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Conducting a domiciliary eye examination

When carrying out eye examinations in a domiciliary setting you should:
  1. ensure that a relative or carer is present, where possible
  2. carry out whatever tests are possible to determine the patient’s needs for vision care for both sight and health. The format and content of the eye examination will be determined by your professional judgement and the legal requirements
  3. consider whether it is appropriate to offer low vision assessment and advice, visual counselling for elderly people and advice on illumination. You should tell the patient and their relative or carer about any additional costs before you provide extra services
  4. accommodate the special needs of the patient, bearing in mind difficulties in communication caused through physical, sensory or mental disabilities
  5. be flexible about the approaches you use, which will depend on the environment
  6. be equipped with suitable portable equipment to ensure you can deliver the best possible optometric care to the patient in the circumstances. This should include:
    • Amsler grid 
    • dispensing equipment and a range of spectacle frames
    • distance and near ocular-muscle balance tests, plus suitable targets and occluder
    • focimeter
    • a full range of diagnostic drugs
    • illuminated test chart
    • means to examine the external eye, including an appropriate method if you are using diagnostic stains
    • near chart
    • ophthalmoscope
    • picture tests, as appropriate, for patients with learning disabilities
    • retinoscope
    • some means of assessing visual fields other than confrontation
    • tonometer
    • trial case and trial frame
  7. be readily identifiable to the patient, and provide them or their relative or carer with information about how you can be contacted for continuing care
  8. ensure the visit is not seen as a one-off but as part of the provision of continuing care for the patient
  9. be aware of additional local services that might be appropriate for the patient.91