“I know I’m providing a vital service to some of the most vulnerable people”

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

Stephanie Lipsey-Liu (SLL): Ann and I started Freedom Eyecare in Nottingham after I finished working for one of the larger domiciliary companies, who were all about targets – targets for how many eye tests we could do and how many people we could sell glasses to. We thought that if we were independent, we could carry out home visits much more ethically.

What do you enjoy most about domiciliary optometry and why?

Ann Hamilton (AH): I enjoy the incredible variety in domiciliary optometry. Every day is different: the patients, the homes, the situations. I know I’m providing a vital service to some of the most vulnerable people – those who genuinely need eye care at home. I also love the change of scenery and the unexpected surprises, like meeting furry pets along the way. It’s never the same, and that keeps it rewarding and engaging.

What would you change about domiciliary optometry and why?

SLL: I would change the pre-visit notification system on Primary Care Support England (PCSE). It is honestly an infuriating system. Also, the General Ophthalmic Services forms on PSCE in general. I can’t think of anything I’d change about the actual job, though.

I also love the change of scenery and the unexpected surprises, like meeting furry pets along the way

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

AH: I think the most common misconception is that domiciliary optometry is boring, repetitive, or all about going into care homes. People think it’s difficult or unexciting. But actually, every patient is different, and you get to hear their stories, meet fascinating people, and make a real difference in their lives. It’s far from boring — no two days are ever the same.

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

AH: For me, it’s not so much a single moment as it is dealing with the systems in place – particularly the IT infrastructure like the NHS systems and PCSE website. They just aren’t designed for the practicalities of everyday practice. For example, completing forms in areas with poor signal can be incredibly frustrating, and the website layout is not user-friendly at all. It’s not updated to reflect what we actually need on the ground, and it really slows things down.

If you get bored easily in practice, you definitely won’t get bored in domiciliary

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

SLL: If you get bored easily in practice, you definitely won’t get bored in domiciliary. Every patient is so different. Also, speak to the patients how you’d like to be spoken to. Don’t assume that they can’t hold a normal conversation just because they might have a dementia diagnosis. The number of times I’ve had a staff member tell me ‘oh, she won’t not answer your questions or read the chart,’ and then the patient does it brilliantly.

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

SLL: My retinoscope. It seems obvious, but there are a lot of elderly patients who aren’t great with their subjective or can’t do it at all, so having great ret skills are a must. It helps me in practice too – it means you’ve already got an accurate starting point.