Visual fields

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The other two 'fields' competencies I've always found strangely specific. They are 5.13 The ability to assess visual fields of patients with reduced visual acuity and 3.9 An understanding of the special examination needs of patients with severe visual field defects.

Regarding 3.9 'severe visual field defects' for me would mean something like a hemianopia or a large central scotoma from macular degeneration. This competency starts with 'an understanding' so could be achieved without a relevant first-hand experience (ie without patient record - PR). However, if possible, seeing such a patient would make it immediately apparent as to the special care and alterations to a 'standard' routine that may need to be made with such a patient. This could be showing you are aware not to approach a patient from their blind side, or relying on purely subjective rather than objective refraction methods. If no PR is obtainable then careful consideration needs to be made by discussion with a supervisor as to what type of case scenario (CS) patients could be used by an assessor. As always, it is easier and safer to offer your own evidence. Also, how would you measure the field of vision present for such a patient? For example patients with AMD can still develop glaucoma. This strays into the area covered by 5.13.