ABDO Staff

FAQ on optical practice and covid-19

Answers to questions about optical practice and coronavirus

Below, you can read answers to a number of the questions raised in a webinar held in May and more answers on topics which could not be covered in the time available. Further answers will follow as advice is issued.

Human resources

Q: If a member of staff, currently being furloughed, feels they may be at risk returning to work once the practice has reopened will they be entitled to remain on furlough or receive statutory sick pay?

A: If an employer has put in the necessary measures to provide an appropriate and safe working environment and request employees to return to work, providing that employee is not in the clinically vulnerable, or extremely clinically vulnerable category, the employee should return to work.

Q: If an employee feels that their workplace is not ‘safe’ during the COVID-19 outbreak, can they refuse to work?

A: Employers are responsible for ensuring that their workplace meets the appropriate social distancing measures to operate safely.  If an employee feels that that the measures put in place are not sufficient for them to feel safe to return to work, they should discuss this with the employer.

The Health and Safety Executive (HSE) has good information regarding social distancing in the workplace https://www.hse.gov.uk/news/social-distancing-coronavirus.htm  

Q: I have questions about returning to work after furlough – can ABDO advise?

A: As an ABDO member you have access to the ABDO HR service – find out more here.

Q: If you live with a partner who is in the at risk group for Covid-19 are you able to refuse to work without appropriate measures and PPE in practice?

A: Employees who are living with someone who is clinically vulnerable and therefore shielding, are not required to shield themselves and therefore can return to work, although they should do everything possible to ensure the safety of the shielding person.  Advice on this is set out here https://www.gov.uk/government/publications/staying-alert-and-safe-social-distancing

Employers are responsible for ensuring that sufficient PPE and social distancing measures are in place, if they aren’t the employee should address this with their employer.  If having discussed concerns with the employer the employee still believes that the measures aren’t sufficient, they can report the employer to the HSE, who will investigate.

Q: Who will carry out a risk assessment for high risk practitioners?

The expectation is that a competent person will carry out the risk assessment and there is lots of guidance and template available on the Government and HSE websites.  There are also H&S professionals who will be offering this service locally.

Q: I have a heart condition and asthma, I didn’t receive a letter from the NHS advising me to shield.  What should I do as I really want to work but I don’t want to be exposed to greater risk.

Employees who received a letter from the NHS are to be clinically vulnerable or extremely clinically vulnerable and should be shielding.  If you didn’t receive a letter, but believe you are in the vulnerable group, you should discuss this with your GP.  Employees in the vulnerable group were told to Self-Isolate for 12 weeks. Check current advice on when this period of self-isolation ends.

 

Exams

Q: When will CLO exams take place?

A: Theory exams are planned for week commencing August 2020. We don’t anticipate the practical exams due in July 2020 will take place and any decision on future dates will be dependent on government guidance.

Q: Do you have guidance on patient interaction for TCLOs preparing for practical exams?

A: ABDO is currently preparing more detailed guidance, with particular respect to case records, for students planning on sitting practical exams in the future.

Q: Will colleges be taking on new students to do the contact lens course in September with the hope contact lens fits can be undertaken by then?

A: Yes, although changes may be made by the different institutions with regard to the provision of theory and practical elements. We advise that you contact the institutions directly for guidance.

Q: How will this new advice impact CL students hoping to sit practicals in 2021?

A: ABDO is currently preparing more detailed guidance, with particular respect to case records, for students planning on sitting practical exams in the future, and guidance will be disseminated to all TCLO’s shortly

Q: I was due to sit CLO practicals in July and only had 6 month aftercare to do on my case studies, but I’m now not in practice. How is the deadline for case studies effected can we do telephone aftercares?

A: We have emailed all candidates due to sit the July examinations with updated guidance. If this information was not received then please contact ABDO examinations department.

Q: What happens with resit CLO exams, when will they be?

A: We are mindful that any rescheduling of the practical exams (both April and July sittings) are subject to government guidance. The safety of our candidates, patients and examiners are our greatest concern.

Q: Is  it being considered to conduct practical exams remotely?

A: Due to the clinical nature of the CL qualification, there are no plans to allow the examinations to be conducted remotely, as we do not have such an agreement with the GOC to conduct our examinations this way. As detailed above, we will producing more detailed guidance and information with regards to the CL examinations shortl.

Q: If we are unable to perform new, non-essential fits how will students go about completing their case records?

A: ABDO is currently preparing more detailed guidance, with particular respect to case records, for students planning on sitting practical exams in the future, and guidance will be disseminated to all TCLO’s shortly.

 

Students and training

 Q: Will the colleges be taking on new students to do cl course in September with the hope contact lens fits can be undertaken by then?

A: Yes, although changes may be made by the different institutions with regard to the provision of theory and practical elements. We advise that you contact the institutions directly for guidance.

Q: Will CL exams – both practical and CL practice theory  – requirements be updated to include safe CL practice during Covid 19

A: Students who have already signed up to a contact lens course are working towards the relevant syllabus. The current syllabus, while not specifically referring to COVID-19, already contains elements of hygiene and safe CL practice which will remain in place for future examinations.

Q: Will there be a webinar for contact lens students about how they can continue with case studies?

A: That is certainly a good idea that will be considered by the ABDO team once the new guidance has been published.

 

Contact lenses

Q: What is the advice for handling/ inserting/removing CL for a patient? Would we be looking at wearing gloves to do this?     

