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Eye Doctor in Canberra – When Do You Need a Referral?

Ophthalmologist in Canberra.

Understanding the difference between an optometrist and an ophthalmologist can sometimes be confusing. But it’s an important distinction in Australia, where you can’t obtain a Medicare rebate without first obtaining an ophthalmologist referral from your primary care optometrist. Some eye doctors may refuse to see any patient without such a referral.

If you think you need a referral to an eye doctor in Canberra for advanced eye care procedures, this article should be helpful.

Cataract Surgeries

Cataracts cloud the natural lens in our eyes, leading to impaired vision. In Australia, an optometrist plays a significant role in the initial detection and early management of such cases.

I remember John, a long-time patient, who came to me with complaints of blurred vision. After diagnosing John with cataracts, I referred him to a leading Canberra eye doctor for surgery.

Ophthalmologists treat cataracts through a surgical procedure called phacoemulsification. During this surgery, a tiny incision is made in the eye, through which the clouded lens is broken up using ultrasound vibrations and then removed. Subsequently, an artificial intraocular lens (IOL) is inserted in its place, restoring clarity to the patient’s vision.

The entire procedure is typically outpatient, meaning patients can return home the same day.

Cataract surgery is generally not painful due to the use of eyedrop anaesthesia administered before the procedure. This ensures that the eye is numb, preventing patients from feeling anything during the surgery. Most patients only report a slight sensation of pressure.

After the anaesthesia wears off, some patients might experience itchiness or a gritty feeling in the eye for a day or two.

Any post-surgical discomfort is usually mild and can be managed with over-the-counter pain relievers or prescription medications, as advised by the ophthalmologist. It’s essential for patients to avoid rubbing their eyes after surgery and to follow post-operative care instructions to minimise discomfort and promote healing.

After the immediate postoperative period, long-term follow-up care can be managed by an optometrist. They can monitor the patient’s vision, prescribe corrective eyewear if necessary, and ensure that the eye remains healthy in the long run. The optometrist can also detect any potential late-onset complications or issues that may arise after the surgery and refer the patient back to the ophthalmologist if needed.

It’s a collaborative approach, with both the ophthalmologist and optometrist playing crucial roles in ensuring the patient’s complete recovery and optimal visual health.

Eye doctors operating in Canberra clinic.
Eye doctor talking with Canberra patient.

Anti-VEGF injections for Diabetic Retinopathy

Diabetic Retinopathy is a complication that can severely affect the vision of diabetic patients.

I remember Sharon, a dedicated nurse, and diabetic patient. She was unaware of the potential eye complications until she experienced them. After detecting the advanced state of her condition, I promptly referred her for Anti-VEGF injections, a treatment administered by a Canberra ophthalmologist.

Imagine the back of our eye, the retina, as a movie screen. Due to high blood sugar levels from diabetes, the tiny blood vessels in this screen can get damaged. When these vessels are damaged, they can start to leak or bleed, causing blurry vision or even seeing spots floating around. If not addressed, it can get worse, leading to significant vision issues or even complete blindness.

Now, here’s where it gets interesting. Our eyes have a substance that can cause these harmful vessels to grow; and this is where Anti-VEGF medications come into play. A trained eye doctor can inject these medications into the eye to halt and even reverse some of this damage. So, for anyone with diabetes, regular eye check-ups with a regular optometrist are a must to catch and manage this condition before the damage is too late.

Corneal Transplant a.k.a. Keratoplasty

Let me share with you the story of Lin, a local sports enthusiast. When she suffered a corneal injury during a squash game, she was extremely concerned. After my assessment, it became clear she might need a corneal transplant, and I referred her to a specialised ophthalmologist.

Corneal transplants, also known as keratoplasty, are procedures where a damaged or diseased cornea (the clear front surface of the eye) is replaced with healthy tissue from a donor. Imagine the cornea as the window of the eye; if it gets clouded or damaged, the view becomes blurry. An ophthalmologist, a specialised eye surgeon, performs this procedure by carefully removing the affected part of the cornea and replacing it with clear donor tissue.

An optometrist plays a significant role in post-operative care for patients who have undergone corneal transplants. After the surgery, the patient’s vision may still need fine-tuning, and the optometrist is typically involved in this aspect. Here’s a breakdown:

Monitoring Healing: The optometrist will routinely check the transplant site to ensure it’s healing properly, ensuring that the graft is adhering correctly and that there aren’t any complications like graft rejection.

Prescription Adjustments: After the surgery, there may be changes to the patient’s vision. The optometrist will assess the need for and provide updated eyeglass or contact lens prescriptions as the eye heals and the vision stabilises.

Management of Astigmatism: It’s common for corneal transplant patients to experience astigmatism (where the cornea is curved more in one direction than another). Optometrists can provide specialised contact lenses, such as rigid gas-permeable lenses, to help manage this and offer the patient clearer vision.

