Yes. You may still carry and transmit the virus, as it is still uncertain whether the vaccination will prevent carriage of the virus in the nose and throat of people who have been vaccinated. The primary purpose of the vaccine is to prevent you from becoming unwell from COVID-19 infection.

Updated: 18 February 2021

Yes. You should continue to follow social distancing and infection prevention controls in practice, including the wearing of PPE. The primary purpose of the vaccine is to prevent you from becoming unwell from COVID-19 infection and may also reduce the chances of you being able to spread the infection by coughing less. However, you may still carry and transmit the virus, as it is still uncertain whether the vaccination will prevent carriage of the virus in the nose and throat of people who have been vaccinated. The effectivity of the vaccine may also vary with new and emerging variants of COVID-19.

Updated: 18 February 2021

The requirement to isolate is currently under review in each nation, check your Nations government website. We will update this when each nation has confirmed their policy.

Last updated: 15 July 2021

No. The vaccines being used produce a protective immune, antibody, response which can be measured by blood tests. However, they should not affect a PCR swab test, which is the basis of diagnosing COVID-19 in the nose and throat. They also do not affect the results of lateral flow test. PCR tests will be used as part of the vaccine effectiveness assessment in those who are vaccinated and subsequently develop symptoms of COVID-19.

Last updated: 18 February 2021

Yes, until more information becomes available, you should continue to complete the test twice weekly. It is important you report the result for every test you complete accordingly on the web portal.

Updated: 15 July 2021

No. The vaccine will induce an immune response but this should not affect the lateral flow test. If you test positive with a lateral flow test you should self-isolate and arrange a PCR test. The vaccine is not 100% effective, so there will be some cases where clinicians who have been vaccinated contract COVID-19. 

Updated: 18 February 2021

England
From 11 November 2021, anyone working or volunteering in a care home will be required to be fully vaccinated against coronavirus (COVID-19) unless medically exempt. 16 September is the last date to receive your first dose in order to be fully vaccinated in time to comply with the change in the rules. The College of Optometrists Guidance for Professional Practice (B36) states you should keep up to date with immunisation. If you cannot have the COVID-19 vaccination, you should speak with your employer and representative organisation.

More information: GOV.UK, Vaccination of people working or deployed in care homes: operational guidance

Scotland, Wales and Northern Ireland
It is strongly recommended all health care professionals are fully vaccinated against coronavirus (COVID-19) unless medically exempt. Although it is not a regulatory requirement, it may be a condition of your employment – for current employment contracts this would need to be discussed. For new employees, this could be specified as a contractual requirement of employment. The College of Optometrists Guidance for Professional Practice (B36) states you should keep up to date with immunisation. If you cannot have the COVID-19 vaccination, you should speak with your employer and representative organisation. 

Issued in conjunction with The Association of British Dispensing Opticians (ABDO)

Updated: 24 August 2021

If you have tested positive for COVID-19 you should recommence lateral flow tests 90 days after their positive test was taken. 

Updated: 18 February 2021

You may offer them a surgical mask to wear or rebook them in for their appointment as clinically appropriate. If they decline to wear one, please refer to the relevant FAQ.

Updated: 15 July 2021

If a patient tells you they are unable to wear a face covering, the practice should endeavour to accommodate the patient so they can still access eye care.  

It is important to follow official guidance at all times. For example, you should not insist on evidence or proof of their disability or medical condition, as it should be presumed that the patient is acting in good faith. In most cases however patients will provide this information when they explain why they are not wearing a face covering.  

It is also important to remember that a practice should not refuse to see people on the grounds of their disability or medical condition if they can make a reasonable adjustment to accommodate that patient.  

