Introducing Martin Diep (MOptom BOptom BSc FACBO) from  See Optometry, Victor Harbor SA. He has a special interest in Behavioural Optometry and is doing some amazing things in the world of Vision Therapy and Binocular Vision. Read ahead to find out more! 

Tell us a little bit about yourself and how you got into Behavioural Optometry

Born and raised in Sydney, I studied Optometry at UNSW and graduated in 2014.  My first gig was in regional South Australia in Port Augusta, a small town of 14,000 people 300km north of Adelaide, where I worked for 4 years before moving to my current practice in Victor Harbor, 80km south of Adelaide.  It only took me a few months after graduating when I realised that my undergraduate degree only taught me the bare basics needed to survive the world of optometry, and I needed to upskill myself to actually know what I was doing, especially with patients with visual symptoms but no clinically significant visual findings. Hence I started my journey into the world of behavioural optometry; getting my Masters degree through UNSW in 2017 and my Fellowship with the Australiasian College of Behavioural Optometry (ACBO) in 2019.

-Tell us about your typical day or week at work

Optometry in my practice probably looks a bit different from a regular city optometry practice. On top of all the regular optometric clients, I also do a fair few paediatric consultations that have been referred by other optometrists and educators for learning related vision problems.  These include a full binocular vision check as well as a developmental information visual processing check where I investigate problems with reading eye movements, visual spatial dysfunction, issues with visual analysis and visual memory, as well as visual-motor and visual-auditory integration skills.  Throughout my week, I also do in-office vision therapy with my clients for a wide range of visual dysfunctions, from convergence insufficiency, to learning related visual dysfunctions and post traumatic vision syndrome following concussions and strokes.

How did you get into this unique area of optometry?

It took me about three months after graduating when I realised that there were a lot of patients where I could not explain the symptoms they were getting from the tests that I got taught at university and so I started trying to find some answers.  I knew there was a gap in my knowledge (which were not a result of falling asleep in many lectures at uni!)  I discovered that ACBO offered many postgraduate courses that covered the topics that I was least confident about and decided to go to the Art & Science course offered by the Optometric Extension Program.  That was when my I realised that there was SO much that optometrists could offer clients that was not even mentioned during undergraduate study!  As I learnt, I discovered how optometry is really the only profession that has the functional vision science knowledge to provide services for vision development, enhancement and rehabilitation and this opened up my world to the optometric management of developmental delays, autism, brain injury, sports vision and other visual issues that conventional optometry has no way of treating.

How do you keep up with the optometry world?

Postgraduate courses are the crux of my professional development.  I go to more postgraduate courses than that needed to meet my minimum CPD requirements; at one stage I racked up 350-odd CPD points in one registration period!  Keeping up with colleagues in the industry is also a great way of keeping in touch with what is happening in optics and it gives me great ideas on how to implement changes to my practice to enhance the patient experience.

Do you have any goals for your optometry career?

In Australia, the delivery of vision services to brain injury clients is abysmal.  Even a basic visual acuity check, refraction and gross assessment of binocular vision is severely under-valued in hospitals and rehabilitation centres around the country.  It is one of my goals to increase general awareness of the huge impact brain injury can have on the visual system and that optometrists can fix a lot of these problems with a simple pair of glasses. 

I would also love the general optometric community to begin to understand that the unique tools that we have access to - lenses, prisms, tints, filters - can be used in more than one way. I want to encourage other optometrists to think outside the box; think about the person as a whole and how can you use what you have in front of you to change their lives for the better?  For example, using based down yoked prisms in a CNIV paresis to eliminate diplopia on downgaze when reading. Sometimes the solution is easier than you think!

What keeps you sane outside of your work life? Do you have any hobbies or passions you pursue?

My hobbies are what keep me sane enough to to work in a high pressure environment with clients with complex needs.  I work out regularly, 5 days a week at the gym and run a few times a week.  I would like to think this is to keep fit, but in reality it’s to offset my love of baking for friends and family (and myself)!

What advice would you give to other optometrists who also wish to pursue this area of practice?