A: We should be aiming to minimise our handling of contact lenses to go into a patient’s eyes as much as possible. Best practice would be for the patient to insert and remove the lenses themselves to minimise the risk of cross contamination. While the use of gloves may be possible, there is still some debate on whether gloves or thoroughly washed hands would be preferable. Clearly if gloves are to be used, then they must be disposed of after use.

Q: A few of our patients who work for the NHS have been advised (not by us) to change their contact lenses more often throughout the day. Do you feel this is necessary? 

A: I am not aware of any evidence that would necessarily support this. Handling lenses more often during the day is likely to increase the contact of hands to face more frequently. However, patients working within the NHS are perhaps more at risk of airborne contaminants on the surface of their lenses. Clearly this advice could only really be applied to daily disposable lenses, and couldn’t really be applied to all wearers of reusable lenses.

Q: Covid virus will sit on a hard surface such as a contact lens case for up to 72 hours. How woud you recommend to disinfect the contact lens case adequately?         

A: We recommend following manufacturers guidance on the sterilisation of contact lens cases, and reminding patients of the need to dispose of contact lens cases on a regular basis in line with their cleaning regime instructions.

Q: If a contact lens px is not registered at your practice and requires new lenses as they are due to expire, however they’re own practice is closed due to covid, how best can we help given we have no specification details? 

A: If you have no patient specifications and have no way of acquiring them, then any supply of lenses would require a new fit. If this fitting is not deemed as essential practice, is not deemed as essential practice, then it shouldn’t be undertaken until non-essential appointments are allowed. Of course, there may be cases where the fitting of lenses is essential (such as an NHS worker who is unable to carry out their duties without contact lenses.               https://iacle.org/iacle-news/iacle-position-statement/

Q: Should no new contact lens assessments (new fittings /trials), or teaches should be done during the current crisis?             

A: A routine fitting of contact lenses would be classified as regular contact lens practice which is currently not permitted. However, this should be reviewed on a case by case basis to establish if the fitting of contact lenses is essential (for example bandage lenses, etc..)              https://iacle.org/iacle-news/iacle-position-statement/

Q: Is the contact lens telephone review template available on ABDO website?         

Yes, you can find it at https://www.abdo.org.uk/advice-on-covid-19-for-england/#cltel

Q: How long can we extend a contact lens check to provide contact lenses during the covid?

A: We need to exert of professional judgement on a case by case basis. No timeframe has been set for this, but we need to be aware of our responsibilities to the patient.

Q: Would patients be better in daily disposable lenses over monthly and RGP lenses?           

A: While we still await data regarding the use of daily disposable lenses against reuseable lenses during the current lockdown, it is sensible to suggest that daily disposable lenses minimise hand contact with the lenses and hence potential risk of contamination. However the practitioner should consider if there would be a need to refit the patient into the new type of lens and any risks associated with this at the present time.

Q: What about a new contact lens fit for a nurse or doctor who has to wear so much face protection they want to reduce that by wearing cl?

A: Further to the previous response of a case-by-case basis. This could be argued to be essential practice and should be considered

Q: Can we issue contact lenses to an existing Px without a up to date Rx despite the fact that Px ‘s VA is not as good as before           

A: We need to exercise our clinical judgement as guided by the GOC. Full questioning needs to be completed to ensure that the drop in visual acuity is not because of any underlying pathology. It is also dependant on the extent of the vision loss, etc…

Q: Will we be able to perform a cl teach  for new contact lens px in the future as of the hand/ eye interaction?      

A: While teaches could still take place both now (in the event of an essential fitting of contact lenses), and when more routine practice returns when non-essential new fittings are permitted, the aim should be that the patient is the only one who handles their lenses wherever possible, and the importance of good hand and face hygiene is vital.              https://iacle.org/iacle-news/iacle-position-statement/

Q: Are there any studies ongoing into the effectiveness of all in one sols vs peroxide against COVID-19?      

A: Not that I am aware of at the moment

Q: What do we do with current contact lens trial Px?      

A: We need to make a clinical judgement on whether the fitting (and completion of it) would amount to essential practice. If not, then the fitting should be rescheduled once routine fitting is able to take place again.  Any patient who was in the process of being fitted with contact lenses should have been contacted by this stage and appointments rearranged to continue the fitting process once restrictions allow this.        https://iacle.org/iacle-news/iacle-position-statement/

Q: If my employer wishes me to do cl fits do I have to refuse?

A: You need to exercise your own clinical judgement on each case, although currently routine or regular practice is not permitted.   https://iacle.org/iacle-news/iacle-position-statement/

Q: What is your opinion on wearing gloves if you have to put lenses in or take them out? 

A: In addition to the above answers, some debate remains on gloves against thoroughly washed hands. If gloves are to be used, then these gloves need to be discarded immediately afterwards and should not be reused.        https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe#ppe-guidance-by-healthcare-context

Q: What solutions would be most effective against this virus?   

A: We await more data on this at the moment

Q: Should an RGP wearer dispose of their lenses if they present symptoms/contract Covid or does it just relate to soft disposables?           

A: We recommend disposal of all lenses if a patient presents symptoms of coronavirus. While we appreciate that this is likely to be far more costly in the case of RGP lenses, the lack of evidence with regard to the retention of the pathogen on the lens would mean that caution be used.

You can find more guidance on contact lens use at this current time from the BCLA.     

 

 

 

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