Refraction

ABDO Advice Concerning Refractive Surgery

C11.2.2 Dispensing opticians are well-placed to educate patients by providing general information about a variety of surgical procedures, including refractive surgery.

This is likely to be verbal but can also be supplemented by offering leaflets, web-site addresses, CD-ROMs and/or videos that provide additional information and further assists the patient in their decision making process.

C11.2.3 ABDO recommends that you inform patients, who express an interest in refractive surgery procedures, about the different treatments that are available. The relative pros and cons of each as well as the comparison with alternative forms of correction (such as contact lenses) should be discussed. It is important that this information is factual and objective; if you are not up-to-date with the latest established techniques, then it is prudent to refer the patient to another party who is up to date, or alternatively, to another educational resource, such as internet websites.

C11.2.4 A qualified and unbiased recommendation of refractive surgery is appropriate where, with the information available, the patient fits the general suitability criteria for surgery. It MUST be made clear that you are giving general advice and that ultimately only an ophthalmologist specialising in refractive surgery can determine individual patient suitability. The final decision will be made jointly between the surgeon and the patient and will be accompanied by the signing of an informed consent form.

C11.2.5 In an increasingly litigious society dispensing opticians are advised to only provide objective information in accordance with their knowledge of the subject. As stated in ABDO’s general Advice and Guidelines a registered dispensing optician should be satisfied that he or she possesses the necessary knowledge, either by existing training and examination or by additional knowledge and skill. Documentation is, as always, the only suitable defence in the unlikely event a patient decides to seek redress for their outcome, following the issuing of advice. You must therefore be clear in the advice you give to patients and keep clear, detailed records of that advice on the patient’s record card. This applies equally to those in general practice as it does for those working for a refractive surgery clinic.

C11.2.6 It is ideal, but not essential to provide details of more than one clinic to a patient. You may have a relationship with a particular refractive surgery clinic (or clinics), whereby to the best of your knowledge and your considered clinical judgement they offer a good service that you are happy to recommend to your patients. However referral to another clinician or organisation for clinical care must not involve a fee or its equivalent. You or a colleague may be providing a local co -management programme for your patients on behalf of your preferred clinic, either pre-operatively, post-operatively, or both. Any financial recompense for professional time and/or consultation MUST also be divulged to the patient in order that this remuneration is transparent to all and seen as appropriate.