Back To Work: Is This The New Normal In Optometry?

I’ve been back at work for two weeks now after being on furlough since we went into lockdown at the end of March.

For 12 weeks or so, optometrists could only see emergencies and those with urgent problems. My colleague (and friend) Hannah was on-call throughout to attend to those patients. Now, Optometry in England at least, is in an amber phase. We can provide routine eye care with strict guidance about PPE, social distancing, and procedures.

Social distancing

I work in Benjamin Opticians, a high-end, hi-tech independent optometry practice in the heart of Skipton. Pre-Covid, we ran three concurrent clinics provided by two optometrists and one contact lens optician every day. Alongside the clinical staff were at least two dispensing opticians and reception, admin and management staff.

We currently operate a one-in, one-out policy to ensure social distancing. The door is locked and patients are advised to come alone to minimise footfall in the practice. For both reasons, there is only one optometry clinic per day, I work Monday to Wednesday and Hannah works Thursday to Saturday. As you can imagine, we have a huge backlog of patients to see so, we’re working longer hours: 7.30am-6pm. We’re in a separate bubble with three or four other colleagues who work on the same days. This means should anyone from either bubble display any symptoms of Covid, that bubble can isolate as necessary while the other one can keep working. Another of our optometrists will work on Sundays from this week along with the owner of the practice to offer a clinic for the more vulnerable patients.

During the first two weeks, we saw one patient per hour. It gave us time to don and doff our PPE and to clean and sanitize every surface and piece of equipment after every patient. We’re getting used to some state-of-the-art new equipment too, so we needed a little more time initially, (more about that in a future blog post). From next week, we’ll do 45 minute appointments so we can see a few more patients per day.

PPE and a “safer” eye examination

I never dreamt I’d wear scrubs, goggles, a mask, apron and surgical gloves to work.  (I actually had a visor at first which was a nightmare because it kept steaming up and getting in the way. Goggles are a huge improvement). It’s very difficult to wear spectacles with PPE so I now wear multifocal contact lenses to work. We change into and out of scrubs at the start and end of the day to minimise the risk of cross-infection between home and work. As soon as I get home, I put them in a hot wash then shower and wash my hair for the second time that day.

For every patient, we use new gloves, mask and apron so there’s a LOT of donning and doffing. I wash and sterilise my goggles after every patient too. Our patients must wear a mask and sanitize their hands several times during their visit. The doors are locked and after the patient has rung the bell to get in, it too gets sanitised. We really are doing everything we can to look after each other. 

We’re fortunate to have three (beautifully decorated) private dispensing rooms where patients can try eyewear in peace. They can try on as many frames as they like because they get sterilised in a UV cabinet immediately afterwards. Very few optometry practices have the luxury of separate rooms. Most have their eyewear displayed on the “shop floor.” Our rooms guarantee social distancing and reassure our patients that it’s safe to choose their new specs.

PPE is uncomfortable: the masks are hot and lead to dehydration. The weather has been glorious this week, so I’ve already been warm by the time I’ve walked to work. The gloves make for cumbersome fingers especially when typing. It’s hard work. I cannot imagine how hot and uncomfortable doctors, nurses and other frontline workers must be in theirs. I’m grateful to have  a few minutes’ respite every hour and I’m fortunate to work in a practice where patient and employee health and safety is the absolute priority. 

The new normal in optometry?

Lockdown is being gradually eased. One day it’ll be over. But I wonder if this will be the new normal. I think we’ll all be more mindful of social distancing and infection control going forwards and I believe that’s a good thing. It should reduce the transmission and spread of all viruses and infections.

Will we still have a locked-door policy? Do we only include procedures that are essential or indicated rather than carrying out the same tests, (for example a visual field test), on every patient? Will we triage over the phone or via video rather than in practice? Will we carry on working in bubbles? At this stage, I don’t think anyone knows.

For me personally, I love the new equipment. It’s brilliant, future-proof and has altered how we test sight. I’m happy working longer days. They’re consecutive so I get four days off to write my blog and my optometry columns and to do house stuff. I don’t mind early starts and I’d rather do three long days than four short. I miss the rest of the team though; we’re friends as well as colleagues, though our little bubble is great. As for scrubs and PPE? I can see a modified version becoming the new normal in optometry. I miss wearing my nice work clothes, jewellery and lipstick, (it comes off on the mask), but it’s actually rather nice not straightening my hair and wondering what to wear. That was the old normal.