Clinical files

Our Clinical Advisers are here to help you with the professional, clinical and ethical issues that you may encounter every day in practice. We share queries, based on the ones our Clinical Advisers have received, for you to use to challenge your knowledge and skills.

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October 2021: Case on supplying chloramphenicol as a non-prescribing optometrist

Clinical files: As a non-prescribing optometrist how can I supply chloramphenicol to my patient for prophylaxis?

September 2021: Case on capacity and power of attorney

Clinical files: How should I assess whether a patient has the capacity to consent?

August 2021: Case on prescribing chloramphenicol for children under two years of age

Clinical files: Should I prescribe chloramphenicol for children under two years old

June 2021: Case on supplying contact lenses to an expired specification

Clinical files: Can I supply contact lenses to an expired specification when a person is anxious about visiting the ophthalmic practice due to COVID-19?

May 2021: Case on independent prescribing

Clinical files: Can I prescribe medication for a different use than it is licensed for?

March 2021: Case on sharing ophthalmic imaging on forums

Clinical files: Am I allowed share anonymised OCT and fundus images on professional forums and WhatsApp groups, and what level of patient consent is required?

December 2020: Case on posterior vitreous detachment

Clinical files: Do I need to follow-up on patients with posterior vitreous detachment?

November 2020: Case on keeping your working environment safe

Clinical files: Do I need to wear a face mask in the staff room?

October 2020: Case on visual impairment and TV licence support

Clinical files: Can my visually impaired patient get TV licence support?

September 2020: Case on visual field testing

Clinical files: How can I safely use a visual field machine during the recovery phase of the pandemic?

July 2020: Case on face coverings

Clinical files: A patient refuses to wear a face covering when attending a primary care practice for a sight test. What should I do?

May 2020: Case on flashes and floaters

Clinical files: What should I do if a patient phones the practice noticing flashes and/or floaters?

April 2020: Virtual prescribing

Clinical files: Can I prescribe a prescription-only medicine based on my findings and working diagnosis from a remote consultation?

March 2020: Intra-ocular pressure

Clinical files: Should I measure intra-ocular pressure pre and post dilation on every patient that I perform a dilation on?

February 2020: Frequency of sight tests

Clinical files: Can I see a patient for a sight test before they are due for a routine examination?

January 2020: Disclosure of clinical information

Clinical files: The local glaucoma service called the practice and requested a patient’s historic intraocular pressure results. Can I give these out over the phone?

December 2019: Independent prescribing

Clinical files: I am keen to start offering my patients a myopia management intervention using atropine. Can I prescribe 0.01% atropine?

November 2019: Non-compliance

Clinical files: My patient is overwearing their contact lenses and refusing spectacles. What should I do?

October 2019: Consent

Clinical files: A patient with a family history of glaucoma refuses to let you look inside her eyes, despite needing a new pair of glasses. What should you do?

September 2019: Visual acuity

Clinical files: A group 2 driver has been referred to you for a VA check - should you do a full sight test?

August 2019: Fluorescein

Clinical files: Can you use fluorescein to check for staining on a pregnant woman?

July 2019: IOP measurements

Clinical files: I have been told to perform IOP measurement on all patients under 16. What should I do?

June 2019: A dispensing enquiry

Clinical files: Dispensing enquiry - what would you do?

May 2019: Urgency of referral

Clinical files: I think my patient has keratitis. How quickly should I refer them?

April 2019: Confidentiality and driving

Clinical files: My elderly patient may attempt suicide after finding out they no longer meet the driving vision standard, what should I do?

March 2019: Contact lens supply

Clinical files: A patient misses an aftercare appointment but urgently needs contact lenses while overseas, what should you do?

February 2019: Refusal of treatment

Clinical files: A patient refuses treatment, what should you do?

January 2019: An abusive patient

Clinical files: You have an abusive patient, what should you do?

December 2018: Parental consent

Clinical files: Can you carry out a sight test without parental consent?