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I agree with Les Clarke’s view that to refer into the NHS an optometrist needs a basic OCT, scanning laser ophthalmoscope and a slit lamp. In addition, the optometrist needs confidence to interpret the images and that comes with a thorough learning regime.

However, what constitutes a ‘basic’ OCT? Does basic mean ‘inexpensive’? Does basic mean ‘imprecise’? I would argue that a basic OCT should offer a diagnostic quality SLO fundus image, simultaneously registered with a high-resolution OCT scan, positioned automatically in exactly the same location for each follow-up scan. These three basics ensure accurate measurement of change over time. No fancy bells and whistles required, simply one micron of accuracy so that nothing is missed.