“It is one of the most rewarding roles in optometry”

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

After several years working as a High Street optometrist, I felt ready for a new challenge. A medical camp in India, where I tested patients despite a language barrier, gave me the confidence that I could be adaptable when delivering care for patients. The experience also sparked my interest in exploring new opportunities.

I was instantly drawn to domiciliary optometry, as it allowed me to work outside the conventional test room and care for patients with diverse needs. The gratitude I receive from my patients makes the work even more rewarding.

In 2014, I became a domiciliary partner with Specsavers Home Visits, and I continue to find this role immensely fulfilling.

I was instantly drawn to domiciliary optometry, as it allowed me to work outside the conventional test room and care for patients with diverse needs

What do you enjoy most about domiciliary optometry and why?

Each clinic offers a unique experience, requiring quick adaptation to provide the best care. Patients share fascinating life stories, and time flies by as you engage with their needs, improving their quality of life. It is one of the most rewarding roles in optometry.

What would you change about domiciliary optometry and why?

Domiciliary patients face barriers in accessing care. For NHS-commissioned visits in England, these require a pre-visit notification to the relevant NHS authority. This means that we can't see any patients without giving a minimum of 48 hours' notice, and if we are seeing more than two patients at the same address, the notification period rises to three weeks. Many local NHS referral pathways don’t seem to consider domiciliary patients when considering access to treatment. 

Many local NHS referral pathways don’t seem to consider domiciliary patients when considering access to treatment

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

There is a misconception that domiciliary optometrists can do a lot of travelling. While this might have been true in the past, as demand rises with an ageing population, clinics are becoming more clustered within single postcode areas, reducing travel time and boosting productivity. The flexible hours of domiciliary care can support a work-life balance, allowing, for example, clinics to start after and finish before school runs.

The flexible hours of domiciliary care can support a work-life balance, allowing, for example, clinics to start after and finish before school runs

What is your most memorable moment as a domiciliary optometrist?

I visited a patient with agoraphobia, who had symptoms of angle closure glaucoma. This included vision blurred to 6/36, photophobia, haloes around lights, pain, and red eyes. Examination revealed a mid-dilated pupil and possible remnants of previous synechiae with intraocular pressures above 40mmHg.

We talked about the sight-threatening nature of the condition. My patient was hesitant to leave home for the eye clinic. It was a situation that required adaptability in order to be able to provide care for this patient. I called the triage nurse at the local eye department and arrangements were made for the GP to provide pilocarpine eye drops on the same day.

The result? The patient's condition has been managed at home, with findings reported to the eye hospital. Best of all, her vision was preserved and eye pressures managed effectively. It was a very demonstrable example of how Specsavers Home Visits service is delivering a neighbourhood health service at home for patients, in collaboration with secondary NHS care colleagues.

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

Patients with advanced sight loss are understandably concerned about their circumstances. Understanding their needs with compassion and providing options that support them in their environment are critical. Adapting their environment, for example by improving lighting and using low vision aids, can significantly help.

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

Know that you are making a real difference to people’s lives. Enjoy and embrace the role by providing the best care and options you can for your patients by taking environment, lifestyle and needs into account. Think holistically about clinical management.

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

A portable slit lamp. It’s lightweight and durable, with fantastic optics and magnification. It allows for a thorough examination of the anterior eye, and along with a Volk lens gives a wide fundus view.