In essence, while ophthalmologists perform the surgery and manage early surgical aftercare, optometrists play a pivotal role in the long-term vision care and health monitoring of corneal transplant patients.


Surgical Management of Glaucoma

Glaucoma is a stealthy eye condition, often referred to as the “silent thief of sight.” Most victims do not know they have the condition until irreversible damage has been done. It’s caused by a buildup of pressure inside the eye, which can damage the optic nerve, potentially leading to vision loss.

Ophthalmologists are crucial in the frontline defence against glaucoma. They can treat it in several ways, including laser procedures to improve fluid drainage or other procedures for more advanced cases.

Thankfully, most glaucoma treatments are not painful, but some may cause mild discomfort or temporary blurred vision.

After any surgical intervention, the role of the optometrist becomes vital. They are responsible for post-operative care, which includes monitoring the eye’s healing, ensuring the intraocular pressure remains at safe levels, and detecting any potential complications early.

With the combined expertise of both the ophthalmologist and optometrist, patients with glaucoma can receive a comprehensive care pathway, from initial treatment to long-term management.

Strabismus Intervention

An eye condition characterised by the misalignment of the eyes, where one or both eyes may turn inwards, outwards, upwards, or downwards, is known as strabismus. This misalignment can be due to a variety of factors, including muscle imbalances, nerve issues, or even some systemic diseases.

While strabismus is often noticed in childhood, it can also occur in adults. An optometrist can assist in the early detection of strabismus and incorporate prism correction into glasses. Prisms alter the light pathway before it reaches the retina, essentially “bending” the image in a way that compensates for the misalignment. This can help bring the image into focus and align it with the other eye, providing a unified visual field.

The role of an orthoptist is particularly significant in diagnosing and providing non-surgical treatments for strabismus, using exercises and therapies aimed at improving eye coordination and alignment. One common method of treatment is patching, where the stronger eye is covered with a patch, forcing the weaker, misaligned eye to work harder and become stronger. This method helps to stimulate the vision pathways in the brain and promote better eye coordination.

If non-surgical interventions are insufficient, an ophthalmologist steps in. They can recommend surgical options, which involve adjusting the length or position of the eye muscles to correct the misalignment. Surgical procedures are tailored to each patient’s unique needs and can greatly enhance visual alignment and functionality.

The collaboration of these three types of eye care professionals ensures a comprehensive co-management approach to managing strabismus.


Retinal Detachment Management

Carmel, a young graphic designer, came to see me when she suddenly began experiencing floaters and flashes in her vision. Recognising the signs of retinal detachment, I referred her immediately to an ophthalmologist for emergency treatment.

Retinal detachment is a serious eye condition where the retina – the thin layer at the back of the eye that captures visual information – separates from its supporting tissues. Risk factors are higher for those patients who have significant myopia, diabetic conditions, or who have had cataract surgery.

Without prompt treatment, it can lead to permanent vision loss. Often, individuals affected may see a sudden increase in floaters, flashing lights, or experience a shadowy curtain veiling their field of vision.

An ophthalmologist plays a pivotal role in managing retinal detachment. They can treat it using methods like laser surgery to seal breaks or holes in the retina, a freezing process called cryopexy, or more intricate surgeries like a pneumatic retinopexy or scleral buckle procedure to push the retina back into place.

The role of the optometrist is vital for early detection and referral. Regular eye exams can help identify any preliminary retinal issues, and if a patient presents with symptoms of detachment, the optometrist can quickly refer them to an ophthalmologist for immediate intervention. Collaboration between the two professionals ensures the timely diagnosis and treatment of this urgent condition.


Your Eye Doctor – An Essential Partner in Vision Well-Being

In our beautiful city of Canberra, understanding when and how to approach eye care is crucial. Always start with your optometrist. Not only can they diagnose and treat a range of conditions, but they also provide the essential referrals to see an ophthalmologist when advanced care is required.

Remember, your vision is one of your most precious assets. Trust it to an eye doctor who understands its complexities.

To visit our optometry practice, click the “Book Online” button at the top of the page or call (02) 6152 8585 today.


Author: Juliet Menakaya, O.D MPH

CANBERRA OPTOMETRIST Juliet obtained her Doctor of Optometry degree from the University of Benin, Nigeria in 2006. She completed an internship programme before migrating to Australia, where she completed a master’s degree in public health at the University of Sydney in 2014. Following this, Juliet obtained a Master of Orthoptics from the University of Technology Sydney (UTS) in 2017. Juliet has completed her competency in optometry examination with OCANZ (Optometry Council of Australia and New Zealand), and obtained her ophthalmic prescribing rights from ACO (Australian College Of Optometry Victoria). Juliet has worked in various positions, including retail Optometry, the Ophthalmology Department at Canberra Hospital, and more recently, at the John Curtin School of Medical Research (ANU). As a dedicated Canberra optometrist, Juliet is passionate about helping people with low vision, and binocular vision anomalies hence her interests in Low Vision Rehabilitation, Eccentric Viewing Training and Paediatric optometry.