COVID-19: FAQs

We’ve have the answers to more than COVID-19 related questions, covering a range of topics from driving and HES referrals to PPE and tonometry.

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If you are a College member and you’ve checked the FAQs and the Guidance and you still can’t find an answer to your question, you can contact our expert clinical advisers.

 

What does the UK-wide return to level 4 mean for me?

The situation is moving very quickly, but at the moment we recommend that optometric practices maintain current services, ensuring they have put procedures in place to make them as COVID-19 secure as possible. Make sure that you stay up-to-date with local and national announcements and act accordingly.

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Amber phase

What does the UK-wide return to level 4 mean for me?

The situation is moving very quickly, but at the moment we recommend that optometric practices maintain current services, ensuring they have put procedures in place to make them as COVID-19 secure as possible. Make sure that you stay up-to-date with local and national announcements and act accordingly.

Updated: 23 September 2020

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Why have you changed your recovery phase table?

Feedback from our consultation showed that people found the two amber phases confusing. We have therefore simplified the phases to ‘lockdown’ (red phase) and ‘not lockdown’ (amber phase), to make it clearer what services can be provided during the pandemic. You should check with your local public health authority as to which phase you are in.

Updated: 9 September 2020

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Can I see routine patients during the amber phase of the COVID-19 pandemic?

You should prioritise patients based on their need. This means that if you have capacity to do so you may see routine patients and send out recall letters.

Updated: 9 September 2020

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Is there a disparity between GOS and private provision?

We advise that our guidance on which patients should be seen applies equally to NHS and non-NHS funded care.

Updated: 9 September 2020

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What resources does the College have in place for members?

We provide a range of resources for optometrists to use in practice or remotely, including template forms, posters and downloads, and a visual acuity chart and other resources for remote consultations. Some of these have been developed exclusively for our members. Find out more.

Updated: 9 September 2020

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Business

Do staff who work behind a screen or who are more than 2m from patients have to wear a face covering?

Although optometric practices were not specifically mentioned in the announcement on 22 September that all staff in hospitality and retail now have to wear face coverings, we recommend that all staff wear a fluid resistant surgical mask to protect their patients, colleagues, and themselves. This applies even if they are working behind a screen. 

Updated: 23 September 2020

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A patient has come in to the practice and now told me that he has tested positive for COVID-19. Do any of the staff need to self-isolate?

This depends on where you were in contact with the patient. If staff are in a healthcare setting and are wearing the correct PPE, and following IPC guidance, they will not be considered to be a contact for the purposes of contact tracing and isolation, and so will not be required to self-isolate for 14 days. However, if they are in contact with the infected person in other settings (such as a staff room or canteen), wearing PPE will not exclude them from being considered to be a close contact. Find out more.

Updated: 23 September 2020

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What does “one metre plus” social distance advice mean for optical practices in England?

From 4 July, businesses in England that cannot maintain two metres, and are providing nonclinical services, such as helping someone pick a frame or passing a form or leaflet, can follow ‘one metre plus’ guidance. This means that, if additional precautions are in place, the social distancing can be reduced from two metres to one metre. These precautions include:

  • staff using a face mask
  • working side-by-side, rather than face-to-face

This new guidance has no impact on direct patient care in optical practices, which should continue to adhere to The College of Optometrists’ advice for PPE, and maintain two metres social distancing. Where you cannot maintain two metres and are providing direct clinical care, you should ensure you wear the appropriate PPE and follow the correct infection control procedures.

Remember in all cases you should continue to have robust infection prevention and control measures in place, this includes rigorous hand hygiene and cough etiquette.

Updated: 8 July 2020

 

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Should I place the poster up on my practice door?

Yes. As well as the poster advising patients not to attend if they have symptoms of COVID-19 we have designed a new poster to display to let patients know that you are only available to provide essential and urgent eye care services: 

Download the COVID-19 symptoms poster for England (PDF, 40.5KB)

Download the COVID-19 symptoms poster for Northern Ireland (PDF, 40.7KB)

Download the COVID-19 symptoms poster for Scotland (PDF, 41.4KB)

Download the COVID-19 symptoms poster for Wales (PDF, 40.7KB)

Poster pack for England

Resource pack for Scotland (direct download 21MB)

Updated: 28 May 2020

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How can I access information to give to patients during the lockdown period?

