Independently manage patients at an appropriate work-rate, employing the most appropriate clinical examination equipment and investigation modalities.

Domain of Clinical Practice Patient Management
Level Level 2
Special Interest Area Cornea and Ocular Surface
Code COS2.1
Descriptors
  • Manage patients, with non-complex conditions suitable for management by the generalist, with indirect supervision. 
  • Manage patients, suitable for management by a generalist, at an accepted rate. 
  • Manage time and resources effectively. 
  • Demonstrate effective consultation skills, including effective verbal and non-verbal interpersonal skills. 
  • Identify and manage barriers to communication, including language barriers, sensory and cognitive impairment.
  • Use the exophthalmometer and interpret the findings with relevance to the specific patient.
  • Use appropriate tools to assess the cornea e.g. pachymeter and know when to use specular microscopy.   
  • Understand when to use, and competently employ a variety of lenses for binocular fundus and gonioscopy examination with the slit lamp. 
  • Use a portable slit lamp competently. 
  • Use a binocular indirect ophthalmoscope with a variety of lenses, selected to the situation and appropriate indentation. 
  • Perform refraction and understand the relevance and importance of the refraction. 
  • Assess a patient’s spectacles using neutralisation techniques and focimetry. 
  • Assess a patient’s binocular co-operation and assess whether optical correction for this is necessary. 
  • Select investigations appropriate to the likely diagnosis. Know when they need to be ordered urgently and how to interpret the results. Know their contra-indications, limitations and implications (including cost). 
  • Employ and interpret new methods of assessment and investigation when they are introduced into clinical practice.
  • Assess the progress of a patient’s condition and respond accordingly. This includes observation of the natural history of a disease and clinical improvement or deterioration in response to interventions.
  • Understand and apply knowledge of lasers. Apply this knowledge when recommending laser treatment. 
  • Employ safe practice, including complying with local laser safety procedures. 
  • Have knowledge of the common Low Vision Aids and the conditions for which they may provide benefit.
  • Perform minor ocular surface procedures, including, but not limited to, contact lens insertion and removal of corneal foreign body removal, ocular surface suture insertion and removal. 
  • Understand the indications for and use appropriate tools to assess the cornea (e.g. pachymeter, corneal topography, anterior segment OCT) and to recognise obvious deviations from normal. 
Method of Assessment
Other information