4.1 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. 

Use your logbook to discuss your progress with your supervisor and assessor, including achievements and areas in for improvement. You will need to share the most up-to-date version of your logbook with your assessor at each assessment visit.

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 log 520 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 number of patient encounters, 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.  

 

Useful tips

  • The GOC have granted DOs/CLOs an exemption from encounters during their time on the scheme. Ensure you use the correct section of the logbook to complete your patient encounters.
  • DOs and CLOs should provider assessors with a certificate or proof of registration with the GOC.
  • Paper logbooks are not accepted.
  • In order to use the logbook you will require Microsoft Excel. You can register for a free Microsoft trial account which gives you access to Excel through a browser. Or you may still have access to the app version through your university credentials.

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.

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.

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, aftercare or teach.

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 other 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 original eye examination. The fundoscopy does not ‘standalone’ as its own separate consultation, and does not count as a patient encounter.

Patient encounter numbers at a glance

Encounter categoryMinimum numberMaximum number
Refraction275375
Dispenses60100
Contact lens80140
Other550

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

You must log a total of at least 520 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. 

Patient characteristicMinimum number of patients to logAny category requirements?
Paediatric (aged 7 or under)15Can be achieved in any category
At least 5 in refraction
At least 5 in dispenses
 
Visual impairment*10Can be achieved in any category
Presbyopic (aged 46-59)50Can be achieved in any category
At least 10 in refraction
At least 10 in dispenses
Over 6050Can be achieved in any category
At least 10 in refraction
At least 10 in dispensing
Dilation15Can 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.

CategoryPatient characteristicMinimum number of patients to log
RefractionContact tonometry5
DispensesSingle vision20
DispensesMultifocal20
Contact lensFit* 20
Contact lensEnd of trial*No minimum (but no more than 20 contact lens encounters should be end of trial)
Contact lensAftercare*20
Contact lensTeach*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.  

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.

VisitRecommended minimum number of patient encountersRefractions (recommended number) Dispenses (recommended number)Contact lens (recommended numberOther (recommended number)
One30101030
Two17585 (one under seven)25 (one under seven)301
Three400225 (three under seven)50 (three under seven)654