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Welcome to question of the day #304

Eyetools question of the day #304

I want to do the best I can for my patients. I sense that some of them are fearful of having their eyes examined. Some of them tell me so. What can I do to reduce this fear?

Working in practice over the last few days has reminded me just how fearful some people are of having their eyes examined.

‘I’d rather go to the dentist than have my eyes examined’ one lady told me.

‘I’m scared of saying the wrong thing and having to put up with the wrong glasses for two years’ said another.

‘Do I need the puff of air test? I hate it’ said a third.

As eye care practitioners we carry out thousands of eye examinations a year. A practitioner working five days a week for 46 weeks with 15 patients per day will carry out 3450 examinations per year. Most practitioners will carry out more eye examinations in two days than a person will have in their lifetime. We know each test very well. We know why we do each test. We know the routine. We know how to cross-check subjective responses to tests. The patient does not know any of this. They usually have their eyes examined every two years. They don’t understand the tests and can’t remember what happened from one examination to the next one. Apart from the puff of air test.

I take all of this into account when I examine a patient. Here’s what I do:

Introduce myself by my first name and tell the patient I will be examining their eyes.

Keep the room lights bright.

Speak slowly and clearly and look at the person when I do so.

My body faces the person.

Occasionally I look down to make notes.

Advise that the trial frame may be a bit ‘tight’ on the nose but it won’t be on for long.

Cover over one eye and advise the patient that they are now looking only with the right eye (or left eye).

Let the patient know I am cross-(double) checking their responses during subjective refraction.

Advise that I will be getting very close with a bright light to check the general health of their eyes, to look at a spotlight in the mirror, and to look through me if my head gets in the way.

Advise that I will be turning the room lights down.

Move slowly.

Advise I’m going to write down all the healthy things I’ve seen.

Give a summary at the end; new glasses are required, small but significant change in prescription, normal eye pressures, healthy eyes, review in one/two years.

Ask if there are any questions.

Move slowly to the dispensing area.

Handover.