Patient face coverings are just one of many IPC steps designed to help protect practice staff and patients and practice. Even where a person cannot wear a face covering (for a medical reason) but needs to access face-to-face eye care then, the other steps combined help minimise the risk of COVID-19 transmission. This is why your practice should establish a plan of how to provide eye care to patients who it is impossible to wear a face-covering due to their disability or medical condition. This may include: 

1. offering the patient a remote eye care appointment and the opportunity to postpone their face-to-face appointment if they are asymptomatic.
2. arranging an appointment at time during a quiet period when they may attend, when fewer people are in the practice = as the patient will also want to reduce risk when they are travelling to and from the practice
3. using the largest consulting room available.
4. streamline the appointment as recommended in the College COVID-19 guidance, use imaging where possible, avoid the use of handheld instruments and complete as much of the examination remotely, to minimise the time required face-to-face.
5. asking the patient if they would be able to wear a mask for a short period of time while the optometrist performs the internal examination while they are closest.

If as a result of an individual risk assessment there is no one in the practice team who are able to examine patients who cannot wear a face covering, the practice may be in a position where it is unable to meet the patient’s needs safely – ie. make the reasonable adjustments required. In this situation the practice should explain the situation and refer the patient to another local provider. You should keep a record of when you do this and the reasons given to the patient. Having this arrangement in place locally should be agreed in advance with other local practices. 

Updated: 15 July 2021

If patients do not have a medical reason for the being unable to wear a face covering, yet refuse to wear a mask, you have the right to refuse to see them if your practice has carried out a workplace risk assessment that concludes face coverings is a necessary infection prevention and control measure – the safety of all patients and practice staff is paramount. However, you should take all reasonable steps to identify practical working solutions with the least risk to all involved on a case-by-case basis. Where available, continue to offer remote eye-care to this group of patients.

At present, there is no legal requirement for a patient to wear a face-covering in an optical practice. However, Public Health England, the College of Optometrists and the Association of Optometrists advise that they are worn at all times unless the patient is unable to wear one on the basis of health reasons or due to a disability. Government guidance states that people do not need to provide evidence of their disability or medical condition. 

Updated: 18 February 2021

Although you may politely encourage children to use a face covering, you cannot insist that they do. Patient face coverings are just one of many IPC steps designed to help protect the practice. Even where a person cannot wear a face covering, the other steps combined help minimise the risk of COVID-19 transmission. 

Your practice should establish a plan of how to provide eye care to children. This may include: 

1. offering the child and parent a remote eye care appointment and the opportunity to postpone their face-to-face appointment if they are asymptomatic.
2. arranging an appointment at time during a quiet period when they may attend, when fewer people are in the practice
3. using the largest consulting room available.
4. streamline the appointment as recommended in the College COVID-19 guidance, use imaging where possible, avoid the use of handheld instruments, and complete as much of the examination remotely as possible, to minimise the time required face-to-face.
5. asking the child if they would be able to wear a mask for a short period of time while the optometrist performs the internal examination while they are closest.

If as a result of an individual risk assessment there is no one in the practice team who are able to examine children who do not wear a face covering, the practice may believe it is unable to make provision for children the practice may refer the child to another local provider who can provide GOS funded sight tests. This should be agreed in advance. You should make a record where you refer a person to another practice and the reason why.  Public Health England does not recommend face coverings for children under the age of 3 for health and safety reasons. 

Updated: 15 July 2021

You should refer to the FAQs above, as practice processes should account for your risk assessment. If you are returning to work and have not yet had a risk assessment your employer should arrange this for you, alternatively you can access a template here.  
 
Depending on your individual circumstances you might be advised to work remotely or in-person but at a distance of more than 2m or more.  
 
If you feel your health is negatively affected by your working conditions, you should discuss this with your employer in the first instance – they must perform a workplace risk assessment to help protect you from coronavirus: Risk assessment - Working safely during the coronavirus (COVID-19) pandemic. The result may be that children or patients who are unable to wear a mask due to a medical reason are triaged to another clinician in your practice, or if you are a sole clinician, those patients can be referred to another local practice. This should be agreed in advance. You should make a record where you refer a person to another practice and the reason why. 

