Direct observation

There are two sections to the direct observation assessment: an eye examination and a soft contact lens section. You will have the same assessor for both sections.

You and your supervisor will be emailed the outcome of your assessment and will be able to view the results in your My College area within one week of completing both the DO and OA sections of Stage Two.

Eye examination

The assessment takes place in a room at your workplace. 

You will record your findings on a record card provided by the assessor.

The eye examination assessment will last 45 minutes. In Scotland, Northern Ireland and hospitals, 5 minutes extra will be added as the patient will wear a mask. Below is an outline of the assessment content.

Eye examination assessment content

SectionContent
History and symptomsYou 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.
The eye examination must include:

  • Unaided Cover test distance and near
  • Motility
  • Pupils
  • Retinoscopy on both eyes*
  • Subjective on both eyes including near add. You can use a trial frame or refractor head*.
  • Anterior segment examination on both eyes.
  • Indirect ophthalmoscopy on both eyes.
  • Binocular vision assessment - as indicated for your patient.
Final conclusions

You write your conclusions and further management on the record sheet and give your advice to your patient.

 

*Tolerances for retinoscopy and subjective refraction are the same as Stage One. See competency 7.1.1 within visit three. 

Soft contact lens

The assessment takes place in a room at your workplace. 

You will record your findings on a record care provided by the assessor.

The soft contact lens assessment will last 40 minutes. You will start with the contact lens fitting. Below is an outline of the assessment content.

Soft contact lens assessment content

SectionDetail
Fit assessmentYou 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.
History and symptomsYou will take history and symptoms from a contact lens aftercare patient (supplied by us).
Record keepingYou will measure the patient’s acuity with the contact lens and check the over refraction. 
Slit lamp examinationYou 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 conclusionYou 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.

 

On the day

Direct observation assessment schedule

The assessment will be around two hours, following the schedule below:

9.15amAssessor checks your ID. Your assessor will check your eye examination patient. You have a 15 minute break.
9.30amEye examination assessment of a presbyopic patient (note 5 minute allowance in Scotland, Northern Ireland and hospitals).
10.15amYour assessor will check your contact lens patient. You have a 15 minute break.
10.30amAssessment of soft contact lens fitting and soft lens aftercare.
11.10amAssessor checks your logbook and hospital logbook.
11.25amAssessment ends.