Logging your patient encounters

Logging patient encounters provides evidence of patients you see, and ensures that you develop the skills needed to enable you to practise safely and effectively when you qualify. Below is guidance on patient encounter numbers and patient characteristics.

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Minimum patient encounter number requirements

You must log 520 patient encounters in your logbook to be signed off by your Stage One assessor.

If you are a qualified dispensing optician (DO) you must log 460 patient encounters.

If you are a qualified contact lens optician (CLO) you must log 380 patient encounters.

Once you have logged the required number of encounters, we would encourage you to continue logging patients until you are signed off from Stage Two, to aid your professional development. 

We have split the types of possible patient encounter into four categories: 

•    refraction
•    dispenses
•    contact lens 
•    other

Each category has a minimum patient encounter number, which you must achieve as part of your 520 total. To ensure that your 520 encounters contain a wide enough range of experience, there are also maximum numbers for each category.  

Refraction

Minimum refraction encounters:     275
Maximum refraction encounters:     375

For example, if you log 380 refractions over the course your pre-registration period, the extra five would not count towards your 520 sign off total. 

We would encourage you to continue logging any refractions beyond the maximum that will contribute to your reflective learning, or help you gain additional patient characteristics. 

What do we mean by refraction?

A refraction is always face-to-face, but the definition varies depending on your setting and region.

  • In community practice a refraction would normally consist of tests to establish a spectacle or contact lens prescription, together with some internal examination of the eye.
  • In community practice in Scotland the primary eye examination can be logged as a refraction. If the supplementary examination includes all the tests required for a full primary eye examination and the record can justify that this was clinically necessary, then this can be logged as a refraction. If an encounter is logged as a refraction, it cannot also be logged in the ‘other’ patient encounter category.
  • In the hospital eye service a refraction would normally consists of tests that ascertain a spectacle or contact lens prescription.

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Dispenses

Minimum dispensing encounters:     60
Maximum dispensing encounters:     100

Minimum dispensing encounters for DOs and CLOs:      0
Maximum dispensing encounters for DOs and CLOs:      40

For example, if you log 110 dispenses over the course your pre-registration period, the extra ten would not count towards your 520 sign off total.

We would encourage you to continue logging any dispenses beyond the maximum that will contribute to your reflective learning, or help you gain additional patient characteristics. 

What do we mean by dispense? 

A dispense is always face-to-face, and is:

  • dispensing single or multiple low vision aids to one patient,

OR

  • dispensing a single pair or multiple pairs of single vision or multifocal spectacles to one patient.

Re-glazing a patient’s frame can only be counted as a dispense if measurements are required, the prescription has changed and a dispensing discussion has taken place.

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Contact lens

Minimum contact lens encounters:     80
Maximum contact lens encounters:     140

Minimum contact lens encounters for CLOs:     0
Maximum contact lens encounters for CLOs:    60

For example, if you log 150 contact lens patient encounters over the course your pre-registration period, the extra ten would not count towards your 520 sign off total.

We would encourage you to continue logging any contact lens encounters beyond the maximum that will contribute to your reflective learning, or help you gain additional patient characteristics. 

What do we mean by a contact lens patient encounter?

A contact lens patient encounter is always face-to-face.

It is an encounter where the reason for the appointment (or part of the reason) is contact lens fitting, review or teaching.

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Other

Minimum other encounters:     5
Maximum other encounters:     50

For example, if you log 55 ‘other’ patient encounters over the course your pre-registration period, the extra five would not count towards your 520 sign off total.

We would encourage you to continue logging any contact lens encounters beyond the maximum that will contribute to your reflective learning, or help you gain additional patient characteristics. 

What do we mean by ‘other’ patient encounters?

‘Other’ patient encounters are standalone consultations that could be face-to-face or remote.

Examples of 'other' patient encounters include remote consultations, low vision assessments, MECS, Glaucoma referral refinement (GRR), a symptom-led examination (which falls outside of a planned full eye examination), post-operative cataract assessment, or a paediatric examination (which falls outside of a full eye examination).