Updated: 18 February 2021

As a healthcare setting there is no requirement to display a NHS QR code in your practice at present. Most people attending the practice will be registered in the appointment book and will have undergone an initial triage and check for symptoms of COVID-19 for either themselves or their household. In addition you should have effective infection control procedures in place. Where there are unscheduled visits to the practice for browsing, collections or repairs, in our view there is no requirement to keep a list of attendees for short duration visits as long as social distancing is maintained and staff are wearing appropriate PPE.

Updated: 15 July 2021

Patients who attend optical practices and who subsequently test positive for COVID-19 are not generally considered contacts for NHS Test and Trace/Test and Protect purposes when the practice has been following IPC procedures and practitioners have been wearing PPE properly when they were in contact with the patient.

Each Test and Trace/Test and Protect call handler is a clinician who will make a clinical judgment about the risk of each person's interaction but may not fully understand the nature of primary eye care and how IPC in our sector operates.

If you are contacted by NHS Test and Trace/ Test and Protect call handler, it is essential you explain to them that the contact was within a healthcare setting and to describe the PPE you were using and the IPC procedures you were following.

If you are asked how long you spent with the contact, make sure you let the call handler know BOTH the total duration of the sight test AND how long you were close proximity to the patient. For many contacts, proximity will be a relatively short period of time. (Such as the time at the slit lamp, behind the slit lamp Perspex screen, with the rest of the consultation performed at two meters or more.)

If you believe the call handler has incorrectly assessed the risk of the interaction, you should escalate the decision by requesting a second opinion. This is an accepted part of the internal process at NHS Test and Trace/ Test and Protect and will not cause offence.

If, after the escalation request and further discussion, it is decided you did not have a close contact and can return to work, you can then do so. However, it is a legal requirement to follow the advice of the call handler, including isolation for 14 days, even if you believe this to be an incorrect decision.

If you had to escalate a decision, or believe the advice was incorrect, please contact the College or your representative body so we can collectively collate examples to feedback via the College to the relevant NHS tracing service.

Updated: 15 July 2021

The government recommends that healthcare workers working in a healthcare setting, such as an optometry practice, pause the Test and Trace app or turn off their 'Bluetooth' while at work. This is important so that a smartphone in a locker is not incorrectly recording interactions with patients visiting the practice.

Updated: 13 October 2020

We recommend that all staff wear a fluid resistant surgical mask to protect their patients, colleagues, and themselves. This applies even if they are working behind a screen. 

Updated: 15 July 2021

Yes.

Download the COVID-19 symptoms poster for England (PDF, 40.5KB) 

Download the COVID-19 symptoms poster for Northern Ireland (PDF, 40.7KB) 

Download the COVID-19 symptoms poster for Scotland (PDF, 41.4KB) 

Download the COVID-19 symptoms poster for Wales (PDF, 40.7KB) 

Poster pack for England

Resource pack for Scotland (direct download 21MB)

You can find a poster on our website to remind patients that they should wear a face covering upon entering an optical practice (PDF).

Updated: 15 July 2021

We have information and a risk assessment for staff here.

Updated: 9 September 2020

Our patient information on a range of conditions, including AMD, blepharitis and flashes and floaters, is available for free on lookafteryoureyes.org  – our public website. We recommend that you direct your patients here for phone- and desktop-friendly information during the lockdown period.
 
