Welcome to question of the day #345

Welcome to question of the day #345

I have just opened my first community eye care practice. Things are going well but I want to make sure that the people I’m seeing now will come back to me when their next eye examination is due and not to one of my competitors. Do you have any advice to help with this?

When I work in community practice I have access to a portable fundus camera. I charge it overnight and it then has enough charge to last all day in the clinic.

Although it works best with a dilated pupil in older people (60 years old and more) I can get good images from un-dilated pupils that are at least 3 mm in diameter.

When I get successful images I show one to the patient and explain:

‘Here is a photograph of the back of your right/left eye.

The round yellow/orange disc is your optic nerve and this connects your eye to your brain.

The red lines are your arteries and veins/blood vessels and they look very healthy.

The orange areas make up your retina and these are healthy as well.

I’ll add your photographs to your clinical records so the next time I see you I can take some more photographs, compare them to the ones I’ve taken today, and see if there has been any change in your eye health.’

These are typical patient responses to seeing a fundus photograph:

‘Wow.’

‘Wow, no one has ever shown me my eye photographs before.’

‘That’s amazing’.

‘You are very thorough’.

‘That’s the most thorough eye examination I’ve ever had.’

‘Glad to hear you can keep the photographs until my next eye examination.’

I can of course use the photographs to highlight any exudates, drusen, haemorrhages, glaucoma, and age-related macular degeneration where appropriate.

I don’t have any figures on patient return rates but I’m confident that knowing I have these photographs stored and that I can take more in the future and compare them to these will persuade people to use my practice for their long-term eye care.