The supply of spectacles or contact lenses to patients who are registered as sight impaired or severely sight impaired must be carried out by or under the supervision of an optometrist, dispensing optician or doctor.³⁸ 

You must supply the patient with the most appropriate low vision device. Factors to consider include magnification, care and ergonomics.

Advice on visual ergonomics should include reading posture, reading stands, copyholders, clipboards and higher reading additions.

You should consider binocularity and accommodation when supplying a patient with any device.

Before you supply any device, you should assess patients carrying out relevant practical tasks with the device to identify any limitations, such as using a switch or left or right hand use.

After supplying any device you should provide the patient with full instructions on: 

1. the tasks the device has been issued for
2. how to use the device, including:
   • how far the device should be held from the eye and the object
   • which spectacles, if any, to use with it
   • any specific advice on lighting
3. the initial programme of low vision training, including:
   • reading or skill practice
   • aftercare
   • what post-supply support is available
4. care, storage and cleaning of the device, including maintenance of batteries and integral lamps if appropriate. 

You must give appropriate instructions in writing to comply with the Medical Devices Directive.³⁹

You should be aware of the limitations of optical devices and direct patients to agencies that can advise on non-optical devices and electronic aids, such as electronic vision enhancement systems (EVES).

If you consider a low vision aid unnecessary or unsuitable, or the patient rejects it, you should explain to the patient that their situation or technology may change and encourage them to return for regular assessments.

Dispensing opticians are a valuable part of the low vision team. ABDO has advice and guidelines for their members on low vision practice.⁴⁰