or worse? Is the pain constant, intermittent, worse with eye movements? Where is the pain located?Any photophobia?Any loss of vision? Sudden or gradual loss? Total or partial loss? What was the pre-incident vision like? E.g. strabismus or amblyopiaAny discharge? Is it clear/mucus-like/sticky/yellow?Any redness or itchiness?Any recent trauma?Any surgeries? Previous refractive surgery? Was it done overseas (missed follow-ups)?Any systemic illness? Allergies? Medications?Are they a contact lens wearer? Are they compliant or overwearing their lenses? Are they currently using eye drops? How often? When did they last use them? How old is the bottle? Are they preserved?Has this happened before?Any flashes or floaters?Any diplopia?Any headaches? Where are they located? How often? Any history of migraines/visual auras?
The next step is to perform a detailed clinical examination.
It is of extreme importance to perform visual acuity testing in emergency eye cases, both as a visual measurement and for legal purposes. We must always keep in mind that a visual acuity of 6/6 does not necessarily mean nothing serious is occurring. Both eyes should be measured individually using occlusion, whilst being careful not to apply too much pressure to the covered eye. Improvement with pinhole indicates residual refractive error and a best corrected visual acuity should always be obtained in these situations.
Do not forget to look at the patient as a whole! Check if there is anything immediately obvious, for example, if the eyes are at the same level or lacerations/bruises.
Cover Test and Motilities
Performing cover tests at both distance and near is important to assess for nerve palsies. Ocular motility testing is essential to ensure all extraocular muscles are working correctly. It is important to perform in cases of trauma (e.g. blow-out fractures) as well as for nerve palsies, in patients with diabetes, if any complaints of diplopia or systemic conditions such as thyroid eye disease. The Hirschberg test is simple and easy to perform and we can ask the patient to report any pain with eye movement or diplopia.
Slit Lamp Biomicroscopy
One of the most crucial parts of the red eye assessment. A systematic approach is best from anterior to posterior, looking at the:
Pupil testing is a crucial assessment of both the afferent and efferent visual pathways. We test for direct pupil responses as well as consensual, with the swinging torch test used to determine if a Relative Afferent Pupillary Defect is present. We must also measure the difference between pupil sizes in light and dark illumination as this can be used to diagnose certain conditions such as Horner’s Syndrome.
Intraocular pressure is necessary to measure, with a normal range of 10-21mmHg and a difference greater than 2mm serving as a prompt for further investigation. High intraocular pressures can be indicative of acute angle closure, ocular hypertension, primary and secondary glaucomas (e.g. neovascular glaucoma) as well as certain types of uveitis (e.g. Posner Schlossman). A lower eye pressure in the affected eye could also be a sign of uveitis.
Gonioscopy is important to assess the anterior chamber angle and rule out angle closure. Check out our blog on gonioscopy here for further information: https://www.yoptoms.com/Blog/10498873
We must always look at the posterior eye, dilating when indicated to rule out certain sight-threatening conditions such as retinal detachment or intraocular foreign bodies. A systematic approach involves assessing the optic disc, macula, blood vessels and retina both centrally and peripherally.
Infection Control Procedures
Many ocular emergencies present as a red eye. With any red eye assessment, we must keep in mind certain procedures and precautions throughout the examination. These include washing our hands, wearing gloves if required, cleaning equipment using alcohol wipes as well as using minims or strips for assessment to avoid contamination (dilation drops and anaesthetic drops) and using separate tissues and fluorescein strips for each eye in case of viral infections.
Sight-threatening and life-threatening emergencies can manifest in many ways. Below is a summary guide of the Australasian Triaging Scale, a clinical tool used by emergency clinics such as Sydney Eye Hospital to determine the maximum waiting time for certain eye emergencies.
Triage Category 1: Immediate referral for life-threatening conditions.
Triage Category 2: Assessment and treatment required within 10 minutes, otherwise sight-threatening. Examples of conditions include chemical burns (irrigation to be initiated from the outset – no waiting!), penetrating eye traumas (place shield if possible), sudden painless vision loss (Central Retinal Arterial Occlusion) or severe ocular pain (acute glaucoma).
