Feature, Orthoptics Australia

Orthoptists and clinical research

Orthoptists play an integral role in clinical research across Australia. Western Australian orthoptist GARETH LINGHAM outlines his work at the Lions Eye Institute and how it has benefited his practice.

Accurate and meticulous collection of data is an essential component of good research. This can be a real challenge, particularly in uncooperative or unwell patients, who are often the very population in which research is required.

Orthoptists’ understanding of eye conditions, expertise in ophthalmic investigation and ability to interact with patients and research participants makes us particularly suited to clinical research. Perhaps then, it is no surprise that orthoptists are extensively engaged in clinical research throughout Australia.

At the Lions Eye Institute (LEI), orthoptists are embedded in clinical research teams such as the clinical trials, genetics and epidemiology teams – and they are valued for their ability to efficiently and precisely conduct investigations.

Gareth Lingham.

LEI is a not-for-profit, world-class research institute and the largest ophthalmic research institute in Western Australia. There are more than 20 sponsor and investigator-initiated clinical trials currently active at LEI and the institute outputs approximately 50 to 100 scientific publications annually.

Research participants are given the ‘VIP’ experience at LEI and are often seen by clinical research teams, including orthoptists, allowing them to skip the clinic queue. Participants are seen in a dedicated research suite, complete with waiting area, two consulting rooms and a tea and coffee area. There is a stream of patients, orthoptists and other staff regularly coming and going from this research suite, with orthoptists doing everything from assessment of best-corrected visual acuity and colour vision to ocular motility examinations, microperimetry and fundus imaging.

I first became involved in clinical research through my work in clinical trials, mainly recruiting patients and collecting data for multi-centre clinical trials. I’ve since become involved in epidemiological studies and clinical trials that are initiated and conducted at the LEI, allowing me to become more actively involved in study design and data analysis and interpretation.

I enjoy being able to communicate with the research participants and find that they are always interested in discussing the study or finding out about the latest results and updates in eye research.

An understanding of how studies are run, conducted and the collection of research data also enables orthoptists (or any researcher) to interpret and understand the data and results.

I’ve been fortunate enough to be involved in studies on refractive error, strabismus and amblyopia, glaucoma and pterygium and having the insight of having collected the data has always been of enormous value. This was reinforced recently as I analysed data on strabismus and amblyopia in a birth cohort.

I’ve also been lucky to work on many exciting studies such as atropine for the treatment of myopia, intravitreal implants for the treatment of macular telangiectasia, intravitreal injections for geographic atrophy, and studies on retinal gene therapy and of intravitreal brolucizumab (Beovu) for wet age- related macular degeneration. It is exciting to be on the cutting edge of new research and gratifying to see some studies progress to a stage where they can impact patients’ lives.

Being involved in clinical research has benefited my ability to practise as an orthoptist. Although I spend most of my time in clinical research, I do have the flexibility to work sporadically as an orthoptist in retinal and paediatric clinics in regional Western Australia. Patients (not so much the children!) are often interested in learning about the latest research and advances in treatment of their eye condition and what current clinical trials they may be eligible to participate in.

I appreciate maintaining this patient contact as it is a reminder that all research is ultimately intended to improve the lives and vision of patients. While it often takes some time for research to have an impact on patients’ lives, it is nonetheless gratifying to see the importance of clinical research to patients and to know that the research I am involved in as an orthoptist will go on to make a difference.

Of course, it isn’t just orthoptists involved in clinical research and I am lucky enough to work alongside ophthalmologists, optometrists, nurses, doctors, scientists, programmers and engineers. I enjoy interacting with researchers from such a variety of backgrounds and I have no doubt that the mix of views this variety generates improves the research that we are able to do. Within the mix of professions and specialties within eye research, orthoptists continue to make a valuable contribution to research at LEI.

ABOUT THE AUTHOR: Gareth Lingham is an orthoptist based in Western Australia. He graduated in 2014 and has since worked in clinical research at the Lions Eye Institute, recently completing his PhD.

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