First of all, thank you for choosing an independent optician as your eye care provider! We will look after your residents as if they were family and provide the best eyecare possible. This blog will run through the basics of what happens when we come to test peoples eyes at a care home.
Booking the visit
When a date and time is agreed upon then we will send a notification to the NHS to let them know when we intend to carry out the eye tests. If there are only 2 people in need of an eye test then we can notify 48 hours before hand. Then we can pick up an additional 3 people that day if needed. Any more than 2 people and the NHS requires 3 weeks notice.
A list if the residents that need testing along with their date of birth is required. If this is the first time we have seen them we will need to know when they last had their eyes tested, either at your care home or at their own home if they or their family has that information. If a resident is new to your home and that information cannot be found out then we can book them for their first check up right away.
Usually people ages 60-70 have an eye test every 2 years and over 70s, every year. Sometimes people will be seen more or less often than this depending on individual circumstances. If a patient requires an eye test sooner than their recommended recall this is fine if they are struggling with their vision or in the case of non verbal patients, if they are perceived to be having problems with mobility etc. Some people think they must wait until they are due for another test but some eye problems can start quite quickly with little warning. So if a patient has any concerns then we will book them in for an early check if needed.
The day before
We will phone the day before to make sure the visit is still appropriate and to check information such as who is diabetic, who is on eye drops and if everyone is well enough to be seen the next day. We will also ask for everyone's next of kin name and phone numbers so we can call them after the eye test to discuss the results of their relatives test if the resident wishes for us to do this. Some homes prefer to check with families in advance to make sure they are happy for us to contact them. For residents who control their own finances or who don't have any family we will talk through the results with them/you at the home. We will always discuss results with the residents first.
On the day
We will set an arrival time with you before hand. Usually straight after breakfast or lunch. For large numbers of residents there will be 2 opticians, for small numbers, usually just one of us will come. We will require a room that is at least 3 meters long to set the chart up in and enough space for patients in wheelchairs. Ideally if the room is big enough we will use part of it as a waiting room for the next patient or for patients who require eye drops to be dilating. If it is a small room then we can use a separate waiting room. If any residents require/want a member of staff to be present and or a family member then this is absolutely fine. Any patients who are bed bound or suffer with anxiety can be seen in their rooms.
You will hear us asking residents normal history and symptom questions regardless of any diagnosis of dementia etc. This is because there is such a wide range of understanding and cooperation we will not assume someone isn't able to do something until we have tried. This goes for reading the chart too. I will try letters, numbers and pictures at various distances. Often a staff member will say "she won't be able to read that". Sometimes they are right but sometimes the patient will surprise them and read out the letters or numbers. We will the proceed with the eye test as similar to in an opticians as possible.
Once the eye test is done then glasses can be chosen if required or requested. Again, if the patient wants staff to help them choose, that's fine. If glasses don't help or they cannot see small print with them then we can also try some magnifying glasses out. These are free to try and then can either be purchased privately or a referral for NHS aids can be made (this requires a hospital appointment).
We will run through the results with each patient as we go along and at the end of all the eye tests we will discuss each residents eye test results with your chosen member of staff (eg senior carer, nurse, manager). This gives you an idea of how good each person's vision is and whether they require new glasses and who needs referring to their GP or eye hospital if there are any eye problems that need further investigation. We will give you a copy of the prescription for the care plan and ask you to sign any eye test vouchers that haven't been able you be signed by the patient (eg dementia or stroke patients who can't sign their own).
For residents who require new glasses we will need payment upfront either from the resident if they are in control of their own finances or the next if kin who deals with their finances. Payments can be made by cash or card or we can email a link to pay online if needed.
If the resident receives a benefit called pension credit guaranteed credit, there will be an NHS voucher that can be used towards the cost of the glasses. If you or the family doesn't know if they receive pension credit then you can call this number to find out 03456088545.
Glasses will take 3 weeks maximum. We will engrave the patients name and date the eye test was done inside the arm of the glasses so staff know which pair belongs to which resident and whether they are the most recent ones. We will also provide you with a picture of the glasses and what they should be used for. This can be kept in the care plan or taped inside the residents wardrobe so staff know which ones they should be wearing.
Adjustments and breakages
You can call or email us anytime to arrange an appointment for us to come and adjust any residents glasses for whom we have provided glasses for. If they are not our glasses, we can still adjust them at the residents own risk (older glasses are more prone to break when adjusted). If a screw has come out or glasses have broken we will repair them as best as we can. If the patient has broken them due to a medical condition such as dementia or Parkinsons and they receive pension credit guaranteed credit, they will be entitled to another voucher to pay towards replacing them if they are irreparable.
