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:³²  

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 arrange with another practitioner, hospital or GP practice to examine 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. 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.

You may charge an appropriate fee for emergency examinations unless you participate in an NHS- or government-funded scheme to see these patients.

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.