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The role played as an optometric consultant in a nursing facility can be as creative and unique as one desires. In the role of consultant, the optometrist may be asked to assist the nursing home in developing policies or to provide suggestions on ways to improve the function of residents other than providing examinations. Optometrists certainly provide eye care services to the residents, but many other areas of optometric expertise may be needed. Who better to consult regarding floor coverings or wall color selection to enhance visual discrimination and reduce glare effects than the optometrist. Can falls be reduced, resident mobility be improved, and reading enhanced with a change in the facility lighting? How much lighting is optimal for residents and staff? A discussion of computer workstation design may be helpful. Are there large print materials including talking books and magnification devices available for the residents' use? The facility may need an eye safety workplace evaluation and a safety vision program started. How about organizing a health fair for the staff, residents, and families? Many facilities have newsletters that go to not only the residents but their families as well. Timely articles about eye care issues would be most welcomed by the newsletter editor. As a consultant, the optometrist may be asked to present lectures or inservice training sessions to staff or to residents and their families. Topics of interest might include the aging eye, low vision care, diabetic retinopathy, macular degeneration, cataracts, and glaucoma. Nursing staff members may benefit from a presentation on dry eye, how to instill eye drops, how to correctly administer hot packs or lid scrubs, or how to recognize common subjective symptoms of common eye problems or eye emergencies. Advice may be requested to design the best way to administer the eye portion of the MDS and assess the accuracy of the assessment. What other factors should the nursing staff consider in making appropriate referrals for optometric care? Residents with diabetes should have annual dilated exams. Residents with glaucoma need follow-up and medications reviewed periodically. Residents on long-term steroids need examinations to detect glaucoma and cataracts. Optometric provision of eye care services is certainly an important facet of the optometric consultant’s role. Studies suggest that nearly 80 percent of nursing home residents never receive eye care once they enter a nursing home. If optometric services are available within the facility, this number can be dramatically reduced. Although it takes time and effort to transport optometric equipment to the facility, the benefits are tremendous to both the resident and optometrist. Comprehensive examinations or problem-oriented visits can be performed with modern portable equipment.
Instruments and Equipment.
Eyeglasses can be provided when appropriate; however, most optometrists find optical services and dispensing to be a small portion of a nursing home practice. Utilization of optometric assistants is critical to efficiency in delivering care to nursing facility residents. From assisting in the examination to frame selection and dispensing services, optometric assistants play a very valuable role.
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