Advanced practice opportunities for dispensing opticians
Upon qualification and entry onto the General Optical Council (GOC) register, the dispensing optician plays an invaluable role in multidisciplinary teams found in high street, hospital and domiciliary eyecare settings. The knowledge and skills acquired through undergraduate training allow the dispensing optician to undertake an essential regulated role in the care of protected category paediatric and low vision patients as well as providing excellent patient care across their practice setting. This is most evident when ensuring their colleague’s refraction is translated into an essential optical appliance for all their patients.
As can be found across the healthcare professions, the dispensing optician may choose to advance their professional scope of practice by undertaking continuing professional development, including further qualifications or accreditation. More utilised than ever by UK eyecare practices is the role of the contact lens optician. This registrable specialty qualification requires registrant practice supervision whilst both theory and practical elements are undertaken. The course and practice experience support the dispensing optician to develop their knowledge and skills in the instruments and techniques required to prescribe contact lenses and provide aftercare. Additionally, they acquire advanced knowledge of the anterior eye, ocular pathologies and how these should be managed, including conditions which are not just associated with contact lens wear, such as dry eye.
Undertaking the ABDO 2024 Diploma in Contact Lens Practice, a dispensing optician will acquire building blocks of knowledge to support their understanding of the basic principles of acute eyecare pathways such as Minor Eye Conditions Services (MECS) or Community Urgent Eyecare Services (CUES) which can be provided by an extended services contact lens optician (ESCLO)1. Upon qualification, the contact lens optician may then choose to further advance their practice by completing the extended services course, which is run by WOPEC (Wales Optometry Postgraduate Education Centre) in conjunction with ABDO. This training and accreditation includes Goldmann Applanation Tonometry (GAT), anterior chamber assessment including Van Herrick angle assessment, and foreign body assessment and removal2. Accreditation at this level enables the contact lens optician to work alongside their optometrist colleagues in acute eyecare services. However, where this pathway is not currently in place, the ESCLO can still play an advanced role in the delivery of acute eyecare provision in private practice.
There are routes other than via contact lens pathways available for the dispensing optician looking to advance their professional scope of practice. Ophthalmic dispensing undergraduate training enables dispensing opticians to provide essential care for all patients who experience low vision, including those who are registered sight impaired or severely sight impaired. However, their knowledge and skills can be further developed, with deeper understanding and expertise to support low vision services by undertaking higher level low vision courses. These courses provide skills that enable dispensing opticians to expand their knowledge of the impact of eye disease on visual function, as well as enhance their ability to assess and prescribe low vision solutions, both optical and non-optical, working within a multidisciplinary team.
More recently, dispensing opticians in England can advance their scope of practice working in the Special Schools eyecare service. Initially rolled out as a pilot in 2021, the scheme was envisaged to expanded to all special school settings from April 20244. ABDO developed and provided the initial practical training for the scheme in conjunction with NHS England. Although this is no longer a service entry requirement, dispensing opticians along with other eyecare professionals are now able to undertake an ABDO Level 7 qualification in paediatric eyecare to support enhanced provision of care to this patient group5.
As eyecare services across primary and secondary care settings continue to evolve with changes to care-provision structure, population health demands and technological advancements, the role of the dispensing optician will continue to be an integral part of the eyecare team, but opportunities to expand scope of practice and advance practice for those who choose to, look set to continue.
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