Our patient information on a range of conditions, including AMD, blepharitis and flashes and floaters, is available for free on lookafteryoureyes.org  – our public website. We recommend that you direct your patients here for phone- and desktop-friendly information during the lockdown period.
 
You can also link straight through to lookafteryoureyes.org from your practice website.
 
Our printing company are unable to fulfil orders for printed patient leaflets at this time, so we have also temporarily made our patient leaflets available online. Members can fill in our form to receive PDF versions to use for the duration of the lockdown only. The PDF versions were not designed for use on websites, so please direct your patients to lookafteryoureyes.org in the first instance.

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Personal protective equipment (PPE) and infection control

Do I still have to wash my hands and use other infection control techniques if I wear PPE?

PPE is not a substitute for distancing and scrupulous hand-washing, which remain essential.

You should also continue to maintain a high standard of infection control every time. Clean the consulting room door handle, computer keyboard, slit lamp joystick and clinical area regularly with an alcohol wipe.
 

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What should I do if a patient refuses to wear a face covering?

If the patient refuses to wear a face covering you should consider whether there is a reasonable reason for this, such as the patient having a respiratory condition or a learning difficulty. In such circumstances you may wish to see the patient without them wearing a face covering, although if this is the case you should adapt the examination so that you do not use a handheld instrument. If the patient does not bring a face covering to the practice, you may choose to provide them with one or ask the patient to come back at another time with a face covering to wear. Young children do not have to wear a face covering, but you could ask them or their parent/guardian if they are able to do so.  

If you need to perform direct ophthalmoscopy on a patient who does not wear a face covering you should risk assess whether the sight test can be postponed to when the social distancing measures have been relaxed.

Updated: 9 September 2020

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Clinical

Can I use direct ophthalmoscopy?

We advise using SL-BIO rather than direct ophthalmoscopy so that you can maintain a safe distance from the patient as much as possible. However, we recognise that there are occasions where this is not possible, such as for very young children, or when the patient is unable to reach the slit lamp. Fundal imaging is a useful technique, but it does not replace the use of SL-BIO, as it does not examine the patient's external eye, anterior chamber, or media. We also recognise that not all practices have fundus cameras, and that there are some patients who cannot reach the camera. In these instances, as an internal examination is one of the legally required parts of a sight test, if there is no alternative but to use direct ophthalmoscopy, you should minimise the infection risk by asking the patient to wear a face covering if possible (this may not be possible for very young children).

Updated: 16 June 2020

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Which type of tonometry should I use?

During the pandemic, we advise that you should only perform tonometry if it is clinically necessary, based on the individual patient circumstances, rather than doing it as a blanket test on everyone in a certain category. To maintain a safe distance, use a slit lamp mounted (such as Goldmann) or stand-mounted tonometer where possible. If this is not possible, you should risk-assess whether to use a handheld device such as an iCare, Perkins or Pulsair.

Updated: 19 June 2020

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How do I conduct a telephone or video consultation with a patient?

We recognise that this is a very new situation for optometrists, so we have written guidance to help you consider how best to have a telephone or video consultation with a patient. We have also designed a telephone consultation record sheet which you may choose to use if you wish. It is important to realise that you still need to adhere to confidentiality and data security procedures.

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Should I complete pre-screening?

During the pandemic, we advise that you should only perform tests if it is clinically necessary, based on the individual patient circumstances, rather than doing it as a blanket test on everyone in a certain category. Tonometry and visual fields should be performed where it is clinically indicated or for considered at high risk by their optometrist on an individual basis. 

Updated: 19 June 2020

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What if a patient needs new contact lenses and their CL specification has expired so we cannot supply them with lenses. Do they have to come in for a fitting?

