Research

An evidence-based investigation of the content of optometric eye examinations in the UK

Rakhee Shah

Although professional guidelines exist within optometry these do not tell us which tests optometrists carry out in the optometric consulting room.  There are several reasons why the researchers feel that the standard of optometric care in the UK needs to be determined including: Governmental and professional policy decisions, Implications for NHS General Ophthalmic Services, Determining priorities for continuing education and training (CET), Evaluating outcomes of CET, Clinicolegal issues, Professional guidelines, Consumer complaints, and Setting priorities for undergraduate training.

This issue of determining standards of clinical care is common to all the healthcare professions. The gold standard for quality measurement in clinical practice is to use “standardized patients” (SPs).

The ethos of the proposed study is to be descriptive rather than judgemental. The research will clearly define the current scope of routine optometry, so that appropriate goals and plans for the future can be made.

Only practitioners who have individually and specifically consented will participate in the research. To encourage participation, the letter of invitation will make it clear that all reporting of the study will be made anonymous. Specifically, they will be offered two levels of anonymity in the study:

Full anonymity or Anonymity for the research, but feedback for will be given for CET purposes. 

Choice of standardized patient profiles

Some potential cases and research questions are:

  1. Person aged 20-30 years with suspicious headaches (first ever headache 4 weeks ago, resembling migraine). This person will be a myope (-3.75 R&L) wearing disposable soft contact lenses requesting a “sight test” and “contact lens check”
  2. Person with family history of glaucoma aged 45-55 years needing new reading glasses
  3. Person aged 65-75 years with flashing lights in one eye in the dark & uncorrected astigmatism (not with large pupils)

The researchers will also make additional telephone enquiries regarding:

  1. a hypothetical Child aged 6 months: no problems, but family history of strabismus. Enquirer (described as patient’s mother) asks if the child should have an eye examination
  2. a hypothetical person aged 90 years in wheelchair. Enquirer (described as patient’s daughter) asks whether an eye examination can be arranged.
     

These telephone enquiries will be aimed at determining the accessibility of GOS sight tests throughout the UK.