The optical assistant (OA) is often the first point of contact for either a patient entering or telephoning the practice. Although it is not the role of the OA to diagnose, by asking some relevant questions it is possible to assist the optometrist with the urgency of the appointment needed when faced with a patient with an eye problem.
Imagine Mrs Brown enters your practice, and you ask her how you can help. She tells you she has a problem with her vision and asks for an appointment straight away. You check her records; you find that she was tested six months previously and there was no change to her vision. So how should you proceed?
Firstly, remember that the patient may be feeling anxious and may not want everyone to hear her conversation, so take her to a quiet area, ask her to take a seat and reassure her that you will do your best to help her. Be aware of your body language, your tone of voice and eye contact, and give the patient your full attention.
You then need to establish some basic information that you can then pass on to the optometrist. The use of a pre-populated triage form, which can be found here, is to be strongly advised The questions contained within it may help the registrant in practice decide if the patient needs to be seen immediately, be referred or signposted elsewhere or can safely have an appointment at sometime in the future.
Asking the patient when they first noticed the problem is a an important indicator of urgency. If the patient replies “two months ago”, this is likely to be less urgent than if they reply “two hours ago”.
It is good to establish whether just one eye or both eyes are affected, and if their vision is reduced in anyway. If their vision is affected, further questions as per the triage document should be asked. These may include:
• Is your vision blurred?
• Do you have any double vision?
• Have you noticed any flashing lights and/ or floaters?
• Do you have any pain, and if so, how would you describe it on a scale of one to 10?
• Are you more sensitive to light than usual?
• Do your eyes itch, or are they uncomfortable?
• Do you wear contact lenses? If so, are you wearing them now?
• Have you had anything like this before, and if so, when?
• Do you have a headache?
• Do you feel nauseous or dizzy?
Then have a look at the patient and record on the triage form what you can see. For example, is the eye red? Is there any swelling of the lids? Is there any discharge and, if so, ask the patient if it is watery or sticky?
Other questions may follow on, depending on the patient responses. You should record all the information (many practices have a triage sheet) and then pass this to the registrant as soon as they are free.
The registrant will then decide on the best course of action for the patient. Either way, having some prior information is very helpful to the clinician optometrist.
It also means the anxious patient is able to explain their problem as soon as they enter the practice, rather than have to sit and wait to be seen.
Sue Deal FBDO R is a practising dispensing optician, ABDO College examiner, senior tutor and supervisor for dispensing opticians. She is also a practice visitor and external moderator for ABDO. She was recently awarded the ABDO Medal of Excellence for her outstanding services to the profession.