Assessing Eye Sight and Ocular Health: The Practical work of optometrists

Lead Research Organisation: King's College London
Department Name: Management


Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.
Description 1) Presenting problems and difficulties Optometrists invite clients to present problems and difficulties with their eyes at the start of the consultation and the information reported is consequential to the encounter. We observe that:

- questions from the optometrist orient both to the existence of problems and the reasons for the client's visit;

- in response clients appear to experience difficulties distinguishing between problematic changes with their eyes and expected 'normal deterioration';

- clients also attend to normative issues around the appropriate status of the consultation;

- optometrists use follow-up questions to pursue relevant information and so treat clients' answers as possibly incomplete.

2) Testing vision and assessing performance After openings, the consultation proceeds through a series of tests and checks:

- optometrists initiate, organise and assess testing through their vocal and visible actions;

- responses by clients provide a resource for the optometrist to determine how to proceed with the remainder of the test;

- clients frequently display a desire to do 'well' in tests and comment on their own performance;

- optometrists produce assessments at the end of tests and at transitionary points during them. Whilst end of test assessments refer to the quality of the client's result, transitionary ones respond to displays of difficulty and effort, ameliorating the consequences of 'failure'.

3) The various consultation tests involve the deployment of tools and technologies:

- different tools and technologies have alternative consequences for interaction, particularly where opportunities for eye contact are increased/decreased;

- the visible actions through which tools/technologies are positioned relative to the client are frequently highly distinctive. They function to help establish the test environment and provide time for the client to prepare for the upcoming test whilst displaying sensitivity towards 'personal space';

- instruction-giving is closely coupled with the placement of tools/technologies. This coupling prompts the type of response required from the client, enabling the production of test results.

4) The professional status of the optometrist becomes visible through various consultation practices, including;

- the use of follow-up questions to pursue potential client problems;

- the construction of key optometric distinctions using terminology accessible to the client;

- the deployment of gestures - for instance in the placement of tools/technologies - that are consistently distinctive and functional but also sensitive to arising difficulties;

- sensitivity to contingencies in the consultation, including spatial organisation and client actions and reactions.

5) Video recordings can be highly beneficial to optometric training and professional development, providing a resource for consideration of key issues such as;

- the layout of the consultation room;

- optometrist-client interaction, for instance in relation to instruction giving and eye contact;

- the alternative use of paper and electronic records;

- the deployment of tools and technologies, in particular the use of advanced, automated equipment.

Our findings point to the potential for future research, in particular to look at:

- Optometric training and the development of both formal and tact knowledge;

- The transformation of optometric technical and professional practice through the development of new examination technologies.
Exploitation Route The findings are relevant for communication training in optometry and the health services more generally.
Sectors Education,Healthcare

Description The findings have been used by teachers and trainers of communication skills in optometry. Some of our collaborators have begun to use video in the teaching of communication skills in optometry. Also, we have used the findings to write a successful application for an ESRC Knowledge Exchange project. The KE project run between 2013 and 2014
First Year Of Impact 2012
Sector Education
Impact Types Cultural,Societal

Title Video-based Research Methods 
Description Video-recording are used as primary data to study social action and interaction. 
Type Of Material Biological samples 
Year Produced 2012 
Provided To Others? Yes  
Impact Since 2012 we have shown optometric practitioners and teachers of communication skills in optometry how they can use video to reflect on their practice. 
Description Engendering response : professional gesture and the assessment of eyesight in optometry consultations 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Presentation at Microsoft Research Cambridge as part of day long seminar on 'Social Interactions in Medical Settings'

The participants approached the speaker for further information about the project and its relevance for healthcare practitioners
Year(s) Of Engagement Activity 2012
Description Professional gesture in optometry : a case study of video-based field studies 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Work, Interaction and Technology Research Centre at King's College London is a

centre of excellence in video-based field studies that illuminate the ways in which workplace

activities are accomplished through socially organised interactions involving vocal, bodily and

material actions. This paper provides a case study of analysis undertaken as part of a recent video-

based study of optometry. It describes the processes through which data collection, analysis and

dissemination were conducted. In doing so it demonstrates the methodological, conceptual and

practical benefits of this kind of approach.

The workshops were very interested in participating in the research and in learning more about communication skills in optometry.
Year(s) Of Engagement Activity 2008,2011