To be successful in behavioural optometry, you must approach it with an open mind, and be ready to learn and learn and learn. Once you start, you only then begin to realise how much you don’t know about the very job you’ve been trained to do and have been doing for the last however many years. ACBO is the best resource for optometrists looking to further their knowledge on binocular vision, learning related vision problems, and higher level topics like brain injury and sports vision.  They have material of all levels that can meet your needs regardless of how in-depth your knowledge is in the area.  Colleagues that have been practicing behavioural optometry for decades still benefit hugely from the ongoing CPD they provide.

It's easy to get stuck in the bubble of Optometry. What's something that you wish people knew about behavioural optometry?

Optometry is not just about subjective distance refraction and eye health. Don’t get me wrong; they are hugely important and they are the basic things all optometrists must test, but there is a whole other level of fundamental visual functions that a lot of optometrists do not even consider.  For example, when was the last time you thought about fixation, let alone test for it? How do you even test for it?  When you really think about it, what are the basic visual skills a person must have to even read your logMAR visual acuity chart? A few come to mind with examples:

●       Accurate fixation and saccadic movements - to even know where to look let alone read across the line without skipping letters or confusing lines

●        Accommodation - think of the psuedomyope with poor control of accommodation in the distance

●        Vergence control - divergence excess strabismus have poor vergence control in the distance

●        Visual spatial skills - how do you distinguish between an S and Z when they are fundamentally the same squiggle, just mirrored?

●        Visual discrimination - how do you differentiate between a Y and V when one just looks like a longer version of the other?

●        Visual figure-ground & central-peripheral control - How do non-amblyopes isolate the letter they are fixating on without getting distracted by all the other letters around them?

●        A proper understanding between spatial concepts like text with temporal concepts like speech - How do they know that the visual representation of “A” is the same concept as the sound it makes?

How do you think a child with these vision problems would do at school with reading comprehension and spelling? They may see 6/6 and refract plano but there is so much more at play here and you as the optometrist can be the one who changes their lives.

It's almost the best time of the year... Christmas! It's not unusual for patients to bring in gifts, such as chocolates, or a bottle of wine. But, can we accept these gifts? Where do we draw the line? 

Consider the following scenarios:*

• Margaret is a long-term patient of yours that you see monthly for epilations. Just prior to Christmas she gives you a large box of chocolates and a card thanking you and the staff for your care. 
• Ben is a new patient of yours and he comes in on a Thursday night with a very expensive bottle of wine and two Gold Class Event tickets, to thank you for the detailed eye assessment. 
• John was a long term patient of yours and you were co-managing his glaucoma. Sadly he passed away, and his wife comes in and gives you $2000 in cash as a token of her gratitude. 

Most gifts are innocent gestures of goodwill, and patients don't give these expecting preferential treatment or something in return. However, beware the patients who may have other motives - some may think their gift entitles them to additional services, you squeezing them in during your lunch break or bending the rules just for them. If you accept their gift, you might find it difficult to refuse their demands and requests. If you reject a gift, remain tactful as otherwise the patient may interpret this wrongly and be hurt by the gesture. You could explain the rejection in terms of a general policy and/or ethical obligation, for example "I really appreciate the gesture, however our office policy doesn't allow me to accept such a gift.“

Realistically accepting small gifts is reasonable, however monetary, large gifts or personal items might be considered unethical. Of note, the Medical Board in Good Medical Practice: A Code of Conduct for Doctors in Australia writes:

Doctors must be honest and transparent in financial arrangements with patients. Good medical practice involves… not encouraging patients to give, lend or bequeath money or gifts that will benefit you directly or indirectly.

So what happened in the scenarios?

• You thanked Margaret for the chocolates and shared them with the office.  
• You thanked Ben for the gesture, however politely declined this. You felt uncomfortable with the gesture and after discussing this with another optometrist at the practice, they offered to take over the care for Ben.
• You told John's wife you were sorry for her loss, but could not accept the monetary gift. She decided to donate the $2000 to Glaucoma Australia instead. 