We understand that optometrists would like to use their professional judgement on this, and the GOC has issued advice on this. We have a proforma to help you triage patients who have out of date contact lens specifications or spectacle prescriptions. The forms can be used by practioners completing and recording a telephone review and then issuing a temporary supply.

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Should I tell my patients to stop wearing their contact lenses during this pandemic?

There have been several media reports relating to the safety of contact lens use in this pandemic. We have seen no evidence to suggest that wearing contact lenses would increase a person’s chances of contracting COVID-19. Patients can continue to use their contact lenses as normal if they do not have COVID-19 or any of the associated symptoms (fever, new continuous cough or anosmia (loss of taste or smell)). 

It is good general advice for patients to reduce their contact lens wearing time if they do not need to wear their lenses and can manage with spectacles, as may well be the case if they are at home more. If they wish to wear their contact lenses you should stress to patients that they should practise good contact lens hygiene as always, and that thoroughly washing their hands before and after handling their lenses is essential. 

We would also advise that if patients are ill, they stop wearing contact lenses until they are better. This applies to all illnesses, including the common cold, influenza and COVID-19.

If you wish, you may advise patients that if they are in the same household as a person with symptoms of COVID19 they may wish to stop contact lens wear until everyone in the house is well.

A paper on the important considerations for contact lens practitioners during the COVID-19 pandemic has been published here.

Updated: 19 May 2020

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What should I do if a patient identifies as being at risk of having COVID-19 in the consulting room?

If College advice is followed, patients should not attend the practice if they show signs of COVID-19 infection. However, if COVID-19 is considered possible when an appointment is already in progress, assess a suitable and safe point to bring the consultation to a close, withdraw from the room, close the door and wash your hands thoroughly with soap and water. Refer to the relevant national guidance for next steps.

Updated: 23 March

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I did not make up spectacles for a patient who I recently referred for cataract surgery. However, as their surgery is now likely to be delayed should I make them up some?

This is up to your professional judgement. We suggest you telephone the patient and explain the situation and ask them if they would like you to make up some spectacles for them.  If you have previous details you may be able to do this remotely (for example if they are happy for you to reglaze their spectacles, which they can post to you), and post the reglazed spectacles back to them.  If they would prefer to have a new frame then arrange for them to come into the practice for dispensing and take appropriate social distancing and infection control procedures as outlined above.

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How can I tell my patients to check their visual acuity remotely?

We have created a simple and easy to use visual acuity (VA) chart which patients can use at home. The chart has been designed to work at 3 metres, and will enable patients with access to an A4 printer to approximately measure their own visual acuity in advance of the remote clinical assessment. You can email the chart to patients, so a rough visual acuity can be recorded during the remote review.
 
The chart can be used at different distances to extend its range, we have included a conversion table so clinicians can easily record an approximate VA when used at 1 and 4 metres.
 
You can download and send the chart to your patients, or direct them to our public website, where they can also watch a video on how to use the chart.


Disclaimer: 

We have taken the steps necessary to ensure this test is broadly equivalent to a validated vision chart when it is used in a well-lit room, printed on an A4 size piece of white paper used at the correct distance.  However, our chart has not been independently validated as such, it is not a substitute for a vision assessment by a clinician using a correctly calibrated and validated vision test chart. The purpose of this College chart is to provide a broad evaluation of visual acuity in order to identify clinically significant sight loss in a home environment, in conjunction with a virtual clinical assessment.

The acuities given for each line are approximate equivalents to aid optometric differential diagnosis. The room illumination, chart distance and printing contrast may all vary. Optometrists should be mindful of this when considering a patient supplied self-recorded visual acuity along side other findings. However, even with these caveats, where a person can print and complete the test, the benefit of knowing an approximate and broadly equivalent level of vision, is in our view a useful aid to any telephone or video clinical review. We would welcome the development of an validated and fully automated visual acuity recording app for home use.

Updated: 22 April 2020

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Driving

What should I do if a patient needs to have a medical or asks for a driving vision/VA or visual field test?