You can also link straight through to lookafteryoureyes.org from your practice website.

a. The contact is a patient

If you were wearing the correct PPE appropriately in accordance with the UK IPC guidance and How to work safely guidance, you will not be considered as a contact for the purposes of contact tracing and isolation. This applies regardless of your vaccination status or the circulating variant of COVID-19. A COVID-19 test and self-isolation is not required.

b. The contact is a member of the practice team or another person 

Northern Ireland, Scotland, Wales 

If you are notified that you are a contact of a COVID-19 case, you need to complete the required COVID-19 test. If the test result is negative and you are asymptomatic, you can return to work, with daily LFD testing as per your nations’ guidance. The majority of fully vaccinated health and social care staff will be able to continue in their usual role. The following apply when you return to work: 

• You do not have any COVID-19 symptoms
• You should not have any travel related isolation requirements
• You should undertake an LFD test every day for the recommended period following your last contact with the case (even on days you are not at work)
• If you have had a COVID-19 infection in the past 90 days, you should not have a PCR test and should only undertake daily LFD tests
• You should complete the LFD test before starting your shift, and the result should be negative
• You should continue to maintain high standards of IPC and comply with all relevant infection control precautions and PPE should be worn properly throughout the day
• You should not provide direct patient care to extremely clinical vulnerable patients during the recommended period.

If any of the above cannot be met, the staff member should not come to work and should follow the stay at home guidance for your nation. 

England 

If you are notified that you are a contact of a COVID-19 case, you can continue to work as normal provided you are asymptomatic and continue to return negative LFD tests twice weekly. While a negative PCR test is no longer required to return to work, we recommend you undertake and return a negative LFD test before returning to work. You should continue to maintain high standards of IPC and comply with all relevant infection control precautions and PPE should be worn properly throughout the day.  

We also recommend you should not provide direct patient care to extremely clinical vulnerable patients for remaining 10 days following the initial contact.  

If you develop COVID-19 symptoms or test positive, you should follow government guidance.  

c. The contact is close member of my household

England
The risk of COVID transmission may be higher for people within your home than a single episode of a COVID-19 close contact in another environment.  

If you share a household with a COVID-19 case, you can continue to work as normal provided you are asymptomatic and continue to return negative LFD tests twice weekly. While a negative PCR test is no longer required to return to work, we recommend you undertake and return a negative LFD test before returning to work. You should continue to maintain high standards of IPC and comply with all relevant infection control precautions and PPE should be worn properly throughout the day.  

We also recommend you should not provide direct patient care to extremely clinical vulnerable patients for remaining 10 days following the initial contact. 

If you develop COVID-19 symptoms or test positive, you should follow government guidance.  

More information: 

• C1621-living-with-COVID-19-testing-update-letter-30-march-2022.pdf (england.nhs.uk)
• Managing healthcare staff with symptoms of a respiratory infection or a positive COVID-19 test result - GOV.UK (www.gov.uk)

Northern Ireland
You need to self-isolate and arrange the required COVID-19 test in line with government guidance. You should notify your employer as soon as possible.

The risk of COVID transmission may be higher for people within your home than a single episode of a COVID-19 close contact in another environment.

If your COVID-19 test is negative and you continue to be asymptomatic, you can return to work provided all other contingency measures have been explored based on a risk assessment conducted by an appropriate senior manager within the optical practice. You should follow the return to work criteria set out in section “b.” above.

More information: 

• Department of Health Northern Ireland, Fully vaccinated health & social care staff told to self isolate as a close contact may be permitted to attend work in exceptional circumstances

Scotland
You need to self-isolate and arrange the required COVID-19 test in line with government guidance. You should notify your employer as soon as possible.

The risk of COVID transmission may be higher for people within your home than a single episode of a COVID-19 close contact in another environment.

You can continue to work provided you have a negative COVID-19 test, no symptoms, have received the COVID-19 booster jab and return negative LFD test results as set out by Scottish Government. You should follow the return to work criteria set out in section “b.” above.

More information: 

• COVID-19 guidance (eyes.scot)

Wales
You need to self-isolate and arrange the required COVID-19 test in line with government guidance. You should notify your employer as soon as possible.

The risk of COVID transmission may be higher for people within your home than a single episode of a COVID-19 close contact in another environment.

If your COVID-19 test is negative and you continue to be asymptomatic, you can return to work provided all other contingency measures have been explored based on a risk assessment conducted by an appropriate senior manager within the optical practice. The contractor should make decisions about this process in line with the criteria set out by the Welsh government but must advise the health board about their approach. You should follow the return to work criteria set out in section “b.” above.