Triage Category 3: Assessment and treatment required within 30 minutes. Examples of conditions include painless vision loss (Central Retinal Vein Occlusion), presence of a hypopyon and an ‘8-Ball’ hyphema (total anterior chamber filled with blood). In these instances, there is a potential for adverse outcomes or relief of severe discomfort.
Triage Category 4: Assessment and Treatment start within 60 minutes, otherwise there is a potential for adverse outcomes or relief of severe discomfort. Examples include corneal foreign bodies (non-penetrating), painful red eyes, flash burns (secondary to welding), retinal detachments (with a positive history for trauma/injury) or a smaller hyphema.
Triage Category 5: Assessment and treatment within 2 hours. These conditions are less urgent and tend to be chronic or minor in nature. Examples include conjunctivitis, blepharitis, chalazion or dry eyes.
Cases of red eye are common in optometric practice and there can be a myriad of causes, some mild in nature that require chronic management and others acute that require immediate attention. If a patient presents with any of these red flags, same day referral to an ophthalmologist may be required.
My name is Edward Lee and I have been practising optometry for about 2.5 years now. I was born and raised in Sydney for 18 years before moving to brisbane where I went to university at Queensland University of Technology (QUT), graduated and started working at Specsavers indooroopilly for 2 years. Recently in 2021 I moved back to Sydney and have been managing an independent practice in parramatta called “Eyes Only”.
Tell us a bit about yourself
If I'm not testing eyes and scrolling/making tiktoks, you can catch me soaking in the sun.
Hobbies include anything outdoorsy: hiking, kayaking, walking by the water, tanning at the beach.
I’m also a bit of a travel bug and really enjoy solo travelling, sightseeing, taking in new cultures and enjoying all the yummy food and wine they have to offer. RIP to previous and future travel plans due to COVID-19 :(
What made you want to study optometry/be an optometrist?
My family was the biggest influence, we have a small family in Australia but nearly everyone is in the optical industry. My mother is an optometrist and my father has been in the optical industry managing 1001 Optical for the past ~30 years. My 2 uncles are in the optical industry and I also have an aunty that’s an optometrist. Growing up, all the chats at the dinner table were about eyes, glasses, contact lenses so I knew from a young age that this was what I wanted to do.
What inspired you to create an Instagram and TikTok page about Optometry?
It all started in the good old 2020 COVID lockdowns. Innocently downloaded tiktok to kill some time, fast forward 2 weeks and i found myself really enjoying and using the platform a lot.
I wanted to make videos on tiktok to reach and educate a younger audience. I thought to myself, people across the world may not have access to eye health advice/information and I wanted to make this more accessible.
I also wanted to change the perception that optometrists and health professionals are boring. I wanted to show that we also have a fun personality and I wanted to do this through educational content.
Now my content has been half about the eyes and giving advice where I can and half just having fun and jumping on tiktok trends (life’s too short not to have fun).
Where can we find and follow your page?
@edwardbisharalee on tiktok & @optometry_with_eddy on instagram
However, most of my content can be found on tiktok.
Fun surprise fact you can also find me on @optoms_of_ig as I occasionally make a few relatable optometry memes for fun and laughs.
Tell us about your typical day or week as a business owner? What do you find are the most challenging aspects and most rewarding?
Typical day for me would include coming into work in the morning, checking in with my team and having a quick scan of the diary for upcoming appointments and jobs that need to be processed/collected.
Once the diary has been checked and managed, I'll usually scan through all the store emails to make sure nothing is being missed and return any missed phone calls or voicemails.
As the day progresses, we will have patients stroll in for their consultations and try to give them the best eye testing/glasses processing experience possible.
Most challenging aspect would be ensuring my staff and my patients are well looked after. Sometimes this can be quite tricky in the face of confrontation or when differences in opinions/arguments arise between customers and staff.
Most rewarding aspect would be having return customers duck in as they are doing their shopping to just pop in and say hi, or returning customers that wanted to duck in and tell us how amazing their glasses/eye test experience was.
