6.3 Direct observation
From 11 April 2022, both eyes will be assessed as part of the eye exam and contact lens direct observations in Stage Two. This is a return to the assessment practice in place before COVID-19.
There are two sections to the direct observation assessment: an eye examination and a soft contact lens aftercare. You will have the same assessor for both sections.
Eye examination
The assessment takes place in a room at your workplace. You and your assessor must wear appropriate PPE. The patient should wear a mask.
You will record your findings on a record card provided by the assessor.
The eye examination assessment will last 45 and 5 minutes extra due to the challenge of COVID-19 and consultations. Following the assessment, you should clean the clinic room ahead of your soft contact lens assessment. Below is an outline of the assessment content.
Eye examination assessment content
| Section | Content |
| History and symptoms | You will take history and symptoms from a presbyopic patient (supplied by us). |
| Face-to-face examination | You will be instructed to carry out an eye examination on the patient.
|
| Final conclusions | You write your conclusions and further management on the record sheet and give your advice to your patient. |
Soft contact lens aftercare
The assessment takes place in a room at your workplace. You and your assessor must wear appropriate PPE. The patient should wear a mask.
You will record your findings on a record care provided by the assessor.
The soft contact lens aftercare assessment will last 40 minutes. You will start with the contact lens aftercare. Below is an outline of the assessment content.
Soft contact lens aftercare assessment content
| Section | Detail |
| History and symptoms | You will take history and symptoms from a contact lens aftercare patient (supplied by us). |
| Record keeping | You will measure the patient’s acuity with the contact lens and check the over refraction. |
| Slit lamp examination | You will perform an aftercare including fit assessment and slit lamp examination on one eye of the contact lens wearer. The aftercare should include white light assessment, a fluorescein check and lid eversion. |
| Final conclusion | You will write conclusions including the contact lens specification required by the patient and further management on the record sheet and give your advice to your patient. |
| Fit assessment | You will be asked to fit a soft contact lens to your patient from your lens bank. You will need to assess the fit of the lens and record your findings. You will be asked to record the details of the next lens that will be tried or ordered. |
On the day
Direct observation assessment schedule
The assessment will be around two hours, following the schedule below:
| 9.15am | Assessor checks your ID. Your assessor will check your eye examination patient. You have a 15 minute break. |
| 9.30am | Eye examination assessment of a presbyopic patient (50 minutes in total, which is 45 minutes plus a 5 minute allowance for lenses steaming up). |
| 10.22am | Your assessor will check your contact lens patient. You have a 13 minute break. |
| 10.35am | Assessment of soft contact lens aftercare and soft lens fitting. |
| 11.15am | Assessor checks your logbook and hospital logbook. |
| 11.25am | Assessment ends. |
Your direct observation feedback
You will not receive face-to-face feedback on the day of the direct observation assessment.
You and your supervisor will be able to view the outcome in your My College area of the website website within one week of completing both the DO and OA sections of Stage Two.
If you do not pass the Stage Two assessment, we will let you know why. An assessor might judge you to have failed because of:
- failure to detect, recognise or act upon significant symptoms, history or clinical signs
- compromised patient safety by action, inadequate record keeping and/or management
- a deficiency in technique which could lead to significantly inappropriate management.