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 Medical Retina
Code MR2.1
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. 
  • Employ appropriately and interpret optical coherence tomography (OCT) scans.  
  • Employ appropriately and interpret fundus fluorescein angiography (FFA). 
  • Understand the principles and basic interpretation of electrophysiology. 
  • Understand and interpret visual field tests with regard to both medical retina conditions and treatments.  
  • Know common and uncommon long-term side effects of laser treatment e.g. reduction of peripheral vision in DR treatment, night blindness, metamorphopsia. 
Method of Assessment
Other information