“You feel like you’re really helping the person”

When and why did you decide to become a domiciliary optometrist?

I joined Specsavers Home Visits in 2015. I was looking for something a bit different to being in practice all the time – you’re seeing the same problems, and the tests are quite repetitive. I saw the advert, went along and interviewed, and fell in love with domiciliary. I haven’t wanted to go back into practice since.

What do you enjoy most about domiciliary optometry and why?

It’s very rewarding. You feel like you’re really helping the person. I’ve found that I can tailor my advice a lot better to that individual. When you’re in a test room, you’ve got no idea of their set-up at home. You don’t know how bright or how dark their room is. You don’t know how far away they sit from their TV, or how big their TV is. That allows you to identify issues and give them specific advice, rather than just very generic help.

My perception of a big TV, I found out, is very different to that of patients. I would get people saying, ‘I’ve got a massive TV,’ but when you actually see it, it is relatively small, and that’s why they can’t read the text – because they’re sat too far away, rather than there being an actual problem with their eyes or their glasses. It’s much more one-to-one advice, that is tailored to them.

I’ve found that I can tailor my advice a lot better to that individual

What would you change about domiciliary optometry and why?

The NHS pre-visit notifications don’t count weekends. You have to give 48 hours’ notice to go out to somebody, excluding weekends. I don’t understand why that is, in the light of computerised, automated processes. I’ll work a weekend if I need to, but if I try and book somebody in on a Friday, I can’t see them until the Wednesday. It delays getting to people sometimes, especially if they’ve got a problem that they’re really concerned about. It’s not that I can’t get to them sooner, it’s that I can't claim an NHS test any sooner. That would be the one thing that I would like to change – include weekends and bank holidays.

What is the most common misconception you hear about domiciliary optometry and what do you say to demystify it?

People often don’t realise that we can do the same tests as you can in a practice. A lot of people think we will just get them to read something that we’ve stuck on the wall, like a letter chart. They don’t realise that we can still check the health of their eye, that we can check pressures; that we can do fields. We can do all the things that you can have done in the practice. It’s a thorough eye test, but the common misconception is that it isn’t as in-depth.

What is your most memorable moment as a domiciliary optometrist?

I’ve seen patients who are bed-bound, and haven’t had their eyes tested for a very, very long time. One particular lady hadn’t been able to enjoy watching television for years. She was just listening to the TV, and didn’t realise that she had become short-sighted, so all she needed was a pair of glasses. When she got them, she was just elated. There was almost a little tear in her eyes. She was so pleased that she could see the TV again. People are just so grateful. It’s really rewarding, working as a domiciliary optometrist.

What has been your most challenging moment as a domiciliary optometrist and why?

During COVID-19, having to wear a mask was very challenging. Not for hygiene reasons, but because it made you realise how many people struggle to hear, and so rely on lip reading. Because we were covering up our mouths, it was very difficult to communicate with people. They often did not hear what we were asking. It did make it a lot more difficult to do an eye examination, in those circumstances.

What is the one piece of advice you would give to those considering domiciliary optometry?

I would just say to try it. The bigger providers are probably able to offer a trial day, to [enable you to] go out and give it a try. It’s really interesting, and until you actually go out there and do it, you don’t realise that it isn’t difficult. You adapt your test to the environment that you’re in. With my test chart, because I use an iPad, I can change the distance that the patient is viewing it at, so it alters the size of the letters.

You can work in any environment, and it challenges you. Every appointment is different, every patient is different; every test is different. If that means doing a locuming day to try it out, then go ahead.

What is the piece of kit you could not live without and why?

Obviously, my ophthalmoscope, because you need to be able to check the health of patients’ eyes. But specifically to domiciliary, rather than just an eye examination, it would be the test chart using the iPad. Because I can change the letters, and they’re not reading the same letters over and over, they can’t memorise them. It allows me to work at different distances, too.