The College of Optometrists

Just wondering where the optom stands with pxs who fail to return for repeated measurements in terms of responsibility? Eg raised IOPs or field defect which you want to confirm on another day before referring. If the px does not attend for the repeat, is it advisable to refer on the basis of the results you have? Or is this a breach of confidentiality as you don't actually have the px's consent to refer at this point? Would failure to refer in this instance constitute SPM?

Thanks

What you seem to be saying is this:

"which takes precidence Confidentiality in view of Data Protection Act or The Opticians Acts rules on referal"

I don't think this has ever been tested in law (I could be wrong) - but if you act in the patients best interest and they specifically don't refuse your referal or note then there is no confidentiality breach.

This is all covered in the College guidelines here:

http://www.college-optometrists.org/coo/download.cfm?uuid=833C46FD-12FB-14B4-03C0FC34F88CF339&type=ethics_guidelines

So if you have some one with high IOP's and they don't come for a booked pre-referal refinement appointment. You should phone them to rebook (I always write down any referals I make and people I wish to monitor in my diary with their phone number) - if nothing happens then the doctor should be informed of your suspicions.

That would be in the patients best interest as if the doctor didnot know of the high IOP's - and went on to prescribe steroids -the pressures may go even higher and cause glaucomatous damage.

As long as the patient does not forbid you to write to the doctor - then there is tacit agreement to communication to their GP by virtue of them coming for an optometric opinion at the eye test.

I have known people who, on me asking for a retest before referal - told me not to write to their GP. In this instance you should note down the conversation and their reasons. I still had them back for the refinement = and I can't think of anyone who at that test declined referal.

Don't forget, if you tell anyone that they may have a problem - they will go into shock (I know that many go home and weep, especially if it is something they dread) and need some time to regain their poise.

Anyway - - I hope that helps a bit : steve