Focusing on the stuff really that matters
GETTING right up into people’s faces doesn’t faze Marama Lambert in the slightest.
‘‘I might be 5-10cm away from somebody’s face, I may never have met them before, but I don’t even think about it.’’
As an optometrist for Wellington firm Barry and Sargent, it’s an everyday occurrence for Lambert.
‘‘I think anybody who’s had an eye test before knows what to expect, if they haven’t I will generally explain that we’re going to get pretty close but it’ll be ok.
‘‘For me it’s all about their eyes – people just become their eyes when you’re that close to them.’’
Lambert conducts eye examinations on up to 12 patients a day on average.
The mother of four, including three-year-old twins, works parttime, dividing her time between the Wellington and Porirua clinics.
Her Wellington appointments consist mostly of routine eye tests but in Porirua it involves diabetic screenings as well.
‘‘A normal eye exam is a routine test that involves checking vision, running through health checks for the eye, ruling out major eye disease like cataracts, glaucoma or macular degeneration, and then deciding whether to prescribe glasses or send them to an eye specialist if required.
‘‘Diabetic screenings basically involve photographing people’s retinas to screen for damage caused by diabetes.
If treatment is required then that person is referred to a specialist.
As for routine exams, Lambert says a fair percentage need no further action.
‘‘For sure, people come to me when their vision’s not right and we sort glasses out for them, but for a lot of people it’s a routine health check, it’s like a check-in with their GP, they’re just making sure everything is healthy and okay.’’ And that’s the way she likes it. ‘‘I encourage people to have an eye test every two to three years regardless of what’s happening with their vision.
‘‘People think if they can see fine they don’t need their eyes tested, and they’ll only come in if there are issues with their vision.
‘‘But I tell people to make it routine, and come in sooner if there are any sudden changes, that’s the biggest message to be gotten across.’’
Lambert speaks of a woman undergoing a routine eye test who was suffering from a choroidal melanoma, a tumour beneath the retina, but didn’t know it.
‘‘She had no symptoms – breaking that news to her wasn’t nice but, from my point of view, my job was to get her to the right people quickly.’’
Two years after the diagnosis the woman is back having routine eye tests after specialist treatment in Auckland.
Lambert talks about two other cases of retinal detachment that were picked up in routine eye tests.
‘‘There is no pain with a retinal detachment, sometimes there are visual symptoms but not for these particular people.’’
Another case that highlights the importance of regular eye checks is one patient who hadn’t had a test for almost eight years.
‘‘He ended up having glaucoma, yet his vision was fine and he had no symptoms, but if we’d seen him earlier or more regularly we would have been able to diagnose him earlier.’’
Having been with Barry and Sargent for 16 years, Lambert has many regulars she’s built a good rapport with.
‘‘You watch patients grow up before your eyes. I remember seeing this little girl when she was four, I saw her the other day, she’s 19 and in hospitality.’’
She has known her own optometrist since she was a teenager and it was him that inspired her to get into the profession.
‘‘I had glasses when I was five or six. I only got them because I was getting bad headaches, but I was really naughty and I wouldn’t wear them,’’ she laughs.
‘‘They were hideous . . . they were a pain, I could function without them so I did.
‘‘Then I got to high school which meant bigger rooms, being further back from the board, and I couldn’t see the board, That’s when I met my optometrist and started wearing glasses.’’
In her teenage years Lambert knew medicine was never a career option because she couldn’t handle the sight of blood or the thought of needles, yet she was good at science and maths and wanted to do a health science of sorts.
‘‘I went in to get my glasses changed – I’d been seeing Murray Rogers for years, we had a chat about me doing optometry, he raved about it, particularly the continuing education side where you’re not just working but you’re learning the whole time and I thought it sounded really cool.’’
Lambert had always been fascinated with the eye tests anyway.
‘‘Eye tests are so much fun. I think heaps of kids love getting their eyes tested, it’s a really cool experience, I loved it too.
‘‘I wasn’t scared in the slightest, there’s games, tasks, instructions, there’s lights, there’s darkness, there’s all these freaky machines coming around, and the whole attention is placed on you for half an hour – really, what’s not to love.’’
Lambert wound up completing a four-year optometry degree at Auckland University followed by a certificate in Ocular Pharmacology which enables her to prescribe medicines for patients with infections and inflammation rather than having to refer them to a doctor.
During her studies she voluntarily came to Wellington on an ‘‘extern’’ placement with Barry and Sargent, was offered a job and has never left.
‘‘I still see Murray Rogers at conferences, it’s funny because he still looks exactly the same as he did when I was a teenager, but he must see me as this little teen even though I’m now an optometrist and all grown up.’’
Over the years Lambert says the industry has changed, as has people’s attitudes towards glasses.
‘‘As a wearer of glasses still, there are so many more options and cool people wear glasses now – there’s no stigma to wearing glasses, in fact it’s the opposite.’’
The profession itself has moved, in that optometrists can prescribe medication for the likes of glaucoma and conjunctivitis, making continuity of care easier on both the health system and the patient.
More technology can mean more work – in a good way.
‘‘Retinal photography has allowed us to record and monitor more easily and in some cases pick up changes we may not easily have seen without it.
‘‘I remember when I first started using photography I noticed a whole lot of early epiretinal membranes (thin sheet of fibrous tissue at the macula) – they didn’t need treatment but they were so much easier to see with photography.
‘‘Now with OCT technology (optical coherence tomography) I can scan the retinal layers and monitor more conditions in-office rather than sending them into the hospital system.’’
Despite a heavier workload, it’s the combination of science and dealing with people on a daily basis that Lambert loves most about her job.
‘‘It keeps the job varied and that’s what it’s about, doing the same stuff day in, day out would drive me up the wall but this is never the same and if I wasn’t dealing with people I would go nuts.’’
It’s ensuring people’s eye health is as good as possible that is paramount.
‘‘Obviously I want people to be happy with their vision and safe with their eye health, that’s why I do what I do.
‘‘I can’t imagine doing anything else, except maybe if I won Lotto and I was laying on a tropical island, I could probably do that, but I’d probably still work part-time, knowing me!’’