More information: 

• Welsh Government, COVID-19 contacts: guidance for health and social care staff

In England, Northern Ireland and Wales fully vaccinated currently means 14 days after having received two doses of an approved vaccine (such as Pfizer-BioNTech, AstraZeneca or Moderna/Spikevax) or one dose of the single-dose Janssen. We will update members if the UKHSA changes the definition in future to include the booster vaccination.

In Scotland fully vaccinated means 14 days after having received a third booster dose of an approved vaccine. 

Updated:  5 April 2022

England

If you test positive for COVID-19, you should notify your employer and you must not attend work until you feel well enough to do so and you do not have a high temperature. If you primarily work with people who are at higher risk of serious illness from COVID-19 (as determined by your employer) you must not attend work for at least five days, and only return if you feel well enough to do so and you do not have a high temperature. You should also follow guidance for the general public who have a positive test result.

Local protocols regarding return to work criteria, including redeployment, LFD testing and enhanced use of PPE should be followed where recommended by local health authorities. Your employer should undertake a risk assessment before you return to work, including consideration of redeployment where appropriate.   

If you return to work within ten days of symptom onset (or first positive COVID-19 test result) you are strongly advised to wear a face mask and limit close contact with other people in crowded or poorly ventilated spaces, work from home if you can do so and minimise your contact with anyone who is at higher risk of serious illness from COVID-19. 

The risk of SARS-CoV-2 transmission may be higher when returning to work within ten days of symptom onset (or first positive COVID-19 test result), even with a negative LFD test. It is imperative that high standards of IPC are maintained, in communal areas, as well as private staff areas. Clinicians in this situation should not provide direct patient care to anyone who is at higher risk of serious illness from COVID-19 during this period. 

• Managing healthcare staff with symptoms of a respiratory infection or a positive COVID-19 test result - GOV.UK

Northern Ireland

If you test positive for COVID-19, you must self-isolate for up to 10 days. If asymptomatic, you should take a LFD test on day five of your isolation period and another 24 hours later on day six. If both tests are negative and you have no symptoms, you may end your isolation period and return to work. However, you must still complete LFD tests on days six, seven, eight, nine and 10, and ensure they remain negative before starting work each day. If you test positive on day five, then a negative test is required on day six and day seven to release you from isolation. 

If you work with people who are at higher risk of serious illness from COVID-19 (as determined by your employer), a risk assessment should be undertaken. You should report your LFD test results to your nation’s government website.  

If you leave self-isolation on or after day six you are strongly advised to wear a face covering and limit close contact with other people in crowded or poorly ventilated spaces, work from home if you can do so and minimise your contact with anyone who is at higher risk of serious illness from COVID-19 for up to 10 days of symptoms onset (or first positive COVID-19 test result). 

The risk of SARS-CoV-2 transmission may be higher when returning to work on day six, even with a negative LFD test. It is imperative that high standards of IPC are maintained, in communal areas, as well as private staff areas. Clinicians in this situation should not provide direct patient care to anyone who is at higher risk of serious illness from COVID-19 for up to 10 days of symptoms onset (or first positive COVID-19 test result). 

• Lateral flow testing for primary care staff | HSC Public Health Agency

Scotland

If you test positive for COVID-19, you must self-isolate for up to 10 days. If asymptomatic, you should take an LFD test on day five of your isolation period and another 24 hours later on day six. If both tests are negative and you have no symptoms, you may end your isolation period and return to work. If you test positive on day five, then a negative test is required on day six and day seven to release you from isolation. If you work with people who are at higher risk of serious illness from COVID-19 (as determined by your employer), a risk assessment should be undertaken before you return to work. You should report your LFD test results to your nation’s government website.  

