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  • You must decide on the best course of action for patients who present as an emergency. This will depend on the situation and you must use your professional judgement to decide what is in the best interests of the patient.
  • If you conduct an emergency examination of a patient who presents with an acute condition, you should make it clear to the patient that it is not a statutory sight test or full eye examination and that you are only addressing the presenting symptoms.
  • If you decide not to conduct an emergency examination of a patient who presents with an acute condition you should direct the patient to an appropriate healthcare professional and indicate the degree of urgency.
  • You, or your employer, should make sure that practice staff understand the protocol to follow when a patient presents as an emergency.
A77
This Guidance does not change what you must do under the law.
A78
There is no legal definition of an emergency. It may include: 
  1. red eye
  2. recent loss of vision
  3. recent onset of ocular pain
  4. symptoms which strongly suggest a recent retinal tear or detachment
  5. giant cell (temporal) arteritis (GCA).
A79
You must assess the patient and decide on the best course of action. The specific action will depend on the situation and you must use your professional judgement to decide what is in the best interests of the patient. In England, Wales and Northern Ireland there is no obligation to examine patients who present as an emergency, although if you participate in a MECS or similar you may have an obligation to see them. In Scotland, if you consider that the circumstances in which the patient presents constitute an emergency, you must:29  
  1. Carry out an emergency eye examination on the patient, either on the same day or within a reasonable timeIf you are unable to do this, you should  take all reasonable steps to make an arrangement with another practitioner, hospital or GP practice to examine the patient.
A80
If you conduct an emergency examination of a patient who presents with an acute condition, you should make it clear to the patient that it is not a statutory sight test or full eye examination and that you are only addressing the presenting symptoms (refer to COVID-19 guidance). You should: 
  1. record all findings and any advice you give the patient
  2. make it clear that the patient should return to their usual optometrist for a routine eye examination when it is due
  3. refer the patient to an appropriate healthcare professional if applicable. See section on Working with colleagues.
A81
You may charge an appropriate fee for emergency examinations unless you participate in an NHS- or government-funded scheme to see these patients.
A82
If you decide not to conduct an emergency examination of a patient who presents with an acute condition you should:  
  1. direct the patient to an appropriate healthcare professional
  2. indicate the degree of urgency.
A83
You, or your employer, should make sure that practice staff understand the protocol to follow when a patient presents as an emergency.
A84
If a patient contacts the practice by telephone describing symptoms that may indicate an acute condition, you should advise the patient to attend the practice or direct them to another healthcare professional, with an indication of the urgency (refer to COVID-19 guidance).
A85
You should record any advice given.