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Background: Preceptorship has been found to ensure a positive and healthy start to a clinician’s career. Evidence shows increased staff satisfaction and empowerment and decreased medical errors as a result of preceptorship. There is limited literature that includes allied health professionals, particularly new orthoptic graduates. This study aims to: 1) explore the effectiveness of the British and Irish Orthoptic Society (BIOS) preceptorship programme at providing support and confidence in newly graduated orthoptists, 2) explore new graduates’ experience of embedding public health in their clinical practice. Methodology: Focus groups were organised for mentors and mentees to discuss their experiences with the BIOS preceptorship programme and how it facilitated embedding public health into clinical practice. Constant comparison analysis was used to identify key themes of discussion. Findings: The preceptorship document promoted structure, reflection, and engagement all of which contributed to effective transition for the mentees. However, document navigation, lack of preceptorship exposure at undergraduate level and leadership engagement were potential barriers to using the programme. The programme encouraged public health engagement among new graduates but barriers such as time pressure, lack of experience and patient understanding were challenges that often prevented the adoption of public health skills and behaviours within their practice. Conclusion: The BIOS preceptorship successfully supports new graduates in their transition into an autonomous practitioner. The programme could be improved by the implementation of a guidance document to assist mentors in their role. Preceptorship engagement could be improved by increasing exposure to undergraduate orthoptic students and departments alike.

IntroductionApproximately 1 in 3 adults aged 65 and over experience a fall each year. Poor vision is an identified risk factor. The aim of this cross-sectional public health surveillance audit was to determine the prevalence of falls experienced in the previous 12 months by adult patients presenting to an ophthalmology department.MethodsA short questionnaire was given to consecutive patients attending an ophthalmology department at two trusts in the North West to determine whether they had experienced a fall in the previous 12 months, whether they had suffered a fracture, their eye condition and the type of glasses worn.ResultsData was collected for 585 patients (mean age: 69 years, SD: 13.8). Falls in the previous 12 months were reported by 96 (16.4%) patients, and a significant proportion of these were aged 60 years and over (82%, p < 0.0001, one-sample binomial test). Half of the respondents were unaware of their eye health condition for which they were attending the department. Glaucoma was the most prevalent condition in those who had experienced a fall (43%). A significant proportion of the individuals who reported a fall wore single-vision glasses (43%, p < 0.0001, one-sample chi-square test).ConclusionIn an ophthalmology outpatient department, the proportion of older adults who experienced a fall in the previous 12 months was lower than the reported prevalence in the general population. There is a need for health literacy to educate patients about their eye condition, the potential effects on their visual function and, consequently, managing falls risk.

The impact of sight loss on everyday life changes over time, through further deterioration of vision, as well as a result of other physical changes and key events in people’s lives. As such, even the support needs of people with relatively stable visual impairment are likely to change throughout their life course. This article explores the long-term support needs of people with sight loss and the barriers they face when accessing services over time and at the time of need. Data from biographical interviews with 36 participants with sight loss is presented, with particular focus upon three illustrative case studies. The study reveals that many participants experienced problems gaining information about, and access to, services in the short and longer term. There is a need for systematic referral from clinical services to social and voluntary services and for regular follow-up to identify and respond to people’s changing needs.

Background: Macular translocation surgery (MTS) is one of the treatment options for age-related macular degeneration (AMD) followed by counter-rotation surgery (CRS) to correct the resulting tilt. The objective of this paper is to determine the perception of tilt following CRS and identify factors that influence the perception of tilt in the presence of residual cyclorotation following CRS. Methods: Thirty-four AMD patients treated with MTS and CRS were investigated; and all measurements were made preoperatively, and after each surgical procedure. Fundus photographs were analysed with computer software to determine the degree of retinal rotation and reliability was assessed by two independent assessors. The degree of perceptual rotation was measured with Maddox rod and the subjective appreciation of tilt was established by direct questioning. Fixation preference was determined by cover test and convergence. Bagolini glasses were used to determine binocular outcome. Results: Post CRS, 20 of the 34 patients had adapted to tilt. There was a significant difference of 5° ± 7° (95% confidence intervals: 1-8°, t = 2.9, degree of freedom = 19, P = 0.008) between the degree of rotation measured from the fundus photographs and the Maddox rod measurement following CRS. Patients with residual retinal rotation less than or equal to 15° did not appreciate tilt in free space. More importantly, fixation with the operated eye and ignoring the image from the non-operated eye was significantly associated with being free of tilt in natural viewing conditions (P < 0.05). Conclusion: Despite the presence of residual cyclorotation of the macula following CRS of up to 27°, a significant proportion (59%) of patients did not perceive the world as tilted in natural viewing conditions. Differences between retinal rotation and perceptual tilt provide evidence of sensory adaptation. It was patients who fixed with their operated eye and ignored the image from the non-operated eye who did not perceive tilt post CRS.

Aim: In recent years there has been a marked increase in the use of computers, and while they bring many benefits they are also associated with an increase in health risks, including visual disorders. The aim of this pilot study was to begin to examine the relationship between a wide range of ergonomic factors, work routine and ocular symptoms reported by visual display unit (VDU) users and to inform future research. Methods: Questionnaires were distributed to 84 VDU users and workstations were analysed for illumina­tion, viewing distance, temperature and relative humidity on a subset of 45 VDU users. The questionnaire was used to determine age, gender, working conditions, work routine and ocular symp­toms experienced. Each VDU user had to indicate from a list of 10 ocular symptoms whether they experienced each symptom ‘before’, ‘during’ or ‘after’ VDU use. Results: Eighty-three per cent of the VDU users reported at least one ocular symptom during or after VDU use, with headaches as the most frequent complaint. Ergonomic factors, illumination, tempera­ture, relative humidity and viewing distance were not associated with increased number of symptoms experienced by VDU users. However, women experi­enced almost twice as many symptoms as men and younger subjects reported more symptoms. Conclusions: A high proportion of VDU users experienced ocular symptoms which were not related to environmental factors. Age and gender proved to be significant factors associated with VDU-related symptoms. The findings of the pilot study have highlighted the need to explore these significant factors and to include confounding variables such as psychosocial factors and employment status. Further work will also incorporate a full ocular assessment of VDU users to identify why particular VDU users have a predisposition to ocular symptoms.