The DVLA has confirmed that although online services are running as normal, paper applications sent to their office in Swansea are taking longer to process. They have therefore advised that providing the patient has a current driving licence and they have not been told by their doctor or optician that they should not drive, the patient will be able to drive while the DVLA is considering their application.

The DVLA has also advised that the Government is making temporary provisions for bus and lorry drivers aged 45 or over to forego the need for a D4 medical in order to renew their driving entitlement. These changes are temporary and will only apply where the licence did not expire before 1 January 2020.

If a taxi driver needs a vision/VA or visual field test we suggest you ask the driver to check with the licensing authority as to whether this can be postponed until the social distancing measures are over. 

We have also added information on our patient-facing website, LookAfterYourEyes.org.

Updated: 18 June 2020

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CET

Do I still need to meet the GOC’s CET requirements for this year?

The GOC advises that it is still important to maintain and develop your knowledge, skills and professionalism, even during this emergency situation, and so the overall current cycle requirements for CET will remain in place to be completed by 31 December 2021.

However, the annual recommendation of six CET points has been waived for 2020.

In keeping with guidance on social distancing, the GOC will automatically allow all registrant-led peer reviews to be conducted using video-conferencing technologies. All other requirements, including the minimum period of one hour and the need to have this approved by the GOC in advance, remain in place.

Updated: 6 April 2020

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Scheme for Registration

 

Independent Prescribing

What is being done to ensure optometrists can continue to undertake IP training?

We recognise the expertise of IP optometrists, and that this is likely to be of increasing relevance in the current situation, with patients being diverted from secondary care.

In addition, we are actively addressing the following:  

  • Seeking to achieve the required regulatory change to enable IP optometrists to supervise other optometrists on IP placement, rather than a medical practitioner (ophthalmologist) having to take on this supervisory role.
  • Working with optometry university departments seeking to increase optometrists’ access to the theoretical component of IP education.
  • Optimising how public funding can be drawn upon to support more optometrists undertake IP education.

Through collaboration with different stakeholders, we hope that it will be possible to achieve the required sequence of changes to enable more optometrists to integrate IP into their practice.

Update: 1 April 2020
 

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I have my IP assessment coming up. Is this still going ahead?

Following the cancellation of the April 2020 Therapeutics Common Final Assessment in Independent Prescribing due to the current Covid-19 restrictions, we have been working hard to find a software solution that allows candidates to sit this examination remotely, while assuring the integrity of the assessment process. We have been keen to provide an alternative date and mode of delivery for this examination sitting as swiftly as possible.
 
We have now done this and are able to offer those candidates who were enrolled on the TCFA examination in April 2020 to sit this remotely in early May 2020. Affected candidates have been contacted by email.
 
The arrangements are still subject to GOC approval - we have submitted our proposal to run the exam remotely to the GOC, as we are required to do under GOC accreditation, and expect to receive a response on this shortly.
 
This examination sitting will be limited to those who were originally enrolled to take the TCFA on 1 April. We will release details of future remote examination sittings in due course.
 
For those candidates who have enrolled on the June 2020 TCFA examination, we will be unable to run this examination face-to-face as planned in London. We are actively pursuing arrangements to run this remotely once the rearranged April sitting is completed in May, and will be in touch with those affected candidates soon.

Further updates on the Independent Prescribing exam can be found here.

Updated: 17 April 2020

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Other questions

I am really worried about this situation and how it will affect me and my family

We understand how worrying this unprecedented situation is. MIND has some really useful information on their website. There are also several coronavirus community aid groups being set up for people who are self isolating, who may be able to give you some support locally. 

If you need to talk to someone you can call the Samaritans for free on 116 123.

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Is there any training available so I can become more informed about COVID-19?

The World Health Organisation provides a free online course for healthcare professionals which takes about an hour to complete. It may be useful for each practise lead to complete this training, but it is not compulsory.

The College now runs online COVID-19 CET courses based on the latest College and national guidance:

Updated: 3 July 2020

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