Here's a great article from MDA National if you want to read more.

What to say to your boss when you’re planning on quitting

Firstly consider, do you actually WANT to quit? We all have those bad days at work that make us want to quit, but are you simply acting on anger? Can you discuss the situation with your boss? Have you tried discussing this many times before, and it’s obviously a dead road? Is there anyone else you can talk to in the company who may offer you insight? If you think it’s all a matter of miscommunication and can be salvaged, maybe reconsider quitting.

However, if you’re ready for new adventures and are sure about quitting, what do you do?

How do you deliver the news?

Focus on the positives and what the job has taught you. Let your boss know how appreciative you are for the opportunity, but you are ready to move on. It may not be worthwhile bringing up petty disagreements you may have had.

Giving notice

Read over your contract, most organisations require 2-4 weeks’ notice of leave. Give notice in the form of a resignation letter, emphasizing on the positives and how you have benefitted from your time there and offer to help during the transition. Make sure you detail your end date with them.

Restraint of Trade

Read over your contract, do you have a km radius restraint, and if so for how long?

Do you have a job lined up?

Whilst Optometry is thankfully very flexible, consider having a job lined up. Will you take a break and or holiday in between the jobs? If you are unsure about your next workplace, consider sitting in for a few days first to see if you are the right fit for the practice.

Ask your boss for a reference

It’s wise not to burn bridges before you leave! Ask your boss for a written reference, especially as time moves on it, it may be difficult to get a hold of these references, especially if you need these quickly.

Return Company Property

Return any company property, such as company keys, uniform, intellectual property, company equipment, or car (if you were lucky enough to have one!). Do not take any patient information, although this should not leave the practice in the first place.

Telling patients you’re leaving

Over the years you may have built a very strong bond with your patients. It would be respectful to tell them you are moving on and another optometrist will take over your care. If you are certain patients, such as vision therapy cases, which require your care – consider finishing off their therapy or referring them on so they are able to receive best care.

Our 'Unconventional Optometrist' column is where we chat to optometrists who are a bit out of the ordinary! Do you know anyone who we should feature? Let us know!

Here's this month's Unconventional Optometrist. Sarah Pham is an optometrist who works in metro Sydney and has pursued a side career in Events Planning. Read on for her thoughts on how to keep interested in Optometry and how to follow your passions. 

Tell us a little bit about yourself

My name is Sarah Le Pham, 2016 UNSW School of Optometry graduate. I predominantly work a mixture of corporate, mobile and independent practices based in Sydney metro.

Since graduation, I’ve been actively involved with the excellent and devoted Young Optometrists (YO) as an executive for 2 years prior to help bridge the gap between the generations of optometrists which has been very rewarding.

At the same time, I’ve looked into various specialties and discovered that all of them were interesting in their own right. OrthoK and myopia control particularly tickled my fancy! I’ve tried to go further and look at different demographics as the care and management require different finesse.

In terms of who I am, words that are commonly used to describe me are compassionate, curious and enthusiastic. I’m constantly on a journey to try different things and have the most fulfilling experiences in life!

Tell us about your typical week at work 

Every week has been very different hence there’s no such thing as a typical week for me. This is quite refreshing for me personally however I do understand it may not work for everyone!

In my circumstance, my work is deliberately irregular to give myself an opportunity to explore my other interests (more below).

How do you keep up with the optometry world? 

The advantage of optometry being a niche community is that it is not too difficult to keep up. There are CPD events, articles published online and groups (YO, OA etc) that promote discussion.

Being the nerds we all are, even just a regular catch up with the friends you’ve made during university (who have now become your colleagues), talk about developments in optometry come up!

Do you have any goals for your optometry career?

Optometry is constantly changing and consequently, I want to constantly focus on improving my skills and overall care for my patients. My goal is to be a better optometrist than yesterday! 

What keeps you sane outside of your work life? Do you have any hobbies or passions you pursue?

Keeping up with my attitude to trying different experiences, I’ve actually looked into various jobs and hobbies outside optometry. As much as I like optometry, I would not stay sane if every breathing second was about optometry!