We are looking forward to welcoming two care homes on board with Freedom Eyecare Nottingham in the next month and hope to provide eye care to more homes in the future. We believe in spending time with each resident and not rushing. We will answer any questions we can from the residents and or staff. You'll always see the same two opticians, Ann and Stephanie for the eye tests and the glasses deliveries as well as any adjustments. We are always just an email or a phone call away for any questions you might have.
Thank you again for supporting your local independent home visiting optician.
Please email any further questions or enquiries to firstname.lastname@example.org
As an adult you can chose when you wear your glasses within reason. If you cannot see to read the driving standard line without glasses then you must wear your glasses to drive. The same goes for any jobs that require a certain vision standard. However, in your own time, it's entirely up to you if you want to see the world in focus or not. I'll give some examples below.
The low to moderate myope (shortsighted person)
You are a low to moderate amount of short sightedness (myopia). For example your glasses prescription has a "-" not a "+" and says between -0.25 to -1.50ish.
In this case your close up vision, if you are under 40, will be perfect. Your distance vision will be blurred to some degree. To most people, having a blur in the distance is acceptable. Glasses make things clearer but unless they are specifically watching tv, going to the cinema playing golf or driving, they don't mind not being able to see far away. Also for short-sighted people, focusing close up is less effort for their eyes without their glasses on.
Some low myopes prefer to have perfect vision all the time so will keep their glasses on all the time. There is no such thing as wearing your glasses too much and making your eyes worse. Think about it, you are correcting your vision back to zero, as if you had no prescription. Would you tell someone with perfect eye sight to get some glasses to blur their eyes so that they don't make their vision worse by having it perfect all the time?? Of course you wouldn't, that would be ridiculous! So when people ask if they should "give their eyes a break" from their glasses, the answer is no!
The opposite should also be considered, will wearing my glasses all the time make my eyes worse? Absolutely not! By correcting your prescription and giving your brain a clear image this will not lead to an increase or decrease in your prescription. If it was going to change it would have changed regardless of whether or not you wore your glasses (I'm only talking about adults here). People think that wearing glasses full time will make their eyes reliant on them. The fact is, your brain will prefer the clearer vision and once you've been wearing your glasses all day, when you take them off you'll realise how blurred it was before you put them on by comparison! If you want to go back to not wearing your glasses then give it a few days without them and your brain will be used to living in a blur like it did before you started wearing glasses.
The moderate to high myope
The next patient is the moderate to high myope. Your glasses prescription is around -3.00 to -6.00. Now most of these people will wear there glasses all the time because anything past 20-33 cm is out of focus.
When these patients reach their early 40s they realise they can focus better without their glasses on so they lift them up or remove them to read. As long as their eyes remain healthy, they will always be able to see close up without with glasses because this is naturally where their vision is focused, with no effort from their eye muscles.
When it gets to the point where they have to lift up their glasses to see anything that is close up, approximately age 50-60, they find the glasses are on and off all day long. This is the point they usually switch to a bifocal or varifocal. Even then, when reading a book these patients will often take their glasses off and use their natural focal point again.
The low hyperope (longsighted person)
Next is the low hyperope. This time the glasses prescription has a "+" not a "-" on front of the numbers. Eg +1.00 to +3.00ish. As a young person you can use the muscles that change the shape of your lens (inside your eye) to focus long sightedness and see fine.
Long sight means the eye is too short or the lens inside the eye is too weak. By using the eye muscles either side of the lens to increase the power of the lens, we can bring the focal point that was behind the retina, to be focused clearly onto the retina.
When we are young we can do this all day long with no problems. As we age however, the lens inside the eye gets thicker and the muscles find it more difficult to pull it into shape to focus over any long sight. This can lead to eyestrain and headaches. At this point the low hyperope will usually start to wear glasses, not necessarily to improve the vision but to relax the eye muscles and relieve eyestrain, hopefully prevent the headaches they may have been getting.
Whatever your prescription, when we focus for close up, we do the same, use the muscles in our eyes to increase the strength on the lens to bring near objects into focus. So someone who is longsighted and doing a lot of close work, may find they need to use their glasses to relive some of this strain as their eyes will be trying to focus over the long sight and then extra focusing for close up objects too.
The astigmat. Is that a real word? Who knows! I'm talking about patients with astigmatism. Now you can be long-sighted or short-sighted with astigmatism.
