Domiciliary optometry: a student’s perspective

Fourteen years on and as a third-year optometry student, I’ve been working for Specsavers between two stores, in Plymouth and South Wales, for most of my degree. At the start of my third year, the opportunity arose to join Specsavers’ home service at weekends and I saw this as a brilliant opportunity to expand my skill set and learn more about the domiciliary sector.

So alongside the final year of my studies at the University of Plymouth, my weekends have been spent working for Specsavers as a domiciliary optical assistant.

Inside domiciliary optometry

Specsavers’ home service for the South West is based at Specsavers’ Plymouth practice, with the team covering Devon, Cornwall, Somerset, Dorset and Wiltshire.

My job role consists mainly of fittings, with some dispensing, repairs and problem-solving mixed in. Typically, I will see anywhere between seven and 15 patients per day, depending on which area I am allocated to. As the area is vast geographically, I can cover up to 300 miles in a normal working day.

A large number of patients are seen in their own homes, but I also visit residential care homes and, occasionally, hospitals. The patient base is diverse and I see patients with a variety of physical and mental conditions, of a varying age.

I am thoroughly enjoying the role to date. I’ve met some interesting patients and visited places I wouldn’t have otherwise visited. The experience has been invaluable in showing me a different side to the profession and the optical industry. As a result, it has informed the way that I work in the practice environment and at university.

The most unique part of domiciliary optometry is that you see and understand the patient’s day-to-day environment and how they will habitually use their spectacles, depending on the visual needs for that environment. I thrive on the problem-solving element of finding the best spectacles to meet each patient’s needs, which has enhanced the visual task analysis that I routinely perform when dispensing spectacles in practice, or during an eye examination.

One of the most refreshing aspects of home visits is seeing what a difference a pair of spectacles can make. As an optometrist, prescribing spectacles is fairly straightforward and is something we routinely do. However, for a housebound patient, they can improve their quality of life drastically.

I remember during one of my first home visits, I met an elderly gentleman who was housebound. He had terminal cancer and was waiting on new spectacles so that he could read his books and watch television. When I fitted his spectacles, he was incredibly grateful and said how he could achieve so much more now. It’s moments like these that highlight the incredible nature of what we do as a profession.

Skill enhancing

Working in domiciliary has improved my interpersonal skills as a practitioner. The patients have a variety of physical and mental conditions and, as a result, excellent communication skills are vital. Adaptability is also important and occasionally I will have to communicate with patients in non-conventional ways such as through text-to-speech or by them lip-reading. At an early stage of my career, working in the domiciliary sector has further shaped me as a clinician by providing me with greater exposure to patients, alongside seeing them in the university clinic.

At an early stage of my career, working in the domiciliary sector has further shaped me as a clinician by providing me with greater exposure to patients, alongside seeing them in the university clinic

Working in domiciliary, my career goals as an optometrist have been further informed. Once I’m qualified, I’d love to complete a low vision qualification and register with the Low Vision Service Wales. While I thoroughly enjoy low vision practice at university, working with patients in a home-based environment has fuelled my interest in this area. It has also opened my mind to the variety of options that optometrists have in the way they practise – perhaps combining High Street optometry with part-time domiciliary work is something I can do in the future.

Domiciliary eye care is an area of optometry that I feel is often overlooked at the earlier stages of an optometrists’ career, with few opportunities for students to gain this experience at university and during the pre-reg year. However, I believe that experiencing the domiciliary setting is something that every practitioner should do at some point in their career. Not only does it open doors and widen your perspective of the profession, but it provides a refreshing insight into the difference you can make as an optometrist. I know that I will carry forward my domiciliary experience with Specsavers into the remainder of my student years and my career as I strive to be the best optometrist I can be.