I’ve pursued a side career in Event planning. Nothing as extravagant as weddings, but I’ve delved into parties and smaller scale events! (Birthdays, hen’s night etc). This is ongoing as there are always projects for me to get in touch with my artsy and creative side where the precise and logical optometry career path may not allow!

For a busy practice, one might find that they spend the entire day sitting in the consultation room (can’t be helped!) but it does not contribute to us achieving our active needs. Hence, I’ve involved myself in playing a team sport (Volleyball) in my free time which has evolved into a passion allowing me to eventually be appointed Captain of the newest and developing rep team.

What advice would you give to other optometrists who also wish to pursue something a little out of the ordinary?

You’ll never really know if you like something or not unless you put yourself out there and try it!

It's easy to get stuck in the bubble of Optometry. What's something that you wish people knew about the industry you work in now? 

Yes, it is important to grow as a practitioner and deliver your best care but I personally think it’s equally important to mix things up so that you don’t get burnt out!

As rewarding as Optometry is, I find that there are some aspects that the career simply cannot offer. To really pursue a fulfilling and balanced lifestyle, it’s a good idea to look into things outside of Optometry. 

Author: Austin Tang

Mr. Smith who you remember just purchased his $1000 multifocals just a couple of weeks ago comes in and tells you that he just can’t see well out of his right eye… that things just aren’t as crisp and that something’s just not right but he can’t pinpoint it. You vert the glasses and the cyl in each eye has been made correct to the nearest degree: Rx: +1.00/-0.75x66 with a +2.25 Add. Then you go to check the heights and PDs and nothing’s out of line.

Then you remember you actually never saw him; he had brought in his prescription from down the road. You have a closer look at the prescription and its from 6 months ago. Mr Smith says he could see even better out of his previous glasses, so you take those and vert them and see if there’s any difference. The vert reads +1.00/-0.75x 166with an add of +2.25. Axis 166?!

Patients have the right to have their prescriptions dispensed wherever they choose, whether that is where they’ve just had their eyes tested by yourself or whether it’s elsewhere. However, it is often more difficult to resolve any spectacle related problems when prescribing and dispensing are separated. In the case of yourself and Mr Smith, you’ve figured that there well and truly could have been a typo in that outside prescription, but the lenses that you’ve ordered have been made to the prescription that has been presented to you by his optometrist. Or it could have been that his prescription could have changed since his last refraction? You do a quick refraction to get more information and you get +1.00/-0.75x170 and your thoughts on a possible typo heighten.

There are many factors at play in this situation. There can be both prescription and dispensing errors. Difficulties can become more apparent in cases of complicated prescriptions such as those involving high prescriptions, high degrees of astigmatism, prismatic correction, anisometropia and paediatric dispensing. Even aspects such as frame and lens selection could play a large part in a patient’s visual experience.

So who’s responsible in this situation? It can be a grey area. One could argue that the given script was incorrect and it should be the prescriber at fault, since the glasses were made exact to that prescription. However, the prescriber could also argue that they do not take liability of the prescription if it is dispensed elsewhere. 

Some strategies to overcome these situations including educating the patient on the potential difficulties of separate prescribing and dispensing, particularly if they have a complicated prescription or lens form. It can also be suitable to include a disclaimer when releasing prescriptions that states that there is no liability taken on the prescription if taken elsewhere. A refraction check could also be carried out prior to dispensing if the prescription is not recent or if the patient feels that there has been a visual change since the last prescription. Simple steps such as trial framing an outside prescription could also help with reducing such situations.  

Author: Linda Lam 

25% of the population manifests anisocoria as a normal, routine examination finding. The hallmark sign in lesions of the pupillary efferent pathways is anisocoria. 

Changing consulting room illumination helps to differentiate between physiological and pathological cases.

Always test both light and near reflexes and test for a relative afferent pupil defect (RAPD). If an RAPD is present it indicates a problem with the optic nerve. 