It basically means your lens in your eye or cornea at the front of your eye (or both) are more curved in one direction than the other. This is sometimes referred to as "rugby ball shaped eyes". Now that is a massive exaggeration as your astigmatism would be off the charts if the 2 curvatures were that different but plenty of opticians use this analogy. Also it is only talking about the shape of your cornea and lens, not the whole eye.
Basically having astigmatism means you have 2 focal points in your eye. If you have some long-sight with this then your eye muscles can pull the 2 focal points as close to the retina as possible. If you are short-sighted with astigmatism then your glasses will do this for you. If there is only a small amount of astigmatism -0.25 or -0.50 then you might not need this corrected, especially if it is fairly straight (near to 90 axis or 180 axis on your prescription). If your astigmatism is higher than this or if it is at an oblique angle like 130 or 50 then you're more likely to want to wear glasses to improve the vision.
If you are wearing glasses then any astigmatism will be corrected. We would only leave it uncorrected if you didn't want glasses at all. Astigmatism can also lead to eyestrain and headaches if uncorrected although this varies from person to person.
If you are interested, always ask your optician if you aren't sure whether you are long-sighted or short-sighted and if you have astigmatism. Don't be afraid to ask questions about how often to wear your glasses if you're not sure. Hopefully this blog will help you make up your own mind. I must reiterate, this advise is only for adults. See my last blog about the plastic brain for more info about children's vision. Do not tell a child not to wear their glasses unless you have been specifically told by their own optician/orthoptist/ophthalmologist, especially if the child is under 8 years old.
As always, any questions for me, comment below.
My screw has come loose, what do I do?!
You've had your eye test, you get your new glasses, 2 months later one of the screws has worked loose and come out and the side has fallen off the glasses! That's ok, you pop back to your opticians and they mend it for you. Easy right? But what if you had your eye test at home because you couldn't get to the opticians? Should you call them to come all the way back to see you just to put in a new screw? YES! Definitely yes you should. If the side has fallen off your glasses, either they're un-wearable or very wonky! Making sure you can see as well as possible and as comfortably as possible goes beyond the hour we spend with you for your eye test. If your new glasses come loose and start slipping down your nose, call us and we will come and adjust them for you, no charge. Any problem with your sight or your glasses, we will do our best to help you.
My vision is getting worse but I'm not due another eye test for 6 months, what should I do?
Call your optician and book in another check. This goes for high street opticians as well as home visiting opticians. If your optician has recommended a 1 year check, that is assuming everything is normal. If you notice a change even 1 day after your check, you should book another one in. Sometimes it's just a case of adjusting your glasses, but sometimes it can be a problem with your eye health that needs seeing to urgently.
I'm getting headaches and I never used to get them, who should I talk to?
In this situation, as well as contacting your GP, it is a good idea to also book a check with your optician. There are some headaches which can be caused by your eyes and other more serious headaches that can be detected by checking thr back of your eyes. If there is anything causing swelling on the brain, it will often also cause swelling at your optic nerve which can be detected by looking at the back of your eye with an ophthalmoscope. Your optician can then refer you as urgently as necessary. If you have an eye test and everything is normal then you can tell your GP which will help them rule out some causes of headaches.
I had an eye test and didn't want new glasses at the time but now I fancy a new pair.
If your eye test is in date then you don't need another one. You can use the prescription issued to buy glasses wherever you want. If you had a home visit then book in for a home dispensing appointment to choose new frames. If your eye test was done elsewhere we will happily do a quick check to make sure the prescription is perfect before making your new glasses.
I can't see the tv well enough with glasses, can't you make them a bit stronger?
This is a common misconception for distance vision/tv glasses. Your glasses only correct your long or short sightedness. "Making them stronger" will only move the focal distance closer to you which will in fact blur the distance/tv. However, this can work for reading glasses, the stronger the reading prescription, the larger things seem because they are magnified, but also the closer the focal distance will be. So increasing the magnification of reading glasses can be done to a certain extent but be prepared to hold your book much closer to your face. For some people this works quite well. If you are struggling with very small print then an extra dioptre on your reading glasses could make this manageable. However, if you have significant sight loss then this may not be enough even to read large print. This is where hand held magnifying glasses come in. These can be obtained through the NHS at a hospital low vision clinic or privately though your optician. We carry a range of magnifying glasses which you may try for free then if they help then you can either purchase one or be referred for free ones.
As always, any questions please comment or give us a call on 01157866320.