How do you keep up with the optometry world?
Mainly through chatting with colleagues, friends and instagram/tiktok.
Just get started. I think too many people (myself included) focus too much on planning and researching their passion and constantly procrastinate and push back the start date. The best way to learn is from experience, it’s okay to make mistakes, to learn from them and do it better next time round. Nobody will be perfect on their first attempt and it’s all a learning process.
This year, I had the absolute privilege of being part of the Optometry Australia student leadership program for 2021. Due to the volatile situation around Australia, the program was celebrated as a virtual fest where we received our certificates, hampers, and gifts to mark the end. Now, when I went into this program, my expectations were very simple.
My perception was that we would be spending the weeks learning more about Optometry and the industry and how to conduct ourselves on a day-to-day basis. However, what we learned as participants of this program was far greater than what I could perceive.
Throughout the weeks, I learnt some of the most valuable lessons about the importance of leadership and being an effective role model than what I may have ever learned during my course. Through facilitation and discussions, we were exposed to the realities of what it means to be an effective leader in the modern day, adapting to the various changes in technology and healthcare in the future and how we need to focus on reflection as a powerful tool to understand what type of leader we are and ways that we can work to improving ourselves towards the type of leader we aspire to become.
Here are three powerful lessons that I learnt about leadership and how it quite poetically relates to my career towards becoming an Optometrist.
1. Take one step back to take two steps forward
When we are so focussed on completing our courses and deadlines, we often forget to take a breath and understand the underlining lessons that we learn from this process. The value of adapting to ever changing situations, how to manage pressure in an effective manner, ensuring that our motivation and goals align with each other etc. The lesson I learned at the program was that sometimes, to become an effective leader that can inspire several people, we need to take responsibility in identifying when we need to reflect upon our actions and the processes in which we are acting in and look at ourselves to discover ways to improve on. Self-improvement in areas such as communication is such an integral component in patient centred care and often, we don’t realise the need to reflect upon how we interact and take the necessary course of action to improve that. Whether this be enhancing the etiquettes we use, our choice of words and vocabulary or even body language, we need to understand that this is a continually improving learning experience. It may take a bit of time but in the long term, this an investment we should be making for ourselves.
2. Being a health advocate, before being an Optometrist.
There is a quote by Simon Sinek where he states that: “A leader’s job is not to do the work for others, it’s to help others figure out how to do it themselves, to get things done, and to succeed beyond what they thought possible.” I learned that being an Optometrist or any healthcare professional means being an advocate. Patients exist in a complex socio-political sphere that is constantly changing and impacting their overall health. Social injustice brings about disproportionate issues in many demographics. Taking the approach that we are leaders in understanding these social determinants and constantly advocating for better ways to conduct practice in our clinics, better patient communication and consistently learning new material that will inadvertently help patients is an approach that we need to take, especially with the changes in healthcare in the near future. We must be better humans and advocates before we can become better professionals.
3. Adaptability is our greatest strength.
Staying on the Simon Sinek trend, as he was an individual we analysed quite deeply during the program, he stated that: “Leaders are the ones who have the courage to go first, to put themselves at personal risk to open a path for others to follow.”
What the last year or so has taught us is that the health sphere is unpredictable. There will be uncontrollable factors and issues that arise in rapidly changing dynamics that we will not be able to keep up with. Acknowledging this change and not giving into the inertia is a productive step that we need to practise as healthcare professionals. We are accountable for how we react to the different obstacles and changes on the road that we have. In every sense of the word, resilience is the strength that will allow us to continue making progress and grow as professionals and as human beings.
The landscape of healthcare is constantly changing, and it requires us to change with it. If I had to take one point from my experience in this program, it is that we need to focus on the fundamentals of leadership and how we can work to inspire the people around us. This is an interdependent ecosystem that we exist in, and we need to work together, adapt together and bounce back together to ensure sustainability and fulfilment in how we see our profession.
About the writer: Jahin Tanvir
Jahin Tanvir is a 20-year-old third-year Optometry student at the Univerisity of Canberra, policy adviser, keynote speaker, author, and multicultural youth advocate. With a penchant for being multifaceted, Jahin possesses a strong background in youth advocacy and healthcare in leading youth-led organisations.