A quick refresher on some differentials to consider when it comes to pupil reaction:

• Adie’s tonic pupil: post-ganglionic interruption to parasympathetic input to the sphincter pupillae and the ciliary muscle resulting in an internal ophthalmoplegia. Typically in young adult females. Supersensitive to weak pilocarpine (0.1%). No ptosis or motility detected.

• Horner’s Syndrome: due to a compromise of the sympathetic pathway from the brainstem to the eye. It may be described as pre-ganglionic or post-ganglionic depending on whether the causative lesion is situated prior to or beyond the superior cervical ganglion. The affected pupil is smaller with ipsilateral ptosis. If heterochromia is observed it suggests a congential lesion. Reaction to light is normal. Pharmocological evaluation is performed with apraclonidine 0.5% or 1% phenylephrine.

• 3^rd nerve palsy: The patient can present with ptosis, eye diverged, no accommodation, pupil dilated and fixed. If acute suspect an aneurysm if the pupil is dilated, ischemia if the pupil is spared. This is a medical emergency and the patient requires immediate imaging

Pupils are quick and easy to assess and should be done routinely. A thorough case history is also vital in determining acute or chronic cases, especially if the patient has had head trauma in the past.

Join us in welcoming Lucia to the Young Optometrists NSW/ACT Subcommittee! Lucia graduated from UNSW in 2012 and has experience in both regional and metropolitan practices. Keep an eye out for her. 

Read on for our Q&A with Lucia. 

Tell us a little about yourself?

I graduated from UNSW in 2012 and since then I’ve worked in both regional and metropolitan practices, as well as a short stint in London, taking advantage of the Youth Mobility Scheme to work and travel around Europe. I’m currently working part time in Western Sydney due to recently starting a family and deciding to undertake further studies in optometry.

How did you end up in optometry as a career?

Optometry appealed to me because it is a stable and fulfilling job, which allows me to help people by resolving their visual concerns and also work with other healthcare professionals. I’m now also beginning to appreciate the flexibility, good work-life balance and various opportunities in career development.

What are you most passionate about outside of optometry?

I enjoy running as it really helps to clear my mind and relieve stress. I also like it for the way it challenges my mental toughness as ultimately, I choose when to stop. I love watching sports, especially basketball; and spending time outdoors, exploring new places.

What inspired you to join YO as a subcommittee member?

I’ve really enjoyed reading the YO blog posts (Unconventional Optometrist and Real Talk) and have found them to be very informative and relevant. I was then compelled to join YO and assist in furthering the goals of facilitating career development and networking opportunities for young optometrists.

How would you spend your free time?

I’ve started to read a lot more this year, trying to maximize the little “me time” I have outside of looking after a toddler. I also enjoy journaling, travelling and playing board games with my friends.

If you had one superpower, what would it be?

Being able to speak the language of whichever country I find myself in. 

Our 'Unconventional Optometrist' column is where we chat to optometrists who are a bit out of the ordinary! Do you know anyone who we should feature? Let us know!

My name is Sujan Hong and I am a Korean-Kiwi-American... and soon to become an Australian. I have identity crisis when I have to cheer for sports teams... haha. 

What can I tell you about myself?

1.      I have 6/6 vision and hadn’t been to an optometrist before studying optometry at university.

2.      The primary reason for choosing optometry was because I wanted a respectable degree as a back-up to figure out what I really wanted to do with my life.

3.      I graduated with a BOptom, University of Auckland and practised in Auckland, New Zealand as an optometrist for a few years before leaving. 

4.      Music has always been a big part of my life! I never considered music as a career, but I was fortunate enough to have met a very inspiring music teacher during my high school years who helped me to discover my talent and “almost inspired” me to take up music professionally. 

5.      I have ABRSM, Royal School of Music for Piano Performance and AmusTCL, Trinity College London for Music Theory. Teaching music could also be a backup career if I really want a career change (!) - although I feel a bit rusty now. I also played timpani with various youth and community orchestra.

6.      After optometry, I wanted to travel the world and decided to study Computer Programming.  I hated Programming, but landed an amazing opportunity to work as a project manager for a software company. 

