Who's who at eye clinics & how can they help with diagnosis or treatment?

The following article was originally written for Insight magazine.

We all know that early diagnosis and treatment of glaucoma saves sight, which is why delayed appointments and long waits can be worrying. The aim of community-based clinics is to speed up appointments, in the hope of saving sight. You will meet different professionals at community-based and hospital eye clinics, but who’s who and what do they do?

Community-based eye clinics

Community-based eye clinics are suitable for people at low risk of sight loss. They’re held away from hospitals, at places such as GP practices or opticians, and are usually closer and easier for you to get to. You’ll have the same eye health checks as you’d have at a hospital, but you might meet just one eye care professional. Most often this is an optometrist but sometimes it’s a nurse, technician or GP.

Most people are familiar with going to optician practices for routine sight tests and glasses. Opticians fit and adjust glasses and contact lenses based on prescriptions sent from optometrists or ophthalmologists. Other eye care professionals working at optician practices do eye health checks.

Optometrists, who all have four years’ training, specialise in examining eyes and prescribing glasses and contact lenses. Those in community-based eye clinics have additional training in advanced eye health checks and managing glaucoma.

Nurses do health checks, help with treatment and provide care. Nurses in eye clinics have specialist training in ophthalmology and glaucoma.

If the eye care professional can’t answer [your questions], ask to be referred to someone who can.

Technicians are trained to do specific eye health checks.

The eye care professional will:

• do eye health checks;
• refer you to other services, like a hospital, if needed.

Some eye care professionals diagnose eye conditions, make treatment recommendations or prescribe eye drops. They can’t all do this; it depends on their training. If they can’t diagnose or prescribe, they’ll refer you to someone who can.

At a community-based eye clinic, you normally won’t speak with an ophthalmologist. Instead, the clinic will send your eye health check results to an ophthalmologist.

Ophthalmologists are doctors with extra training in ophthalmology. Glaucoma is just one small part of their training. Ophthalmologists will:

• review your test results;
• decide what treatment or further appointments you need;
• call you or send you a letter to tell you what to do next;
• arrange hospital appointments if needed.

Even though you won’t meet an ophthalmologist at a community-based eye clinic, you can still ask questions. If the eye care professional can’t answer them, ask to be referred to someone who can. Make sure you write your questions down and have them ready in case an ophthalmologist calls.

Hospital eye clinics

People at higher risk of sight loss are most likely to visit a hospital eye clinic. Here, you might meet several eye care professionals.

Nurses might:

• ask about your health;
• assess your vision;
• put drops in your eyes ready for an ophthalmologist to examine your eyes;
• give you advice about using eye drops;
• prescribe eye drops (only some nurses are allowed to prescribe).

Technicians might:

• check your eye pressure;
• do visual field tests;
• photograph the back of your eyes.

After eye health checks, you will usually speak to an ophthalmologist. The ophthalmologist will:

• look at your eyes;
• review your test results;
• talk to you about treatment options;
• prescribe treatments;
• carry out treatments such as laser or surgery.

Some hospitals run ‘virtual’ clinics. At virtual clinics, you won’t meet an ophthalmologist. Instead, the ophthalmologist will review your test results, then contact you by phone or letter.

If you need support or advice, remember that you can always ask to speak to an eye clinic liaison officer (ECLO). You don’t need an appointment. ECLOs can:

• give you information about living with an eye disease or sight loss;
• help you access other support services such as community groups, social care or benefits.

Eye health checks are always done by a professional trained to do them. The difference is what else they are trained to do. Ophthalmologists review eye health check results and decide about care and treatment. You get the same treatment, faster, at community-based eye clinics.

If you feel confused about who’s who, it’s okay to ask. You can also call our helpline on 01233 64 81 70 or email helpline@glaucoma.uk.