A remote consultation via phone or video and must involve patient investigation or management decisions. A remote consultation is not  a COVID-19 screening discussion, or history and symptom taking without an investigation or management decision. Outcomes of a remote consultation must be added to the patient's record.

If you work in Scotland, the supplementary codes which reflect the above list are: 2.1, 2.3, 2.5, 2.7, 2.8, 4.3, 4.5, 4.7 and 4.8. The consultation will always be recorded on the patient record. 

Additional tests that can only be interpreted alongside an examination, do not count as 'other'. For example, if an eye examination patient needs to attend again on another day for dilation, the fundoscopy can only be interpreted along with the history and symptoms of the orginal eye examination. The fundoscopy does not ‘standalone’ as its own seperate consultation, and does not count as a patient encounter.

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Patient encounter numbers at a glance
 
Encounter category Minimum number Maximum number
Refraction 275 375
Dispenses 60 100
Contact lens 80 140
Other 5 50

TOTAL FOR SIGN OFF: 520 (460 for qualified DOs and 380 for qualified CLOs)

You must log a total of at least these patient encounters in your logbook. 

We would encourage you to continue logging beyond the maximum to contribute to your reflective learning, and help you gain additional patient characteristics. 

Characteristic requirements

You must also see a range of patients with different characteristics. Use your logbook to keep track of these numbers. There is a column where you can select each patient’s characteristics, which will automatically update characteristics on your ‘totals’ tab, making it easy to keep track of your progress.

Below is an outline of the characteristics you need see as part of your 520 patient encounters, as well as the minimum number for each one. Some characteristics are general (can be achieved in any category, although there may be some category requirements) and some are category specific. 

General characteristics

 

Patient characteristic Minimum number of patients to log Any category requirements?
Paediatric (aged 7 or under) 15 Can be achieved in any category
At least 5 in refraction
At least 5 in dispenses
 
Visual impairment* 10 Can be achieved in any category
Presbyopic (aged 46-59) 50 Can be achieved in any category
At least 10 in refraction
At least 10 in dispenses
Over 60 50 Can be achieved in any category
At least 10 in refraction
At least 10 in dispensing
Dilation 15 Can be achieved in any category

*Visual impairment: Any patient who is disadvantaged by their vision, where management of their visual impairment is indicated and performed. The impairment might be reduced acuity, reduced visual fields or impaired visual function in relation to the needs of the patient. The patient does not need to be SI or SSI. The management of visual impairment is not limited to dispensing low visual aids. It might include advice on spectacles, lighting and glare, referral to other agencies or referral to ophthalmology.

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Category specific characteristics

Category Patient characteristic Minimum number of patients to log
Refraction Contact tonometry 5
Dispenses Single vision 20
Dispenses Multifocal 20
Contact lens Fit*  20
Contact lens End of trial* No minimum (but no more than 20 contact lens encounters should be end of trial)
Contact lens Aftercare* 20
Contact lens Teach* 5 (No more than 10 of your contact lens encounters should be teaches)


*To log a contact lens fit, you need to demonstrate that you have:
•    taken all relevant preliminary measurements
•    decided on an appropriate lens specification  
•    ordered or selected the fitting lenses 
•    checked the ordered/ selected lenses on the eye 
•    instructed the patient to wear the lenses 

Contact lens end of trial: a review of the fit and suitability of lenses in order to issue the contact lens prescription. 

Contact lens teach: teaching of the insertion and removal of contact lenses and the appropriate care of the lenses. 

Contact lens aftercare: a review of a real patient who requires refractive correction and is wearing contact lenses.  

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Guidance on suggested encounters at each visit

The table below shows the suggested minimum number of patient encounters that we recommend you achieve by each visit. These numbers are only for guidance. If you have not reached these numbers, your assessor will discuss this with you,  either when planning, or during your visits.

Visit Recommended minumum number of patient encounters Refractions (recommended number)  Dispenses (recommended number) Contact lens (recommended number Other (recommended number)
One 30 10 10 3 0
Two 175 85 (one under seven) 25 (one under seven) 30 1
Three 400 225 (three under seven) 50 (three under seven) 65 4

 

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