7.      Working in a start-up environment was great experience - it means you have to be really flexible and willing to learn something new - all the time.

8.      I briefly worked for a Product Development and Design team with Benefit Cosmetics in San Francisco.

9.      I was involved with multiple non-profit organisations in San Francisco and also had my own personal social organisations with over 2000 members (between the two groups)

10.  I had a brief appearance in The Five-Year Engagement starring Jason Segel, and played “That Korean Girlfriend”.

11.  I worked as a relief optometrist around NSW with OPSM for a few years.

12.  I currently work as Professional Affairs associate with Alcon. I am loving every minute of my job! Please note that the roles of Professional Affairs and Business Development Manager (AKA BDM or rep) are different, and shouldn’t be confused.

13.  I don’t really think I knew such a role  (Professional Affairs) existed before joining Alcon – so now I make a point of letting optoms know the roles that we each play in helping you grow as an optometrist and as a business.

How did you become involved in helping in a restaurant? How long have you been at it for? Where can we visit your restaurant?

I am a big foodie.  I have eaten at many different places around the world and in my hometown, and I also enjoy cooking (I probably have every imaginable kitchen gadget in my kitchen except for Sous-vide which is next on my list). 

I have always been interested in learning something new and helping others, and I ended up helping some friends set up their new restaurant business. The restaurant, Yuzu Dining is located in North Strathfield, which is about 30 mins drive from Sydney CBD.

Tell us about your typical day/week at work

What I love about my job is that there is no typical day / week at work. Even when I was working as a relief optometrist for OPSM in NSW, there was no typical day and week - as I was in a different practice working with different people every day / week.

Currently, my week may look like:

Monday: Presenting - Deliver an educational talk to optometrists about how to manage dry eye patients with Alcon’s range of products.

Tuesday:University - Teaching final year students how to fit multifocal contact lenses easily and successfully.

Wednesday:  In office prepping follow-up for Monday’s presentation and university teaching session; respond to key questions from client groups and return emails to stakeholders. Set up key meetings for next week and identify what resources are needed. Book flight to next month’s Optometry conference.

Thursday: Liaise with major conference (on Friday) and finalise Agenda and key speaking points. Send through PPT presentation slides and add in 30 sec video to support presentation. Confirm travel and accommodation for next month’s educational roadshow.

Friday: Major Optometric Conference – Introduce a speaker to educate the attendees on how Alcon’s technologies can be used in everyday optometric practice. 

The highlight of my role so far is probably attending the 2019 Asia Pacific Optometric Congress in Manila last month.  Seeing the scope of optometry in the APAC region was phenomenal, and optometrists in Australia and New Zealand are so fortunate to be able to practice with such a big scope.

How did you get into this unique area of optometry?

LinkedIn!  I was contacted by a recruiter and after several rounds of interviews, got into the business. I wasn’t actively looking for a new opportunity, but sometimes they come knocking at your door. I feel so proud to be working for a company with integrity and huge focus on R&D and feel fortunate to work with so many other smart people and learning something new all the time.

How do you keep up with the optometry world?

Through YOU!  I get to meet a lot of optometrists as part of my job. Whilst I may be the one training optometrists, I also learn a lot from the way you all practice.  I love being able to share what I learn from different optometrists – such as tips and tricks of the trade – and bringing these back to you so that you can all be the best at what you do. This cycle of listening, participating and sharing back is how I can give back to our society – practising optometry vicariously through you!

Do you have any goals for your optometry career?