In 2021, Jahin received the 2021 Young Canberra Citizen of the Year in Individual Community Service as well as recognition in the 7NEWs Young Achiever awards for NSW/ACT in the category of community service. Jahin is also a young media spokesperson trained by the Economic Media Centre as part of the Centre for Australian Progress, providing expert media comment on multicultural people's experiences in Australian communities.
Hello! My name is Niv and I’m a vision science graduate from UNSW. I’m currently working as the Health Promotion Coordinator at Macular Disease Foundation Australia. I’m a born and bred Canberra girl who moved up to Sydney for uni. I currently live in Petersham with my fiancé, where I binge on true crime documentaries and charcuterie boards.
After graduating, how did your career path evolve?
I wasn’t too sure what I wanted to do after I graduated! Having a Vision Science degree is so great because you have such a wide array of opportunities at your feet, however by the same token it can also be an overwhelming choice. I toyed with the idea of doing a PhD, but decided that I needed a break from uni (for a bit!) I considered research, but couldn’t find anything I was passionate about. When speaking to my honours course convener she suggested I explore non-for-profit work. I started looking at what was out there and stumbled across the Macular Disease Foundation Australia (MDFA). Although I admit I’m much more of an anterior than posterior eye girl, I loved the idea of working in health promotion and education.
I’ve been at MDFA for just over a year and a half as their Health Promotion Coordinator. I spend most of my time speaking to patients who have been diagnosed with a macular disease, as well as involved in other patient-focused initiatives and advocacy work. Getting to be the first port of call after a patient has visited their eye specialist is a great feeling. I can provide them with all the support and advice they may require during an otherwise very overwhelming time.
Every day in my role is different, and my desire to help people in this capacity originated at UNSW and has since been strengthened at MDFA.
What does your typical day or week at work look like?
A typical week at work prior to COVID-19 was very different to what it is now. Currently it’s all working from home, which I’m very fortunate to do. As I mentioned, I spend most of my time speaking to patients on the phone. Many come to us quite distressed after just receiving a macular disease diagnosis from their optometrist or ophthalmologist. I speak to them about their condition in layman terms and offer support services and resources that may assist them on their journey.
I also work with data a lot, which I surprisingly enjoy. I’m in charge of pulling patient and health care professional data and statistics for our community and try to manipulate them in a digestible way.
Another big component of my job is coordinating education sessions for seniors i.e. those most at risk of age-related macular degeneration. As you would all well know, prevention and early detection is key, so we work with our community to ensure their armed with the best resources to reduce their risk or slow progression of macular disease.
What are some obstacles you have experienced, and how did you overcome them?
My honours research project was investigating the role of intense pulsed light in contact lens discomfort. The inclusion criteria for participants was particularly niche and made it quite difficult to obtain the number of participants required for stats purposes.
Despite all our best efforts, I didn’t manage to get as many as I needed. Instead of scrapping the entire project, I pivoted to a completely different research proposal. I kept the participants I had, and created a small-scale, intimate version of my project where I could follow each participant individually. I also started writing additional papers to explore other aspects of my research, which in turn led me to publish two papers in CXO which was super exciting!
I’m guessing the moral of that story is don’t be afraid to pull a Ross Geller and pivot, pivot, pivot when necessary.
Where do you see yourself in the future?
I’m not too sure what the future holds. Career-wise, I hope to still be working in the education/innovation space within the general field of eye health. On a more personal level, I hope that I get to have my wedding (COVID-pending) and I hope that I still love true crime and blue cheese!
What do you know now that you wished you knew when you were a student?
I wish I didn’t sweat the small stuff. Failing one weekly quiz isn’t going to be the end of the world. As someone who can be a tad perfectionistic at times, if one thing didn’t go my way I felt that I may as well just chuck the whole thing out.
Learning to persevere through the setbacks was a lesson that took me a few years to truly understand. Gaining that state of mind really changed the game for me.
What advice would you give to a vision science student who is pursuing a career as a vision scientist?
