On the ground at the AOP

An AOP explainer on... domiciliary eye care guidance

Henry Leonard, head of clinical and regulatory at the AOP, on the resources for members providing domiciliary eye care services

4 min read

Pixabay/Alexa

Kimberley Young

04 April 2025

The AOP’s new guidance resource for domiciliary eye care is intended to be a one-stop destination where practitioners and contractors providing domiciliary services can find all of the information they need.

Domiciliary eye care is a growing area because we have an ageing population. We often receive inquiries from members who are interested in going into domiciliary work but are unsure where to start and are looking for more information.

There are also members who want to start their own domiciliary eye care business, and need guidance on getting set up, the equipment they require, and how to contract with the NHS, for example.

The AOP has a lot of informative domiciliary content across its website. Paul Chapman-Hatchett, the outgoing chair of the Domiciliary Eyecare Committee (DEC), suggested it would be helpful to pull it together in one area. When I took over as co-chair of DEC, along with Dawn Roberts, I was keen to make sure this was in place.

I think people are becoming more aware of domiciliary eye care. It hasn’t really been part of optometry training, so a lot of optometrists leave university and have a focus on High Street work. Hopefully, with the new education requirements, students are going to be more exposed to domiciliary and we may see more people going into this area. It takes a bit of work to switch to domiciliary as it’s a bit unfamiliar. But hopefully our guidance will help anyone who is interested to start.

The domiciliary eye care guidance is a good overview of all the issues practitioners might come across in domiciliary work. There are loads of examples of fantastic care from domiciliary providers and with experience it becomes much easier. I think, when you are starting out, it can be quite a steep learning curve, so I hope the guidance will make it a bit easier for newer practitioners who want to move into this work.

Domiciliary eye care is a growing area because we have an ageing population

The different challenges of domiciliary

It is always helpful for practitioners to remember that domiciliary work is quite different to High Street work. You have to change your expectations in terms of what patients are going to be able to see, and when you would refer a patient might be different than in a High Street practice. The reason that a lot of domiciliary patients need a home visit is because they find it difficult to get out and about, so you may have a different threshold for deciding when to send them on to secondary care. There are different challenges with domiciliary work that you may not come across in High Street practice.

Our guidance includes a new section on complaint handling. At the AOP we tend to see the same complaints coming up in domiciliary work, usually from the relative of a patient who thinks they have had a sight test or glasses they didn’t need. It is typically a breakdown in communication and misunderstanding that has led to a complaint. Often, when you look at it, the practitioner has not really done anything wrong, but the relative has not realised the care home arranged the sight test, and perhaps the patient has a cognitive impairment and were unable to explain that they don’t need one.

A lot of it is about going the extra mile and making sure, as far as you can, that the patient is due for a sight test and if they need new glasses that this is communicated properly to the relatives through the care home to reduce the risk of misunderstandings.

Included in the resource is a link to the AOP’s ethical optics guidance, which we produced last year. I think it’s particularly relevant to highlight in domiciliary eye care because there is the extra potential for misunderstandings and complaints to arise. Therefore, it’s all the more important that domiciliary providers are seen to be acting ethically and professionally.

AOP members with any questions or concerns can get in touch with the regulation team. Additionally, practitioners can highlight issues to the DEC.

Fast-forward: Coming up at the AOP

1 MAYopia Day: 11 May

OT, in partnership with the AOP, will host a day of online education focused on myopia management. Find out more on the AOP website, and if you cannot join live, keep an eye on OT for coverage and recordings.

2 AOP annual general meeting: 4 June

The AOP will hold its annual general meeting in June.

3 Glaucoma Day: 29 June

New for 2025, OT, in partnership with the AOP, will host its first Glaucoma Day. The event will deliver a day of webinar content dedicated to the discussion of glaucoma.