• Coronavirus (COVID-19): staff testing in NHS Scotland - gov.scot

Wales

If you test positive for COVID-19, you should notify your employer and you must not attend work until you feel well enough to do so and you do not have a high temperature. You should also follow guidance for the general public who have a positive test result.

Your employer should undertake a risk assessment before you return to work, including consideration given to redeployment where appropriate.  

If you return to work within 10 days of symptom onset (or first positive COVID-19 test result) you are strongly advised to wear a face mask and limit close contact with other people in crowded or poorly ventilated spaces, work from home if you can do so and minimise your contact with anyone who is at higher risk of serious illness from COVID-19 (as determined by your employer). 

The risk of SARS-CoV-2 transmission may be higher when returning to work within 10 days of symptom onset (or first positive COVID-19 test result), even with a negative LFD test. It is imperative that high standards of IPC are maintained, in communal areas, as well as private staff areas. Clinicians in this situation should not provide direct patient care to anyone who is at higher risk of serious illness from COVID-19 during this period.  

• Advice for health and care staff on respiratory viruses including COVID-19: guidance | GOV.WALES
• Infection prevention and control measures for acute respiratory infection (ARI) including COVID-19 for health and care settings

Updated: 6 April 2023

We advise using SL-BIO rather than direct ophthalmoscopy so that you can maintain a safe distance from the patient as much as possible. However, we recognise that there are occasions where this is not possible, such as for very young children, or when the patient is unable to reach the slit lamp. Fundal imaging is a useful technique, but it does not replace the use of SL-BIO, as it does not examine the patient's external eye, anterior chamber, or media. We also recognise that not all practices have fundus cameras, and that there are some patients who cannot reach the camera. In these instances, as an internal examination is one of the legally required parts of a sight test, if there is no alternative but to use direct ophthalmoscopy, you should minimise the infection risk by asking the patient to wear a face covering if possible (this may not be possible for very young children).

Updated: 16 June 2020

We recognise that this is a very new situation for optometrists, so we have written guidance to help you consider how best to have a telephone or video consultation with a patient. We have also designed a telephone consultation record sheet which you may choose to use if you wish. It is important to realise that you still need to adhere to confidentiality and data security procedures.

During the pandemic, we advise that you should only perform tests if it is clinically necessary, based on the individual patient circumstances, rather than doing it as a blanket test on everyone in a certain category. Tonometry and visual fields should be performed where it is clinically indicated or for considered at high risk by their optometrist on an individual basis. 

Updated: 19 June 2020

Contact the appropriate local hospital for advice.

Updated: 27 March 2020

In the red phase of the pandemic you may supply contact lenses to an expired specification.

Reissuing of a specification is in our view is equivalent to a contact lenses fitting as it involves assessing whether a lens is suitable and conducting an examination of the anterior eye (Guidance for Professional Practice - Fitting contact lenses: A347 – A349), so where a patient’s specification has expired and need further supply of contact lenses, you should arrange a face-to-face appointment as soon as you reasonably can. However, in our view you may complete a remote fitting in the amber phase of the pandemic in exceptional circumstances provide that:

1. The sight test is in date 
2. There are no clinical indications to attend the practice 
3. The patient is aware of the risks of not attending 
4. There is no change in the contact lens specification.

You must satisfy yourself that it is clinically appropriate, and you are acting in the patient’s best interest. You should make notes in the patient record to explain your decisions and the actions taken.

Updated: 15 July 2021

There is no evidence to suggest that wearing contact lenses increases the risk of contracting COVID-19. Patients can continue to use their contact lenses as normal if they do not have COVID-19 or any of the associated symptoms.

It is good general advice for patients to reduce their contact lens wearing time if they do not need to wear their lenses and can manage with spectacles, as may well be the case if they are at home more. If they wish to wear their contact lenses you should stress to patients that they should practise good contact lens hygiene as always, and that thoroughly washing their hands before and after handling their lenses is essential. We would also advise that if patients are ill, they stop wearing contact lenses until they are better. This applies to all illnesses, including the common cold, influenza and COVID-19. If a contact lens wearer is in a household of another person with COVID-19, they may wish to cease contact lens wear until the whole household has recovered.

