College of Optometrists

Global pandemics have become one of the most significant threats to human health, economic stability, and social order in the twenty-first century. The rapid spread of infectious diseases such as COVID-19, Ebola, Zika, SARS, and influenza has exposed major weaknesses in traditional public health systems, particularly in surveillance, diagnostics, prevention, and response capacity. Factors such as globalization, climate change, urbanization, and increased human–animal interaction have further intensified the frequency and impact of pandemics, making conventional control measures alone insufficient. This article explores the role of biotechnology and nanotechnology as next-generation defenses in global pandemic preparedness and response. Advances in biotechnology, such as genomic surveillance, molecular diagnostics, mRNA vaccine platforms, monoclonal antibodies, and precision medicine have enabled rapid pathogen identification, accelerated vaccine development, and targeted therapeutic strategies. These innovations allow public health systems to move from reactive outbreak management toward proactive and predictive disease control. In parallel, nanotechnology contributes through highly sensitive nanoscale diagnostics, biosensors, lab-on-a-chip devices, improved vaccine stability, and targeted drug delivery systems, particularly benefiting low-resource and decentralized settings. The article also examines the integration of these technologies into public health infrastructures using digital health platforms, artificial intelligence, and bioinformatics to support real-time data analysis and coordinated decision-making. Ethical, regulatory, and governance challenges including equity, intellectual property, data privacy, biosafety, and biosecurity are critically discussed, emphasizing the need for fair access and global collaboration. Overall, the convergence of biotechnology and nanotechnology offers transformative potential to strengthen health system resilience. When supported by ethical governance, public trust, and international cooperation, these technologies can significantly enhance global preparedness and protection against future pandemics.

Kelainan refraksi pada anak usia sekolah merupakan masalah kesehatan yang penting untuk mendapat perhatian. Sejak pandemi COVID-19, seluruh kegiatan dilaksanakan secara daring, yang mendorong percepatan digitalisasi sehingga penggunaan perangkat elektronik seperti smartphone, laptop, tablet, dan gawai lain semakin meningkat dalam aktivitas sehari-hari. Penelitian ini menggunakan pendekatan kuantitatif dengan desain studi potong lintang (cross-sectional), serta mengumpulkan data primer melalui kuesioner dan pemeriksaan refraksi yang dilakukan oleh optometris. Pengambilan sampel dilakukan secara purposive di lima provinsi di Indonesia, yaitu Jawa Barat, Jawa Timur, Kepulauan Riau, Kalimantan Barat, dan Sulawesi Utara, mencakup sekolah negeri dan swasta dari tingkat SD, SMP, hingga SMA, dengan total sampel 201 anak. Data dianalisis menggunakan analisis univariat, bivariat, dan multivariat untuk mengetahui prevalensi dan faktor risiko miopia serta astigmatisma pada anak sekolah. Hasil penelitian menunjukkan bahwa prevalensi kelainan refraksi pada anak usia sekolah di Indonesia adalah 30,8%, dengan prevalensi 25,2% pada SD, 33,2% pada SMP, dan 37,4% pada SMA. Dari lima provinsi tersebut, prevalensi tertinggi ditemukan di Kepulauan Riau sebesar 48,7%. Analisis multivariat menunjukkan bahwa variabel yang paling berhubungan dengan kelainan refraksi adalah uncorrected refractive error (URE) (POR 57,60; 95% CI: 42,15–78,71) dan durasi penggunaan gawai per hari (POR 3,34; 95% CI: 2,32–4,81). Perbandingan antara sekolah negeri dan swasta menunjukkan prevalensi 30,0% pada sekolah negeri dan 31,6% pada sekolah swasta, dengan prevalensi tertinggi ditemukan pada SMA swasta sebesar 42,0%, diikuti SMP negeri sebesar 37,4%.

Daniel Hardiman-McCartney , clinical adviser at the College of Optometrists explains why the sector's AI guidance matters

Dr Sayantan Biswas and Prof Leon N Davies provide an overview of the mechanism and optics associated with presbyopia. The seventh article of a series that captures the clinically relevant conclusions from the BCLA CLEAR Presbyopia publications

The chronic capacity crisis in secondary care glaucoma services has resulted in calls to expand contributions by primary care optometrists. This study aims to map the current geographic spread of optometrists with post-graduate higher qualifications in glaucoma and independent prescribing (IP) within the UK, providing insight into the potential for expansion of capacity in glaucoma care. Data on glaucoma-related and IP higher qualifications accredited by the College of Optometrists, as of April and August 2024, respectively, were analysed. The geographic distribution was mapped at both regional and local district levels using Quantum Geographic Information System software, geolocation application programming interface (postcodes.io) and programming languages JavaScript and Structured Query Language. Results for 2024 were compared with those previously published to determine change over time. From 2021 to 2024, the number of optometrists with higher qualifications in glaucoma has increased: Professional Certificate holders rose by 48% to 1986, Higher Certificate holders by 29% to 223, Diploma holders by 49% to 145, those with both Diploma and IP qualifications by 57% to 127 and IP alone holders by 88% to 1952. Regional variations appear to persist. The number of optometrists holding postgraduate higher qualifications in glaucoma and IP in the UK has increased substantially. These data suggest that primary care optometrists are willing to upskill to gain the necessary glaucoma accreditations required to provide glaucoma care, potentially affording significant primary care capacity expansion to existing glaucoma services.

Dr Amit N Jinabhai outlines part of the General Optical Council's fitness to practise process

IntroductionPapilloedema can be the first sign of life-threatening disease, for example, brain tumours. Due to the potential seriousness of this clinical sign, the detection of papilloedema would normally prompt urgent hospital referral for further investigation. The problem is that many benign structural variations of optic nerve anatomy can be mistaken for papilloedema, so-called pseudopapilloedema. The consequence is that many people are referred to hospital because they are incorrectly identified to have papilloedema when they don’t. As a result, hospital referrals of people with suspected papilloedema in England have increased sharply, leading to increased demand for overstretched hospital services and potentially longer waiting times for hospital appointments for those who do have papilloedema.The work programme is aimed at the development of guidelines and educational materials that will help support health professionals to correctly identify people with papilloedema. This article describes the protocol for gathering evidence of current referral practices and pathways for people suspected to have papilloedema in England and the development of guidelines based on this evidence and extensive engagement with community- and hospital-based healthcare professionals, patients, and the public.Methods and analysisBoth qualitative and quantitative data will be collected from Freedom of Information requests to Integrated Care Boards across England about how they organise their community and hospital services for people with suspected papilloedema, with and without headache. Surveys and qualitative interviews of relevant community and hospital healthcare professionals based in England will collect data on how and when people with papilloedema and pseudopapilloedema with or without headache are currently identified and referred to hospital, if needed. This information will be used to inform a Delphi process with the aim of reaching consensus among health professional experts, commissioners and patients on what the most evidence-based and safe diagnostic and referral practices should be for people with suspected papilloedema. The tailored guidelines will be written for healthcare professionals and patients. We will create a range of educational materials and a website designed for health professionals and patients to support the national roll-out and implementation of DIPP study guidelines.Ethics and disseminationEthical approval was granted by the University of Bristol Faculty of Health Sciences Ethics committee (FREC reference: 12457) and Health Research Authority (IRAS no.: 320395). Results of the study will be published on our DIPP study website and disseminated to our stakeholder groups through peer-reviewed journal publications and conference presentations.

Byki Huntjens and Sarah Farrant continue the TFOS summary series by looking at strategies to ameliorate the effects of digital environments