“We’re there to help people improve their vision and improve their quality of life”

Here, Nasser tells OT about the misconceptions and overwhelming benefits that come with providing domiciliary eye care.

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

I started my domiciliary business 20 years ago. I identified that there was no domiciliary service in Moray, where I live. That aspect of optometry was something that I was really happy to provide. The fact that no one was providing it made it feel like a good thing to do.

What do you enjoy most about domiciliary optometry and why?

The big thing is providing eye care to housebound patients, who are unable to access eye care otherwise, and improving their quality of life.

What would you change about domiciliary optometry and why?

I think it's absolutely fantastic that the NHS provides this service. Some people will use the word ‘free.’ I don’t ever use the word free – I just say, ‘this is provided by the NHS.’ I think it’s incredible to have this service in Britain. I don’t know many countries whose health system supports this service.

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

It’s not everyone's cup of tea, to be providing a domiciliary service. Many optometrists think it is very challenging, which it is. But I embrace those challenges, and I find ways around things. It’s challenging, but it’s not as challenging as people think. The end results of providing the service outweigh anything else. Ok, we can’t carry OCT equipment, for example. But we can still be a massive help. There are still the tools in my hand to do the job.

There is a misconception from the public, and from families, that if somebody has dementia, they might not need an eye test. I provide the understanding that actually, it is those patients who really need it. They are the ones who haven't got a voice. We can pick up eye conditions and eye diseases. We can see what glasses they need through simple tests. That is a really big thing that faces the profession: the misconception of what an optometrist can do for somebody who is not able to communicate with us.

Many optometrists think it is very challenging, which it is. But I embrace those challenges

What is your most memorable moment as a domiciliary optometrist?

In 20 years, there are quite a lot. One particular patient, who was registered blind, comes to mind. Sat at home, it was on his mind. He was thinking: ‘my vision is going to go completely black. When is it going to go black? I'm not going to be able to see.’

I reassured him that this was never going to happen to him with the condition he had, and I was later given positive feedback about what this reassurance had done to his morale.

There are so many incidences of boosted morale. People appreciate your service, even more than they do in practice. In practice, patients can take it for granted that they are seeing an optometrist, and that we will test their eyes. When we find pathology, they are very appreciative. But overall, there is a whole other level of appreciation for the domiciliary service the NHS provides.

I’ll give you another example. Three years ago, primary care in Shetland contacted me. They said, ‘we have not had an optometry service in Shetland for five years. Would you be interested in coming?’ My first thought was, ‘oh my gosh, patients in Shetland have not been seen for five years. Think of the undetected diseases that there will be after five years.’ So, I said yes, and I went.

All the care homes in the area are covered by the council. We saw patients in seven care homes, covering the whole area and hopping from one island to the next. This year is the third year that we have gone back.

I feel passionate about my profession. I think, ‘this is really needed.’ Also, I really enjoy it. I’m not just doing it because it’s needed. I also love it, and what it provides. Now, the locals in Shetland really see us. They come back over and over again. I’ve built such an amazing relationship with the area. It’s rewarding, but it's fun as well.

There so many incidences of boosted morale. People appreciate your service, even more than they do in practice

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

It is about families, and helping them to understand that everyone needs an eye examination. That’s the challenging part. The rest, I can cope with. I can manage patients when they have dementia. I find a way around that. It’s the understanding of the families that is really important. That can be, at times, challenging.

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

Without a doubt, absolutely go for it and try it. People have got misconceptions about domiciliary. Put those to one side. As optometrists, as a profession, we’re there to help people improve their vision and improve their quality of life, as well as detecting diseases. This is a vulnerable part of society, which we can help. To me, it’s very basic.

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

I couldn’t say one. I need my ophthalmoscope. I need my retinoscope. I need my slit lamp. I need to measure pressures. They all go hand in hand.

The most useful instrument when people can’t communicate is a retinoscope, because we can find out the prescription – not 100% accurately every time, but more or less.