A paper on the important considerations for contact lens practitioners during the COVID-19 pandemic has been published. 

Updated: 15 July 2020

This is up to your professional judgement. We suggest you telephone the patient and explain the situation and ask them if they would like you to make up some spectacles for them.  If you have previous details you may be able to do this remotely (for example if they are happy for you to reglaze their spectacles, which they can post to you), and post the reglazed spectacles back to them.  If they would prefer to have a new frame then arrange for them to come into the practice for dispensing and take appropriate social distancing and infection control procedures as outlined above.

We have created a simple and easy to use visual acuity (VA) chart which patients can use at home. The chart has been designed to work at 3 metres, and will enable patients with access to an A4 printer to approximately measure their own visual acuity in advance of the remote clinical assessment. You can email the chart to patients, so a rough visual acuity can be recorded during the remote review.
 
The chart can be used at different distances to extend its range, we have included a conversion table so clinicians can easily record an approximate VA when used at 1 and 4 metres.
 
You can download and send the chart to your patients, or direct them to our public website, where they can also watch a video on how to use the chart.

Disclaimer: 

We have taken the steps necessary to ensure this test is broadly equivalent to a validated vision chart when it is used in a well-lit room, printed on an A4 size piece of white paper used at the correct distance.  However, our chart has not been independently validated as such, it is not a substitute for a vision assessment by a clinician using a correctly calibrated and validated vision test chart. The purpose of this College chart is to provide a broad evaluation of visual acuity in order to identify clinically significant sight loss in a home environment, in conjunction with a virtual clinical assessment.

The acuities given for each line are approximate equivalents to aid optometric differential diagnosis. The room illumination, chart distance and printing contrast may all vary. Optometrists should be mindful of this when considering a patient supplied self-recorded visual acuity along side other findings. However, even with these caveats, where a person can print and complete the test, the benefit of knowing an approximate and broadly equivalent level of vision, is in our view a useful aid to any telephone or video clinical review. We would welcome the development of an validated and fully automated visual acuity recording app for home use.

Updated: 22 April 2020

The UK Health Security Agency (UKHSA) has stepped down its infection prevention and control measures for seasonal respiratory infection in health and care settings, this means the default wearing of face covering no longer applies to those working in optical practices. It is now the responsibility for each person providing direct patient care to perform a dynamic risk assessment of what PPE is required, including whether or not to wear a face covering. Whilst the public may still be asked or invited to wear a face covering, it is no longer a UKHSA recommendation.

Section B39 of the Guidance for Professional Practice provides some overarching principles of when you should consider wearing a face mask:- 

• Performing procedures when in close proximity to the patient
• You consider there is a risk of respiratory infection
• There is a public health requirement to wear one

There is no longer a public health requirement, so whether you wear a face mask is up to your professional judgement on the basis of a dynamic risk assessment. This will include:

• consideration of the proximity you are to the patient,
• the time required,
• where the interaction is taking place,
• ventilation,
• and whether you consider there is a risk of respiratory infection.

By "close proximity" we refer to performing clinical procedures such as direct ophthalmoscopy, Perkins tonometry, micro-exfoliation, foreign body removal and slit lamp examination without a breath shield in the consulting room, where you are close to the patient for an extended period of time.

It is unlikely that face masks would normally be required for:

• Performing screening tests such as visual fields, desk mounted non-contact pressures, fundus photography or other imaging as there is a considerable distance and often an object between you and the patient.
• Performing refraction or taking a case history at a reasonable distance
• When dispensing, fitting and adjusting spectacle frames in the dispensing area where you are at arm’s length, for a relatively short period of time, and generally in a large, well-ventilated area.

