Visual Function Competency 3.1

Competency 3.1: The ability to make appropriate prescribing and management decisions based on the refractive and oculomotor status

The trainee needs to demonstrate the ability to decide whether a new or changed prescription is warranted ensuring that main issues arising in examination are taken into consideration.  These issues include any presenting symptoms any previous prescription and oculomotor status.  The trainee also needs to demonstrate the ability to recognise reduced vision and investigate.

There also needs to be demonstration that the trainee can logically arrive at and accurately records, appropriate prescription in full, and arrive at and accurately record advice and recommendations to meet optical needs avoiding vagueness and ambiguity.

Best Form Evidence

Most Assessors will witness one full routine during the first assessment, so the primary method of assessment here will be Direct Observation.

As with all competencies one piece of evidence is not enough, so an Assessor will probably also look at a selection of Patient Records, the Logbook and may conduct a case scenario/role play.

Case Scenarios and Patient Records are good methods of achieving this competency.   Providing an Assessor with a range of records will help to pass.

The Assessor may pose different scenarios e.g.

  • Adaptation
  • First time Rx
  • First time high cyl
  • Anisometropia with/without amblyopia
  • Intermediate addition
  • Need for prism
  • Spectacles required for VDU only.

The Assessor will also look for evidence that symptoms have been related to advice.

Unacceptable Evidence

Reasons for failure are not making the appropriate decisions, not considering visual needs and visual comfort.  E.g. it is not a good idea to prescribe a reading add that gives a range of 60 -100 cm when the patient has short arms.

If prism is prescribed just saying “ I gave the same as last time” is not an answer.  Know how the level of prism was decided and why it was given, and why it is necessary for e.g. DV only etc.

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