So, I have my Stage 2 date. Unfortunately, despite me telling the College last month that I don’t work Mondays and Fridays, the visit is on a Friday.  Also, the visit is scheduled for 9.15am but we don’t start testing until 10am (the optoms in our store work 10am to 9pm).  All in all, not ideal.  I’ve e-mailed them to ask if they can change it to a day that my room is free for me to use and at a time my supervisor and I will actually be there.

For some reason, I assumed there would be more time between Stage 1 ending and Stage 2.  It’s probably because of the three months between Visit 2 and Visit 3.  Everything is speeding up, except me.

I’ve felt I’ve slowed down in the last couple of days.  My testing time seemed to come down quite naturally from over an hour to 40 mins but now I’m stuck at 40mins.  I did a 25 minute test today but it was a 8 year old with no prescription, no issues and the largest pupils known to man.  I picked up some speed and then I had a very chatty patient and suddenly, I’m running late.  My patient was lovely but would not take the “please leave” hints that I was dropping.  You know, the wrapping up conversation, the standing up and trying to usher him out of the door.  My next patient was in the waiting room but I was trapped politely nodding while I was told all about holiday plans.  In the end, I said, “That’s great. I’m sorry to cut you short but my next patient is over there and he’s been waiting a wee while so I’ll have to take him through.  Lovely talking to you, come back if you have any problems or want to try those reading glasses!”

I also met some reps from one of the contact lens companies today.  They asked what they could do to support pre-regs and I asked about training (thinking about the J&J OSCE courses that are already fully booked, although the reps weren’t from J&J).  I also asked if we could have a patient information leaflet about multifocal lenses, how they work and why the patients need to trial them for at least a week.

For example, I fitted a lovely man with multifocals a couple of weeks ago.  He loved them and went home grinning (I did the eye test, the fit and the I&R all in the same evening).  The next day, I got a phone call from him.  They weren’t that great: his distance vision wasn’t as good as it should be, he needed to have the prescription changed.  I told him to persevere – I wanted him to try them for at least a week before he made a decision.  He had to adapt to the lenses, just like he would adapt to varifocal specs.  When he came for his aftercare the next week, again, he was happy.  I said to the contact lens reps that it would be great to have some information about adaptation and how the lenses work on a leaflet so that, when the patients have their inevitable “these lenses are rubbish!” wobble, they can read the leaflet and remember what us optoms have told them.  If it’s on a leaflet, it’s far more official than me just saying, “You’ll need to give it time so you can adapt.”

Sometimes you have patients who just plain refuse to compromise.  I fitted a senior police man with multifocals and he left the test room seeing 6/4.5 & N5.  A week later, he came into his aftercare with glasses on, saying that he took the lenses out after a few hours on the first day because he wasn’t seeing very well with them.  What he thought I was going to do during the aftercare is beyond me.  Did he want a refit? No. Did he want to try another lens? No. He just booked out 20 mins of my clinic just to turn up and say “Thanks but no thanks”.

Continuing on the subject of contact lenses, I tested an 11 year old boy a couple of weeks ago.  He had quite high cyls and was around +6.00DS in both eyes.  During the test, we chatted about his hobbies and he really loved playing football but his glasses got in the way.  When he played, he would usually take the glasses off because he’d previously damaged them.  I had a word with his mum about contact lenses and ordered some dailies in for him to try.  Now, we couldn’t get his actual prescription in the dailies so I ordered a make-do prescription that would hopefully let him see the ball a bit better.  He came in for an I & R last week and struggled to get the lenses in and out.  Today he came back and I sat with him for the I&R.  He really struggled again.  He’s booked in for tomorrow but I’m really worried that he just won’t be able to do it.  At what point do you say (in true Glaswegian style), “Game’s a bogey” and move on?