Vision science is a pretty broad field, so it can become overwhelming when considering job prospects. Uni will unintentionally give you so many opportunities for growth and new interests, so grab them with both hands. It’s cliché, but I think I still wouldn’t have found my niche if it wasn’t for saying yes to every opportunity that came my way. Those opportunities may just open doors to things you didn’t even know were in your reach.
Why did you start up a business and how did you go starting it up?
We wanted to venture out of being an employee and practice how we wanted to practice. We started our practice because we are passionate about providing holistic and evidence-based eye care that was patient-focused.
We first started off as a part-time practice from home in 2018. This operated after-hours and we also provided home visits, because we noticed a gap in the industry in these 2 areas. Starting up a practice involved doing a lot of research into how to run a business and learning about all the legal and financial aspects behind it. Megan did a Certificate IV in New Small Business, which was a good starting point. We also had discussions with other colleagues and other consultants.
Our patient base started to grow and we realised that we were outgrowing our space and entertained the idea of expanding to a full-time practice in a shopfront. By October 2020, we expanded our practice to a shopfront in Wentworth Point.
Should I take over a business or start brand new?
This is a big decision and it really is up to the individual. There are definitely pros and cons to both options and it is important that you weigh these up thoroughly and seek professional advice before you make a decision.
For example, taking over an existing business means that you already have an existing patient base. This has advantages in cash flow. However, this may also mean inheriting procedures and systems which you may not necessarily agree with. Making changes to these systems may lead to loss of some of your existing clientele.
Alternatively, starting brand new means it is a clean slate and you can set your practice how you want it from the beginning. However, it will take time to build a reputation and patient following.
These are just some things you need to consider before you make your decision.
What are some key points I should consider when going from employee to employer?
If you want your business to succeed, be prepared for long hours, taking work home and doing a lot of things outside the consult room. It is a steep learning curve because you now need to learn your legal obligations as well as be well organised in your administrative and managerial duties. However, we think it is incredibly rewarding in the long run because we are now able to do what we are passionate about without restriction.
How is your work life balance as a business owner?
Work life balance is an incredibly challenging aspect of being a new business owner. Aside from running a business, we both have other commitments and hence this is an area we are still working on HAHA ^^”.
What was the biggest obstacle you encountered during your journey, and how did you overcome it?
Work life balance and time management would be the biggest obstacles that we have encountered so far.
We have been working on these areas by improving efficiency within the workplace and scheduling in personal time so that it is not all work. We hold each other accountable so that we both don’t stray from our goals. Having a good support network really helps especially during challenging periods.
What advice would you like to give to all the YOs that are interested in opening their own business?
Running a business is like planting a tree. Do your due diligence and make sure you think it through before you make the decision. Plan it out. You need to find the location and prepare the land first. Then, you will plant the seed, nurture it, and protect it from the storms. Trees do not grow overnight. It takes time before you can reap the rewards.
There are many benefits associated with owning a business. However, be prepared to work hard as it is a massive investment and time commitment and expect some personal sacrifices along the way.
Tell us a bit about yourself and how you got into optometry
Simon: Like a lot of people, I didn’t really know what I wanted to do after high school. But the reason why I end up picking optometry was because pretty much everyone in my family – parents, sister, grandparents, uncles and aunties all wear glasses. I on the other hand somehow ended up emmetropic so I thought maybe I could become an optometrist to help the family out.
Where can we follow your adventures?
Instagram - @campingwithus
Video of our van build: https://www.youtube.com/watch?v=lB6OyX0VbAU&t=8s&ab_channel=Campingwithus
Being optometrists, we do spend majority if not all of our working day cooped up inside a room. Both of us love being outdoors so we try to get out when we can to balance it out and mobilize those joints that get stiff from sitting all day.
Our van life journey started when NSW went into lockdown last year. Like majority of us we weren’t able to work. Being locums we both didn’t have work for a few months so we decided be productive and tick off a bucket list item which is to travel Australia in a van. We needed a van first of course so we started researching, learning from youtube videos and ended up spending about 3 months building our travel home.
