Plymouth Ocular Motor Unit (POMU)
The Plymouth Ocular Motility Unit is a world leading unit for clinical assessment, teaching, and research in the field of eye movement disorders. It was first set-up to be a leading example of how to run a clinic which strives to provide the highest quality of care for this cohort of patient. By combining extensive expertise and experience, with the use of specialised equipment and other unique available resources, the team effectively investigates, manages, and supports patients of all ages with complex eye movement disorders.
Nystagmus and eye movement disorders can be broken down into different categories:
1. Early-onset developmental nystagmus.
2. Early-onset neurological nystagmus.
3. Early-onset eye movement disorder.
4. Late-onset acquired nystagmus.
5. Late-onset eye movement disorder.
These conditions can present with an array of signs and symptoms which can overlap between the 5 categories, presenting a clinical challenge with diagnosis. Differentiating the various types of nystagmus and eye movement disorder is important because care pathways will vary significantly depending on the condition diagnosed. As an example, if Early-onset neurological nystagmus is identified, this will need urgent neurological investigation however if Early-onset developmental nystagmus is identified, ocular pathology will be investigated. This highlights the importance of early diagnosis. High quality of care is the primary aim of the POMU. To fulfill this aim, the POMU strives to diagnose, manage and support patients as quickly and effectively as possible.
The POMU clinics are based in the Ocular Motility Room at the Royal Eye Infirmary. It is a multi-disciplinary clinic with the Consultant Clinical Scientist and Advanced Orthoptist working alongside each other. This means it is a one-stop-shop when it comes to investigating, managing and supporting the patients.
Initially, a thorough case history is taken with all patients. This is to fully understand the patients background. After this, ocular investigations are undertaken which can include (but are not limited to) assessment of eye movements in free space and with eye tracking, ocular alignment, binocular vision, visual acuity and visual function. If appropriate, general neurological function will also be assessed in clinic. Constant review of clinical care pathways ensure that the clinical care is maintained in-line with up-to-date evidence-based practice.
A multi-disciplinary approach is key to maintaining high quality of care for patients with complex eye movement disorders. Many other professionals within the eye team play an essential role. The POMU has a close working relationship with Ophthalmology (assessment of the ocular health), Optometry (assessment of refractive error) and Ophthalmic Imaging (taking pictures of the ocular structures). Outside of the eye team, referrals are regularly made to Neurology, Neuro-psychology, Neuro-physiology, Neuroimaging, Neuro-rehabilitation, Genetics and Visual Impairment services.
|Dispensing Optician||Visual Impairment services|
|Eye clinic liaison officer (ECLO)||Neuro-imaging|
After reviewing the feedback given to the Nystagmus Network charity from people with nystagmus, the POMU realised that care and support for these patients is lacking nationally. For this reason, the POMU’s priority is not only to investigate and manage the patient but also to compassionately support them by giving them all necessary information about their condition. This is to ensure the patient to fully understands their condition, enabling them to better compensate for the potential problems they may encounter in day-to-day life.
Teaching is a core value of the POMU. Students of all disciplines (Medicine, Allied Health Profession, Nursing etc) are welcomed to observe in the clinics. By getting first-hand experience with the clinic, students learn how to effectively investigate, manage and support this cohort of patient.
The unit also offers expertise when mock practical examinations are organized by tutoring and examining the students. This allows students to get experience with complex eye movement disorder cases, of which they may never encounter before starting as a qualified professional.
Due to the range of complex eye movement disorders that are seen in clinic, interesting cases are videoed and recorded. This is done if the patient consents to it and the information is stored securely and confidentially. The recordings are studyed by students so they can further develop their understanding of a particular condition.
The POMU regularly presents at conferences, clinical governance meetings and teaching days to help expand the understanding of eye movement disorders locally, nationally and internationally.
There is much to be done to further understand nystagmus and eye movement conditions. More specifically, how to better investigate and diagnose these conditions with patients of all ages, how to manage the conditions more effectively and to better understand how these conditions affect people’s day-to-day lives.
Nationally and internationally, clinical care of nystagmus is variable. The POMU understands this and was the first department in the UK to develop a Nystagmus Care Pathway. The pathway was designed in parallel with the clinical care provided in the POMU clinic. Its aim was to standardise the clinical care and support of nystagmus patients between departments nationally and therefore ensure a thorough multi-disciplinary approach is provided to all patients with nystagmus.
Professor Harris is a world-renowned researcher in this field and has published numerous papers on nystagmus and eye movements.
Professor Chris Harris
Consultant Clinical Scientist
Mr Dominic Burdon BMedSci
Advanced Orthoptist – POMU and SEND lead
REI, level 3
Get in touch
If you would like to contact the Plymouth Ocular Motility Unit, please send a letter via the address above or phone the following number: 01752 439319 (orthoptic secretary).