AOP advice in response to member queries

Our response to member queries during the coronavirus pandemic

Optometrists in practice

Do all patients with flashes and floaters require a face-to-face appointment?

In our opinion, in the interests of patient safety, any new reports of flashes or floaters require a face-to-face examination as per the pre-COVID-19 College of Optometrists’ guidance.  

We are aware that it has been suggested that it may be possible to “watch and wait” with lower risk patients, but as these symptoms are inherently higher risk in clinical terms, with potential for sight loss to occur, these patients will require a face-to-face examination, unless the risk of a face-to-face examination outweighs the risk of sight loss. 

Can advice provided by an ophthalmologist via a WhatsApp group or similar messaging platform be relied upon as “advice and guidance”?

Generic advice provided without access to the full clinical details has the potential to lead to misunderstandings and poor outcomes. Members should not be sharing specific patient details via WhatsApp groups or similar. This is particularly true if it is a group chat and not on a one to one basis. If you cannot show that the advice was informed by full clinical details and linked to a specific patient episode, it could be argued that you did not take reasonable steps to obtain appropriate advice, or that the advice was not intended for that patient. 

When relying upon advice you would need to be able to clearly show that advice was sought about a particular case and include that advice within the patient record, if you wanted to use it to explain your decision making. This would mean that the consultant providing the advice would need to understand that they were accepting responsibility for the clinical outcome of the patient. As always good record keeping is of utmost importance and if the advice could not be reasonably included in your patient record, then it should not be relied upon.