As chief executive officer and dispensing optician at Hereford-based independent BBR Optometry, Nicholas Black has been working seven days a week since March to meet the ongoing challenges of providing eye care in the Covid-19 era. With the lockdown across the UK now substantially lifted to varying degrees and optical practices free to offer more than essential services, the goal posts have shifted towards incorporating increasing numbers of patients while maintaining safety.
‘Patient attendance has been increasing since the first week of June,’ says Black. ‘That was when many patients, who qualified as essential under the guidelines but had previously prioritised staying at home, began to come in for things like repairs and replacements. There was definitely a shift in public perception at that point.’
On the dispensing side of the practice, one of the key challenges is taking necessary measurements.
‘What we’ve been doing, whenever possible, is using digital measurements via electronic dispensing aids. Obviously with digital, there’s additional layers that we can measure beyond just PDs and heights. There’s a whole host of lenses out there that require more detailed measurements. So if you’re using a PD ruler, you’re getting closer to the patient for longer than necessary and potentially not able to choose the most suitable lens.
‘We use Nikon’s Lenswear-i, which runs on iPads, and Rodenstock’s Impressionist. I think using these devices or similar ones is important in terms of the impression that you’re giving the patient; that you are taking safety seriously. They allow you to work at a longer range and minimise encroaching within the patient’s personal space.’
If it becomes necessary to take physical measurements, Black feels it is best to consult historic measurements before committing to greater contact.
‘If the digital measurements don’t look right for whatever reason, the first port of call is to check the historic measurements for that patient. If, having considered those, you decide you need to take physical measurements, you need to potentially adjust the level of PPE you are wearing before cleaning your hands with gel and taking the measurement. Afterwards, clean the tools used and wash your hands.’
Frame adjustments should also be carried out in a way that minimises contact.
‘Adjustments should be done at arm’s length and if you are looking at the ear area it is best to access from behind or the side. The patient should be told that you will not necessarily be in full view.’
Looking for positives in the current situation, Black feels that one of the opportunities to come out of the pandemic is that dispensing opticians can be more empowered in their dealings with patients.
‘Controlling the flow of patients is really important at the moment because you can’t just have people waiting around. This means communicating to patients that things are different now. Last week I was talking on the phone to a patient who said that it always takes them forever to make up their mind when purchasing spectacles. I said “well you need to come in a better mindset this time, because we are looking at minimising interventions and the time that people spend with us in the practice, for their own wellbeing and our own wellbeing.”’