Dr. Charles Schlievert, OD
Dr. Charles Optical in Atlanta, Georgia and optometrist in the Geriatric Eye Group which provides inpatient care for residents in skilled nursing and assisted living homes, memory care centers, and correctional facilities.
In this short interview, Dr Schlievert discusses how he uses the QuickSee handheld autorefractor to perform clinical quality vision care to patients in nursing and assisted living homes.
PlenOptika Tell us about your mobile nursing home practice and how QuickSee supports your process.
Dr Schlievert Well, we service hundreds of nursing facilities throughout Georgia and we provide eye care to thousands of residents yearly. We use many handheld devices, and the QuickSee autorefractor has not only modernized our services, but it has also given us a better opportunity to provide quick and accurate measurements in a mobile setting.
PlenOptika What are some of the special considerations that you’ve encountered for achieving high quality results from patients in nursing homes?
Dr Schlievert You know, to achieve the best results, we must be able to provide eye care in each residence room. Therefore, we are constantly moving from one area of the facility to another. We use reliable equipment and the QuickSee has improved the quality of our mobile refractions.
PlenOptika Naturally in nursing homes, you’ll find patients in a variety of different positions, whether they’re in chairs, or maybe even lying down in beds. So how does QuickSee help you accommodate your patients’ positions? And what do you do to ensure that you’re getting a high quality measurement from them?
Dr Schlievert Many residents in the nursing facilities are bed bound or in wheelchairs. And as a service provider, we must be able to test individuals in reclined or even seated positions. The QuickSee is lightweight and simple to use, it makes it easier to test patients in challenging positions.
PlenOptika What special steps do you take to get the alignment of the pupillary distance before you begin the measurement?
Dr Schlievert To get the appropriate pupil distance it’s easiest to stand over the patient as they sit in a wheelchair or as they lay reclined in their bed. This testing position makes it easier to visually align the patient’s pupil with autorefractor.
PlenOptika When you are measuring a patient in the nursing home, what method have you found to be the most effective?
Dr Schlievert Although the device works well with non-dilated pupils, I get faster testing images with a dilated pupil. And although the QuickSee works great binocularly I prefer to use the device monocularly to avoid confusion from the patient. The monocular testing also works well for strabismus patient patients.
PlenOptika When you’re visiting patients in a nursing home you may find them some of them seated but many of them lying down. Can you [describe] your typical technique when measuring a patient in the nursing home?
Dr Schlievert The way I usually start is I have the patient look at a distant target. I have them focused on the clock on the wall or their television set. What I do then is I stand over them slightly, and I hold the instrument over them like a pair of binoculars, and they look straight out at that distant target. Once I align the pupil—and you can do that easily by looking downward at them, you align the pupil with the device—I do each eye monocularly…I press the green arrow and typically I’ll just [count to five] and then I get my result. I then repeat it with the patient’s [other] eye and then I have both accurate results.
PlenOptika What happens when you encounter a patient that’s difficult to align or difficult to get the QuickSee seated very easily on the patient?
Dr Schlievert Sometimes patients will have a facial deformity or a large pupillary distance. In cases like that I can easily remove the black adapter. Sometimes it allows me to get a better view looking downward at the patient to align the pupil or gives me a little bit of an easier alignment, just to get the pupil distance from one eye to the other. In certain cases, as with a patient that has strabismus, I’m able to actually align the instrument with the angle of their strabismus to get the right measurements.
PlenOptika What do you do to prepare before you visit and what special tips do you have while moving around within the nursing home?
Dr Schlievert First off, I always charge the device the night before for roughly six to eight hours. That way I can guarantee it will last the length of my entire shift. I always prefer to correctly turn the QuickSee off when it is not used for longer than 20 or 30 minutes. I keep it position on the crash carts surface when not in use. And the rubber base keeps it from falling off the car in between rooms.