In the past, I was fulfilled through providing the best clinical advice and service to each individual patient that I saw.  Since working in my new role with Alcon, I’ve realised  that I could have been even better as an optometrist had I known even half the things I have learnt since joining the company. Because of this, I’m always eager to share as much as I can with every optometrist I meet and in the future, I’d like to bring together optometrists so we can work together to make the industry stronger. I also wish I could incorporate the scope of optometry in the Asia Pacific region and create stronger alignments with what we do in Australia and New Zealand somehow.  Australian optometrists are very fortunate to have Optometry Australia working continuously to keep our industry strong.   Some optometrists choose not to become OA members because of cost involved (myself included!) but Tim Grant, who is the Head of Asia Professional Affairs for Alcon and is also like a godfather figure when it comes to silicone hydrogel contact lenses (he was part of the team that launched first ever silicone hydrogel contact lenses in the WORLD with CIBA vision) said something very poignant.  He said “We pay forward with our fees to OA. The fees paid by previous members are why we are in a strong clinical position, same for us to pay forward for future development even if we do not receive the benefit.”  I couldn’t agree more and was again grateful to work with and to learn from a great leader in the industry.  (and I will be joining OA for this reason!)

What keeps you sane outside of your work life? Do you have any hobbies or passions you pursue?

I love to eat! But in order to eat, I have to exercise! One thing I miss due to my travel and work is being able to do a daily workout.  I used to cover K-Pop and upload to my personal YouTube channel. I also used to transcribe music for subscribers, so they could play what I play by ear but I don’t really have time to listen to or play piano either. If I had the time, I would love to learn the guitar and the violin (since they are both more portable than a piano!).  If I had more time, I would brush up on languages learnt and learn a new language – if I can speak Japanese, Chinese, Spanish and French enough to have a conversation - I would be happy!  Other than that, I love all living things and enjoy planting and seeing my compost worms eat and reproduce.

It's easy to get stuck in the bubble of Optometry. What's something that you wish optometrists knew about other industries?

I think for most people, once they get into a certain industry, they stay in it for the long haul for various reasons.  Sometimes you may want a career change, but the industry may not be willing to take on someone mature even if you are willing to start from an entry level position.  Alternately, it may be hard to let go of what you already have and to start afresh. 

I think being a specialist in one industry has its merits - but I think it’s important to know whether you want to be a specialist in that one industry. You may not know until you have had exposure to a wide variety of industries whether your passion lies in that industry, or if in fact you want to be elsewhere. When I started out, I never had the mindset of being in optometry for the long haul, so that’s maybe why I ended up exploring other options. 

Following the various experiences I have had and growth in understanding of myself, I’ve identified that my core professional motivation was to work in an industry where I can make a genuine difference in the quality of life of people. To me, this narrowed my focus to the healthcare industry, but I don’t think I would have come to that conclusion if I had stayed in Optometry for 10 years.

From my perspective, if you want to explore other options, put 200% into whatever industry you settle on, and give yourself a decent time period to get invested and explore where you and the industry fit before evaluating whether to stay or go – I recommend this as what you experience and learn within 3 months is very different to what you’re capable of learning over 3 years.

What advice would you give to other optometrists who also wish to pursue this type of optometry?

I think being an optometrist is a wonderful and rewarding career even though it can be disheartening for some with the current direction of the industry.  If we continue to provide our patients with what we have signed up for when we started our degrees – that is, providing primary eye care and making a difference in the quality of our patients’ lives with passion and empathy – then we’ll have the impact we seek. I hope over time people will appreciate and see the important role that optometrists play in this society.

Having optometry background also doesn’t limit you to consult rooms either. There are professional affairs / services roles with various optical and medical device companies where your role is to educate other eye care professionals on how to most effectively use their products to provide best eye care. You can also head non-profit organisations such as Eyes4Everest or Glaucoma Australia to provide eye care for people with limited access to such services; and to raise awareness about certain medical conditions that maybe affecting the eye. 

Or maybe you can simply go into a totally different industry!  What you learn at university is only a foundation for what you need in your life.  I think what you truly learn at university is discipline (studying for all those exams) and working with others (teamwork) which form a crucial basis for everything that you do in life.

For anyone wanting to ask any questions about my job(s), or just how to navigate through life as young optometry graduate – you can reach out to me via LinkedIn: https://au.linkedin.com/in/sujanhong.

The Young Optometrists NSW/ACT networking event saw over 130 optometrists, optometry students and key industry professionals gather under one roof at the Doltone House on 13th July 2019. 

