Research Title: Evaluation of Eye Care Models and Assessment of Novel Clinical Uses of Ocular Imaging to Improve Care of Individuals with Diabetes
Individuals are living with diabetes longer due to an increasingly younger age of onset in combination with increasing life expectancy, placing them at greater risk of complications, including diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. Detecting and managing diabetic complications presents a challenge to provide cost-effective, accessible, efficient, and timely care, especially in the context of diabetic retinopathy, where eye examinations are required to prevent and delay visual impairment.
In the Australian health system, the current pathway for the management and treatment of diabetic retinopathy predominantly consists of ophthalmological care, commonly delivered through public hospital ophthalmology outpatient clinics. Timely access to these clinics is an issue, irrespective of diabetes, with 38% of all patients waiting past clinically recommended timeframes. Extensive wait lists in public hospital eye clinics can prorogue timely care and wait lists are encumbered by chronic and stable ocular conditions.
Eye care models, such as The Eye Clinic at The Sutherland Hospital, a collaboration between Centre of Eye Health optometrists and The Sutherland Hospital ophthalmologists, and The Provision of Eye Health and Equipment Training, a federally-funded nationwide retinal camera roll out, have been established to provide alternative pathways for patients with diabetes who are not receiving regular eye care. Evaluation of these models reveal that optometrists play a vital role in providing alternative pathways.
Ocular imaging devices have become more ubiquitous and are employed to improve the diagnosis and detection of diabetic retinopathy. In addition to routine uses, optical coherence tomography and corneal confocal microscopy visualise changes to retinal thicknesses, and corneal nerves respectively, which are clinically evident prior to the onset of diabetic neuropathy and diabetic retinopathy and therefore might be useful as indicators for diabetes related complications. As optometrists are familiar with these devices, there is potential to provide adjunct pathways that help predict other diabetes complications during eye examinations.
My research aims to:
- Assess and develop effective health care models and pathways for patients with diabetes to minimise visual impairment
- Investigate technology in eye health care to identify ocular markers that improve effectiveness in the management of diabetic retinopathy and other diabetes related complications.
Vincent graduated with a combined Bachelor of Optometry with Honours and Bachelor of Science from UNSW in 2014. He then spent three years in Nowra, NSW working in corporate practice. Here, he developed a special interest in ocular pathology. During those three years he has supervised optometry students under the UNSW Preceptorship Program and Deakin University Clinical Residential Placements. He has also been invited to lecture medical students from the Graduate School of Medicine, University of Wollongong. He became a Fellow of the American Academy of Optometry in 2017.
2014 BOptom(Hons)/BSc – UNSW Sydney
- Khou V, Khan MA, Jiang IW, Katalinic P, Agar A, Zangerl B. Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study. BMJ Open. 2021;11:e044805. doi:10.1136/bmjopen-2020-04480
- Khou V, Ly A, Moore L, Markoulli M, Kalloniatis M, Yapp M, Hennessy M, Zangerl B. A review of referrals reveal the impact of referral content on the triage and management of ophthalmology wait lists. BMJ Open. 2021;0:e047236. doi:10.1136/bmjopen-2020-047246
- Khou V, Katalinic P, Zangerl B. Should optometrists recommend fenofibrate? Pharma. 2018 Sep;15-20.
The Association for Research in Vision and Ophthalmology (ARVO) International Travel Grant, ARVO Baltimore, 2020.
AFFILIATIONS AND MEMBERSHIPS
Fellow of the American Academy of Optometry