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Education Education Education

November 14 2008

Sheraz Daya believes that the demand for well-trained optometrists is set to grow in the field of ophthalmology in the future. Ryan Bradshaw met the award-winning surgeon.

As one of the first ophthalmologists in the UK to perform LASIK surgery in 1995, Sheraz Daya has been at the forefront of the technological advancement in laser eye surgery over the past decade.

The consultant ophthalmic surgeon, who is director and consultant of the Corneo Plastic Unit and Eyebank, Queen Victoria Hospital, East Grinstead won an NHS award this year for Leadership for Improvement for turning his eye unit into one of the best in the UK.

And, as the medical director of Centre for Sight, his ‘boutique’ vision correction centre, he has many strong views about the future of optics and the need for the professions to work together to preserve the eyesight of future generations.

He is currently planning to hold an Education Day, where he hopes optometrists and ophthalmologists can meet to exchange knowledge.

“There’s a huge amount of work for optometrists to do in the future,” he tells me. “One of the biggest drivers is demographics. At the age of 42 you have one eye problem, by 65 you have two eye problems and then by 80 you have three eye problems.

“We’re going to have ten times the population in that age group from the baby boom generation. I don’t think we’re going to be able to cope with the amount of people, so it’s going to be down to the optometrists to get involved.

“They’re going to be doing much more, actual primary care ophthalmology, and they’re going to have to be darn good at it. They’re going to have to be a bit like diagnostic medical ophthalmologists in my view.

“So I see the role of optometrists as extremely bright for the future but more medical than it is right now.”

Mr Daya manages around 70 staff in London, where consultations take place, and in East Grinstead, where the surgery is performed.

Carrying out a range of operations from cataract surgery to glaucoma care, corneal transplantation to oculoplastic surgery, Mr Daya can see anything from 25 to 75 patients a day.

Having worked and trained in the USA and Ireland, he returned to the UK in 1993. With the Centre for Sight growing year-by-year, the company is moving into a new hospital premises in April 2009.

He says: “Since opening in 1996 Centre for Sight has grown into a first class eye surgery centre, contributing to the credibility of laser eye surgery.

“We will be expanding to a private eye hospital on the outskirts of East Grinstead. It is progressing well, the roof is now up and we are doing the interiors.”

Mr Daya’s vision of a medical centre out in the countryside is gradually coming to fruition. Built on farmland, the clinic has been modelled on a modern converted barn.

“Patients will walk into reception with its brickface walls, and lots of beautiful art and murals. It will be high-tech but will have the human touch. Not all white and clinical like something out of Star Trek.”

Expanding with the new clinic and a fresh website and corporate image, Mr Daya would like to begin working more closely with optometrists.

“In a new shared care model, optometrists will be registered with us, initially at no cost, if they need advice and need to refer a patient who has cataracts or glaucoma. Or if they are interested in refractive surgery they can upload images directly onto our system, and we will respond.”

And he has already gained a great deal of interest from optical practices and groups who would like to utilise Centre for Sight’s facilities and expertise, he says.

“My initial conversations with these optical groups are very encouraging. First, we want to get our infrastructure right so we can work together in development.

“They can be advertising a service, and we can be providing it for them. So for instance, if they want to provide refractive surgery or cataract surgery, they do all the accounts, the administration, they send us a patient we examine them and do the surgery and aftercare. All we charge is a facility fee, and they charge the patient the full whack and take the profit. There are many new ways to work with optometrists, and the people we’ve approached find it very attractive to have their own brand of vision correction surgery.”

Mr Daya is also hoping to increase optometrists’ awareness of ophthalmology and eye surgery.

“In our upcoming Education Day we want to provide optometrists with information about shared care. If they want to work with us they will need to know what work we have done with their patients.”

He hopes to gather a group of experts to talk about clinical issues and the optics profession in order to stimulate a range of dialogue between optometry and ophthalmology.

“There is definitely a divide between optometrists and ophthalmologists, which we need to bridge because we are working for the same goal and there needs to be better discussion,” he emphasises.

“I get lots of emails from optometrists who take an active interest in patients that come through us, and they are interested in being educated. It’s very hard for them to counsel patients if they don’t know about certain conditions or complications of surgery. So if we can now do this in a formalised way with an Education Day then we have accomplished that goal.”

With a role that straddles the NHS and private practice, Mr Daya spends one week working mostly in his NHS role, doing surgery and training, and spends the next planning for the Centre for Sight.

With his strong belief in increasing the education of optometrists and bridging the gap between the professions, what does he think of optometrists’ current grasp of eye surgery?

“Optometrists play a big role in laser eye surgery, and around one third of our patients are referred by optometrists’ word of mouth. They understand laser eye surgery better these days, but they haven’t really got involved in the nitty gritty of surgery yet.”

And with many optical companies offering laser eye surgery, how does he think his model compares with others?

“I like to meet my patients and spend time with them, and I like sharing their pleasure after surgery.

“We take an interest in their welfare. We are not just technicians, a ‘doc in a box’. It’s surgery, and we are attacking people’s eyes. It can be unforgiving, but fortunately most of the time it’s not.”

Constantly planning for the future, Mr Daya has already started to look forward to the new technological breakthroughs that will help eye care in the coming years.

“There are some exciting new technologies coming along such as accommodative implants and crystalenses. Cataract surgery is now being done through tinier and tinier incisions. We are now down to 1.6mm from 1.8mm.

“But, one of the most amazing pieces of technology, which I believe will revolutionise the optometry practice is the NGDI (new generation diagnostic instrument), which is coming out next year.

“With tests for cataracts sometimes taking up to three hours, the industry has put together a wavefront and orbscan device to measure pupil, limbus and axial length into one machine, with one access. It will now take one minute to test per eye.

“With the average person living longer, the volume of eye care will obviously increase, and technology will certainly help us.”

For Mr Daya, it will be vital for optometrists and ophthalmologists to work together to deal with the eye care challenges of the future. And education is the key.

“Only optometrists know where their deficiencies lie. Their education can’t be done in big dollops, but needs to be done with small courses on a regular basis.

“There are a huge number of them who are very self-conscious about their professional development. I would say they should plan something every two to three months to maintain this development.

“If optometrists want to progress in the future I believe they need to continue what they are doing and that is to improve their education.”

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