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Key points

  • Patients with cognitive impairment may have additional ocular conditions.
  • You should be flexible when examining the patient and adapt your techniques as required.
  • You must follow the guidance on consent when discussing the patient’s condition with a relative or carer.
  • Making decisions about treatment for patients who lack capacity is governed in England and Wales by the Mental Capacity Act 2005, in Scotland by the Adults with Incapacity (Scotland) Act 2000 and in Northern Ireland by the Mental Capacity Act (Northern Ireland) 2016.
  • You must only prescribe spectacles when it is in the patient’s best interests.
This guidance does not change what you must do under the law.
You must only carry out a sight test if this is clinically justified and in the best interests of the patient.81 You should document the reasons for this on the patient record.