It is important for every staff member to consider their circumstances, and before undertaking any procedure - clinical or otherwise. You should assess any likely exposure to blood and/or other body fluids, non-intact skin or mucous membranes and wear personal protective equipment (PPE) that protects adequately against the risks associated with the procedure, which may include the use of face masks. 

It is also our view, and that of the Domiciliary Eyecare Committee, that in domiciliary settings, clinicians should continue to wear a face mask when visiting both patients' homes and when visiting residential care settings due to the different risk profiles of the setting.

If your patient is suspected or confirmed of having a respiratory infection or if your care pathway mandates it, then both the staff member providing care and the patient should always wear a face mask within the practice if the patient is able to.

If your patient is suspected or confirmed of having a respiratory infection or if your care pathway mandates it, then both the staff member providing care and the patient should always wear a face mask within the practice if the patient is able to.

UKHSA infection prevention and control (IPC) guidance

• England : National infection prevention and control manual for England
• Wales: Infection Prevention and Control Measures for SARS-CoV-2 (COVID-19) in Health and Care Settings

Northern Ireland and Scotland 

We are working with each Nation's government to inform members how these will affect optometry practices on requirements for face masking/covering by staff, patients and visitors. We will provide updates to members of those nations as soon as possible. 

UKHSA infection prevention and control (IPC) guidance

• Northern Ireland: IPC guidance for COVID-19
• Scotland: COVID-19 Guidance for health protection teams

You should make risk-based decision on whether to use a face mask in domiciliary settings. Care homes can initiate their own outbreak risk assessments to make decisions about which outbreak measures make sense for their individual settings. The guidance relating to face coverings is the same in primary care and care home settings in England. Universal masking remains in place in all settings in Scotland. 

Section B39 in the Guidance for Professional Practice states that you should wear a Fluid Resident Surgical Face Mask (FRSM Type IIR) when: 

1. Performing procedures when in close proximity to the patient
2. You consider there is a risk of respiratory infection
3. There is a public health requirement to wear one, such as during a pandemic, unless the mask type specified by the relevant national or local public health guidance recommends an alternative specification and level of protection.

Last updated: 10 January 2023

Each optometrist should continue to follow their Nation’s public health guidance for healthcare workers. Currently, you should perform asymptomatic Lateral Flow Device (LFD) testing twice a week and continue to register your results. This is under review by the UKHSA.

You should ensure that you have access to adequate hand decontamination. You must clean and disinfect your hands regularly and thoroughly to prevent the spread of infection. In a domiciliary setting this may be by fully utilising alcohol-based hand rubs.  These provide rapid disinfection by destroying microorganisms on the skin's surface; however, they are not a cleaning agent and you should not use them if hands are visibly dirty or contaminated with blood, bodily fluids or other potentially infectious agents. Hand rubs are especially useful in situations where handwashing and drying facilities are inadequate such as during domiciliary visits.

The risk of COVID transmission may be higher for people within your home than a single episode of a COVID-19 close contact in another environment.  If you share a household with a person with COVID-19, you can continue to work as normal, provided you are asymptomatic and continue to return negative LFD tests twice weekly.

You should have a mechanism to ensure people who are unwell can postpone their eye care, unless they require an urgent or emergency consultation. Where people have a single respiratory symptom, you should use your professional judgment to ensure you act in your patients’ best interests and not defer appointments or refer to other pathways in the first instance. If a person is affected by chronic respiratory condition such as COPD, asthma, or allergies, you should deliver face to face care as usual.

Where people have two or more recent onset (acute) symptoms of respiratory infection, you should offer remote care where appropriate or deferral of routine care until they are well. However, if these patients require urgent/emergency face to face care, they should be referred to a local service that is able to apply the relevant transmission-based precautions as part of a risk-assessed patient pathway.

Symptoms of respiratory infection may include:

• High temperature or fever
• A loss or alteration to taste or smell
• runny nose
• sore throat
• new, continuous cough
• difficulty breathing or shortness of breath