Tell us about your most memorable experiences
One of my (Simon) favourite hobby is fishing. Being able to travel to all places in Australia allows me to target different species that are more local to a certain area. When we went down to Victor Harbor in South Australia, I wanted to tick off Bluefin Tuna off my list. Managed to hook up a 15kg fish and we spent the next week trying to finish eating it. We love being able to rock up to a place, pull out a chair and table, eat what we catch and enjoy the beautiful scenery Australia has to offer.
Both of us have locummed for at 5+ years now and it has its ups and downs. One of the reasons why we decided to locum was because it gives us the flexibility to travel. I guess we are quite lucky to be able to do what we do as there aren’t many professions that allow you to take months off at a time. There are times where jobs can be scarce but in general, we try to load up on jobs during the busier periods and take time off when it gets quieter. So far it has worked well for us.
We definitely think so, we both love what we do at work but at times you do feel burnt out so it really helps to get away from it every now and then.
Just do it! If you keep holding off for whatever reasons there will always be a reason to not do it. Sometimes it just takes a leap of faith to get the ball rolling. Be open minded and flexible. Live with no regrets.
Gonioscopy is an important technique that enables viewing of the iridocorneal angle and allows assessment and diagnosis of different eye conditions.
Best practice standards for accurate diagnosis of Glaucoma are detailed in the National Health and Medical Research Council (NHMRC) guidelines. These include a comprehensive medical history (to identify risk factors), a full eye examination (including gonioscopy), an assessment of visual function (visual field analysis) and measurement of intraocular pressure.
Reasons for performing gonioscopy – what am I looking for?
Open-angle Glaucoma versus Closed-angle Glaucoma
Gonioscopy is important to perform in both patients with Glaucoma and patients that are considered Glaucoma suspects. It is a crucial box that needs to be ticked on your Glaucoma work-up checklist, to determine if an angle is wide open, narrow or closed. It can also detect the presence of peripheral anterior synechiae (PAS), a sign of chronic angle closure, and in certain instances can be used to break these aberrant connections of iris to anterior angle structures.
An angle is considered to be occludable when the pigmented trabecular meshwork (PTM) is visible in less than 90 degrees of the angles’ circumference. This is determined using gonioscopy with the patient in primary gaze. If a patient is deemed to have an occludable angle, this is an indication for laser peripheral iridotomy (LPI).
Gonioscopy allows for the identification and appreciation of subtle findings such as pigmentation within the angle. Secondary glaucomas like Pigment Dispersion Glaucoma (PDG) will demonstrate very dark pigmentation of the trabecular meshwork (even, tiramisu pattern). In Pseudoexfoliation Glaucoma (PXG), white fluffy material can be seen in the trabecular meshwork. Sampaolesi’s line can be present in both PDG and PXG and is visualised as a dark pigmented line situated anterior to Schwalbe’s line.
Angle recession occurs due to rupture of the longitudinal and circular ciliary muscle fibres following ocular trauma. With gonioscopy, this appears as a localised area of iris bending posteriorly instead of running flat and can also be seen as widening of the scleral spur. Since patients can develop Glaucoma secondary to angle recession after days, months and even years, it is important to perform gonioscopy in cases where there has been ocular trauma both recently and in the past.
Neovascularisation of the angle
Gonioscopy can be used to detect growth of new blood vessels in the anterior chamber angle. These abnormal vessels are leaky and can cause inflammation. It can also lead to scarring and narrowing of the angle. Gonioscopy should be performed in patients at risk including those with a history of Central Retinal Vein Occlusion, proliferative Diabetic Retinopathy, or other retinal ischaemic conditions.
Helpful Gonio Acronym
Corneal or conjunctival inflammation or infection
Lacerated or perforated globes.
Significant corneal abrasions or erosion
Significant epithelial basement membrane dystrophy
NHMRC Guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma 2010 https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp113_glaucoma_1204 04.pdf
Herschler J. Trabecular damage due to blunt anterior segment injury and its relationship to traumatic glaucoma. Trans Am Acad Ophthalmol Otolaryngol .1977;83:239