Methods of optometric management include the diagnosis and treatment of up to 60 eye conditions. The method of management depends to a degree on the condition being treated, the severity, and the prognosis for recovery. Management methods begin with diagnosis, followed by treatment for mild or early stages. For serious conditions, eye surgery may be a part of management followed by a recovery period and monitoring of the patient’s eye care.
Common conditions include disorders of or trauma to the conjunctiva, cornea or eyelid, and frequently diagnosed eye diseases such as glaucoma. Disorders of the uvea, sclera or episclera, or the orbital lacrimal system are less common, but also require specialized treatment and optometric management. The quality of the patient’s general health care is also a factor taken into account by doctors of optometry.
Diagnosis is the initial stage in all methods of optometric management. The optometrist conducts a thorough examination of the patient’s eyes, tests the vision against the accepted standards, and looks for evidence of trauma or injury. Some conditions are found more frequently in patients who are genetically predisposed towards them. Glaucoma, for example, is found more often in Asian people than in those of other ethnicities at a ratio of four women to each man.
When treatment is required as part of optometric management, it may take several forms. In the case of cancerous growths that cannot be removed through eye surgery, the patient may be required to undergo chemotherapy or radiation aimed at eliminating the cancer. Disorders such as conjunctivitis or tear deficiency are treatable using medicated drops or eye ointments. Other conditions such as glaucoma respond to treatment with drugs or topical medications only in mild cases or early stages of optometric management, and usually require ophthalmic interventions by the time they are identified.
Eye surgery is needed in cases of blocked lacrimal ducts, growths in the eye or on the eyelid, cataract removal, and any of the conditions that result in adherence of one part of the eye to another. For example, glaucoma results in blockage of the anterior chamber angle of the eye by the peripheral iris, causing what is commonly known as tunnel vision. If this is diagnosed too late for treatment with drugs and muscle relaxant eye drops, optometric management includes surgical procedures such as an iridotomy. In this procedure, the surgeon makes an incision in the iris to enlarge the pupil.
Recovery after treatment or surgery requires a method of optometric management that supports the patient during the process. This may include the application of eye drops or ointments including topical steroids to promote healing, or the use of punctal plugs to prevent the migration of tears across the eye. The plugs improve the performance of topical medications and reduce the irritation for contact lens wearers, especially following eye surgery. The final stage of optometric management is the ongoing eye care that optometrists provide to their patients.