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Australian Journal of Pharmacy : February 2005
Eye on diabetes M diabetes. ‘One-third of the people affected by diabetes are unaware they have the disease and are at greater risk for vision loss and other complications,’ said Jose S. Pulido, spokesperson for the American Academy of Ophthalmology and professor of ophthalmology at the Mayo Clinic in Minnesota. A significant number of Australian diabetes sufferers are also believed to be undiagnosed. ‘The first step in preventing complications is finding out if you have the disease.’ Each year, between 12,000 and 24,000 Americans ANY factors which contribute to vision loss can be prevented—and a major one is undiagnosed lose their sight due to diabetic retinopathy, a degenerative disease of the retina caused by diabetes. Studies show effective treatment for diabetic retinopathy can reduce severe vision loss by up to 94 per cent. The Academy suggested the following steps to reduce the risk of eye disease: • keep blood glucose level as close to normal as possible through diet, exercise, and if needed, medication; • keep blood pressure under control; • keep cholesterol levels low; • don’t smoke; and • ensure hemoglobin A1c levels are measured at least every four months and are less than 7.1. which is easily available and accessible. As 95 per cent of optometry services are bulk-billed through Medicare, patients are generally able to access optometrists and pharmacist advice at no out-of- pocket cost. Professional collaboration ‘I always encourage optometrists to go and talk to their local community phar- macist, so I’d also have to encourage pharmacists to go and talk to their local optometrist!’ He said that while customers might expect their pharmacist to know every- thing, the reality is that pharmacists can’t, of course, know everything about every health topic. ‘It’s more realistic for pharmacists to know a fair bit, and know where to look for further information. ‘One important source of information is professional colleagues. Pharmacists who have relationships with their local optometrists know that they are prepared to see a patient immediately if referred by their pharmacist.’ ‘We’re actually next door to an optometrist, so we’re easily able to keep them informed as to what we’re ranging,’ said pharmacist Nick Lucas, who owns the Terry White Smithfield pharmacy in Cairns. ‘The optometrist recommends people come to here to purchase products that they can’t provide, and we often recom- mend that customers go and see them if we’re at all concerned about a problem, and feel that they should have their eyes looked at by an expert. So it works well within the allied health model.’ Reconciling health outcomes with business success Optometrists, like pharmacists, are retail- ers as well as health professionals. Ben Har- ris told the AJP that reconciling the need to provide good health outcomes as well as achieving business success could be ‘tricky’. ‘Optometrists make more money out of selling glasses than by selling their profes- sional services, just as pharmacists are not generally rewarded for their professional services,’ he said. ‘I’ve always had a strong belief that good patient care is the bedrock of finan- cial success, even where the links between professional service and remuneration may be weak.’ He said that a pharmacy which is well equipped for the eye care section should include unit dose saline and bottled saline; eye cups; eye patches; contact lens solu- tions (and contact lens cases when required); tear supplements; UV shields/sunglasses; and reading glasses. ‘The way we take on the eye care sec- tion is to have the high-turnover, multi- purpose [contact lens] solutions on pro- motion to drive business,’ Mr Lucas said. ‘To back this up, it’s important to have a wide range, to give customers a good choice of product, and also give the staff a wide selection from which to make rec- ommendations. If you don’t have a good selection, you’re really just not going to get far in the eye care business. ‘There needs to be a good selection available in both the major components of the section. ‘In the artificial tears/moisturisation section, we have a large range, with par- ticular emphasis on single-use products, for hygiene purposes. ‘There’s also a good mixture of soft con- tact lens care products and multipurpose solutions, as well as a smaller selection for the care of hard contact lenses. ‘We also have a tower of reading glasses. These are fine as long as the cus- tomer is made aware that they’re a tem- porary solution for reading or other minor vision problems which require magnifica- tion. They’re not a substitute for pre- scription glasses. ‘We have a reading pad that they can use when trying on glasses, to help us work out the strength they need. So it’s easy to see that eye care really is a section which requires a lot of customer service.’ Mr Harris said that reading glasses should always come with an explanation that an eye test is important in order to check the health of the eye, even if vision itself needs little or no correction. THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 FEBRUARY 2005 ? 103