“You have the opportunity to really change their lives”

Six years on, Bahra tells OT about the gratitude she receives from patients and their families – and why being able to thrive whilst providing domiciliary eye care requires a certain type of personality.

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

Just before COVID-19, I was doing quite a bit of domiciliary work with Specsavers, including an increasing number of shifts on the Kent coast, and clinics to cover a resident Home Visits optometrist. I realised I really did enjoy it, and wanted to pursue it further. COVID-19 then hit, and I had time on my hands to do all the paperwork and get the contract. I now have my own domiciliary business, Southern Optical.

What do you enjoy most about domiciliary optometry and why?

The patients are just so grateful. You have the opportunity to really change their lives, and you really do gain that different perspective.

A lot of these patients don’t go out that much, or they don’t have the confidence. You go and spend some time with them, and they’re able to choose their glasses. You’re able to really help them, holistically. It’s not just that I’ve come to see them for their eyes. It might be the way they’re sitting, or it might be that they need a separate pair of glasses for something that they really love doing, but were previously unable to do. That’s where I genuinely enjoy it.

They need that holistic aspect more so when they’re in their own home. It’s a very vulnerable place and time. They’re inviting you to their home, so for me it’s a privilege to be able to help them. The gratitude they have for it is just something else. That really fills my cup.

My domiciliary work is focused within my local community. That local community feeling, for me, really reinforces that. Whenever I go and see my patients, I’ll bring them their favourite biscuits. It’s bringing back that old school community that I grew up on.

They’re inviting you to their home, so for me it’s a privilege to be able to help them

What would you change about domiciliary optometry and why?

I think it should be stricter in terms of who gets to go into people’s homes to do domiciliary work. You’re dealing with vulnerable patients. If you want to be a dispenser, or if you want to be in that space, you should have to have the DO qualifications, and there should be some sort of governing body to shadow that.

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

Unfortunately, you do get a lot of optometrists saying, ‘Oh no, I would never do that.’ Especially from younger optometrists, or optometrists who have not tried it before, there is a bit of scaremongering. They think it’s dangerous.

You have to ask yourself what you want to gain from this, and why you are looking for it. What sort of optometrist are you? Are you quite good at dealing with elderly or vulnerable patients? Do you get stressed out really quickly? If you do, this is probably not for you. You will be dealing with patients who are quite vulnerable. But if that is something that you enjoy, you’ll definitely get a lot of fulfilment out of it.

It really depends on what sort of person you are. I remember working with the dispenser, and he absolutely loved it, and that’s probably why I pursued it further. For a while, during COVID-19, we had to stop, and we were really sad about it. We really felt like we had extended grandparents. You get to know the patients, and they are absolute sweethearts. You’ve got to be that sort of person to enjoy it.

What is your most memorable moment as a domiciliary optometrist?

A female patient had booked a domiciliary visit for both herself and her husband, but particularly for her husband, who didn’t go out much. He had always loved doing puzzles, but his glasses were quite old. In the end, he chose a really lovely pair of frames, and he was able to see the puzzles again. They were both really surprised, and really happy with the glasses. I had just done my job, but they got really emotional.

Before I left, the patient gave me an eight pack of Kit Kats. She gave me a hug, and said, ‘Have these for your tea, love. Thank you so much.’ It was very much how your nan would speak to you.

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

Sometimes there isn’t enough empathy. You might work with colleagues who get irritated with patients. But sometimes, you do have to reschedule. You might go to a care home, and sometimes they have no idea that they’re going to have their eyes looked at, because unfortunately they’re not very well.

It’s quite challenging to not say anything, when colleagues are irritated. If you have a business, that is really important, but it has to come with integrity as well.

Another challenging aspect is when patients are young. That’s really hard. I’ve seen multiple sclerosis patients who are not much older than me, and some have even been younger. Seeing juvenile Parkinson’s patients is also hard. Somebody who is thinking about starting domiciliary would need to be a bit prepared.

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

Read around it, and also really understand who you’re going to work with, and who you’re going to work for. I wouldn't tell anyone to set up their own domiciliary business, if they were going into it blind. I would say work with a company first, be prepared, and challenge yourself to know what you’re about to get into.

But you won’t know unless you try. My close friend is an optometrist, and she absolutely hated domiciliary. She found it really draining, and emotionally she found it too much, whereas I just loved that I could help people. I know that I was right for it, because it didn’t drain me in that sense. It made me want to help them.

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

The PanOptic ophthalmoscope that I’ve got is really good. Most of the time you are using an ophthalmoscope, but other brands aren’t as good. The PanOptic is brilliant if you’ve dilated, and I generally dilate everybody.

What is your proudest moment as a domiciliary optometrist?

Whenever the patient is really happy, and I get a phone call afterwards from a family member thanking me and saying they didn’t realise that their parent was struggling. Sometimes, they’re so happy that they do actually give me a hug. When they’re happy with my service and what I’ve given them – every instance of that makes me proud.