This event was an invaluable opportunity for individuals within the industry to gain insight into the various facets of the industry, to facilitate discussions and mingle with one another. Optometry students were also given the opportunity to network with key members within the profession for career advice and new opportunities.A final year optometry student commented “I love the idea of the networking night and making it less intimidating for us to talk to older and more experienced optometrists”. 

The night opened with an address from Acting Chairperson of Young Optometrists NSW/ACT, Wilson Luu. He explained the event was conceived to break down the silos that occur in the Australian optometric industry and hoped the night would facilitate genuine discussions between all those present. 

“ We want to break down the silos that occur in the industry and tonight brings a great opportunity to network amongst our peers” - Wilson Luu, Acting Chairperson of Young Optometrists NSW/ACT

The event attracted optometrists from not only Sydney but also regional NSW and guests from Melbourne. The venue was packed throughout the night with plenty of fruitful conversations and new connections forged. An optometrist attendee commented that they enjoyed “professional engagement with younger year optometrists”.

The Young Optometrists NSW/ACT team with the sponsors of the night. Left to right:  Corinne Lam (YO), Sarah Tait (YO), Kelvin Bartholomew (Provision), Megan Tu (YO), Wilson Luu (YO), Joe Tanner (Coopervision), Elizabeth Kodari (Luxottica), Abdul Hamidi (YO), Raj Sundarjee (Specsavers) Jordan Olsen (Specsavers), Celine Zhang (YO)

Young Optometrists NSW/ACT (YO)'s mission is to support recently graduated optometrists and optometry students by providing a dynamic and progressive environment to advance the profession. YO aims to continue doing so by providing further platforms for members of the industry to interact with one another in the future. 

Young Optometrists thanks their generous sponsors Coopervision (Platinum Sponsor), Specsavers (Gold Sponsor), Luxottica (Silver Sponsor),and Provision (Silver Sponsor), for making the networking event possible.

Causes of diplopia or double vision can be a challenge for eye care practitioners to diagnose as they can be benign but also can be life and sight threatening. Is the cause of your patient’s diplopia merely uncorrected astigmatism or could it be a sign of a possible brain tumour? 

We first need to determine whether the diplopia is monocular or binocular. Generally, if the diplopia goes away when one eye is closed, this means that the patient is experiencing binocular diplopia, whereas if the diplopia persists, this indicates that the patient is experiencing monocular diplopia. In most cases, monocular diplopia does not warrant a neurological evaluation and treatment involves addressing the underlying cause. 

Some examples of causes of monocular diplopia include:

• Optical aberrations such as uncorrected astigmatism and ectasiasOcular surface dysfunction such as dry eye 
• Macular disorders
• Lens disorders such as cataracts or displaced intraocular lens 

There are many different presentations and causes of binocular diplopia and in the worse case scenario, a life or sight threatening cause may be underlying.

Knowing  the direction (vertical vs horizontal), onset (sudden vs long standing), and committance (comitant vs non comitant) of the diplopia can guide our clinical diagnosis.

We need to evaluate the motility of the eyes individually and together. Ocular alignment should be evaluated in all gazes and at both distance and near.

Some examples of causes of binocular diplopia include:

• Vascular disorders such as aneurysms, diabetes and stroke
• Myasthenia gravis 
• Strabismus and binocular vision conditions such as convergence insufficiency 
• Brain tumour or other cranial involvement (such as cranial nerve palsies)  affecting EOM movement

 Red flags for urgent referral in association with bilateral diplopia include:

• New headache or ocular pain
• Unilateral pupil dilation
• Neurological features or fatigability 
• Ptosis
• Facial trauma
• Papilloedema 

The main treatment objective in patients with binocular diplopia is to create the largest, most central area of single binocular vision, however this may not be achievable in all fields of gaze.  Patients may adopt an abnormal head position in order to overcome their diplopia.

Conservative approaches to managing binocular diplopia include occlusion of the vision in one eye, vision therapy and refractive correction including the use of prisms. Less conservative options include surgery, in cases where the strabismus is stable.