SECTION 4 – Final Assessment
THE COLLEGE OF OPTOMETRISTS
Scheme for Registration
GUIDANCE FOR FINAL ASSESSMENT
This Guidance must be read in conjunction with Section 5 of the Regulations for the Scheme
for Registration document, which can be found in Section 4 of the Pre-Registration Handbook,
following this Guidance document.
4.1
General Information
Trainees may submit an application for the Final Assessment ONLY when their Assessor has
confirmed in writing that the minimum number of refractions and dispensings have been
undertaken and all the Core Competencies have been achieved as part of Ongoing
Assessment.
The General Optical Council has agreed that all trainees who are already registered with the
Council as a dispensing optician will be exempt from the requirement for the minimum number
of dispensings, however, such trainees will still have to meet the required minimum number of
refractions. Regardless of such dispensation, questions by Examiners in the Final
Assessment regarding dispensings will have to be correctly answered by all trainees.
Candidates must submit one application form for the initial Final Assessment (which covers all
four sections). Where re-sits are required an application form must be completed for each
section to be retaken. The application form(s) confirms that the candidate agrees to abide by
the College Regulations.
The last date of application will be notified to candidates via the College website
(www.college-optometrists.org) but will be not less than six weeks before the Final
Assessment date. Late entries may be accepted at the discretion of the College.
Final Assessment days will take place at regular intervals throughout the year. Details can be
obtained from the College website.
4.2
Assessment Outline
The Final Assessment consists of four sections, all of which may be assessed over one day.
Below is an outline of the Assessment day for each of the four sections (see the Regulations
for the Scheme for Registration for further details of the nature of the assessments and the
General Optical Council Competencies to be assessed in each section).
Routine (45 minutes examination + 5 minutes for clarification)
• One routine eye examination on a presbyopic patient
Contact Lenses Fitting and Aftercare (60 minutes examination + 5 minutes for
clarification)
• One contact lens after care (RGP or soft)
• One contact lens fitting (soft one eye and RGP the other)
Clinical Decision Making (60 minutes reading + maximum 60 minutes oral)
• Clinical Decision Making (CDM) – six scenarios to be read under supervision
• Scenarios examined with two examiners
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Ocular Diseases (60 minutes stations + 30 minutes oral)
• Ocular disease station examination – six stations of 10 mins each
• One ocular diseases and abnormalities (ODA) oral examination
4.3
Assessment Guidance
To assist candidates in preparing for the Final Assessment guidance on each section is listed
below:
4.3.1
Routine
Fitness to Practise: The object of the Routine assessment is to elicit the
necessary information to arrive at an appropriate conclusion, based on that
information and all the available data. The conclusion may be in the form of
prescription(s) for optical aids, advice, further assessment, notification and/or
referral. Safe appropriate patient disposal is important.
Assessment: The Examiner will check that the candidate has demonstrated
the relevant key competencies as listed in the Regulations and achieved a
reasonable degree of accuracy throughout.
4.3.2
Contact Lenses
Fitness to Practise: The candidate must demonstrate an adequate standard of
knowledge and skill to enable them to deal safely with contact lens patients.
They must be competent to safely advise prospective wearers of their
suitability for contact lenses, to prescribe and fit basic forms of contact lenses,
to provide aftercare in such cases, and to provide competent advice to habitual
wearers.
Assessment: In every case the Examiners will look to see that candidates
have an adequate ability in basic fitting and aftercare techniques in order to
manage contact lens patients safely.
Contact Lens Fitting Section
The candidate will be provided with a patient who is assumed to be a
prospective contact lens wearer who has had a slit lamp examination and
Keratometry readings taken.
The candidate will be required to:
o Carry out any further measurements necessary to select a suitable
rigid gas permeable into one eye and a soft lens into the other eye.
o Assess the tear film on the eye that is to be fitted with a rigid gas
permeable lens (this should include tear prism assessment and tear
break up).
o Select and insert a suitable rigid and soft lens on the basis of the
available information.
o Assess and record the lens fit and performance, suggest suitable
modifications to improve the fit and record the contact lenses to be
ordered.
Contact Lens Aftercare
The contact lens over refraction results will be provided.
The candidate should be prepared to examine a patient who is a contact lens
wearer
and will be required to :
o Take a relevant history and symptoms of the patient
o Carry out a suitable assessment of the patient to determine the
effects of contact lens wear on the ocular integrity of one eye,
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o
o
4.3.3
explaining the slit lamp routine and illumination techniques used
during the assessment, and record the results.
Determine the lens care regimen and patient compliance with lens
hygiene and storage recommendations.
Record the need for any remedial action and advise the patient
accordingly
Clinical Decision Making
Fitness to Practise: The candidate must be able to demonstrate the ability to
take information from previously unseen case records and identify the key
issues which arise. They must be able to discuss suitable optometric
management strategies with a view to optimising patient welfare.
Assessment: The Clinical Decision Making scenarios will be structured to avoid
emphasis on ocular pathology as this will be covered in the Ocular Disease
and Abnormality oral examination (see below).
The case scenarios will be presented in a standard format with full clinical
information given as below:
Age and Gender
Ethnic Background
Occupation and Hobbies
Presenting Symptoms and History
General Health and Medication
Present Rx
Centration and Acuities
Pd/Ncd
Vision
Pinhole Vision
Refraction
VA at Distance and Near
Amplitude of Accommodation
Binocular Status
Motility
Near Point of Convergence
Pupil Reactions
IOP
K Readings
Fundus and external eye photographs and sometimes slit-lamp photographs
will be presented, The results of visual fields examination and colour vision
tests will also be included. Candidates should be prepared to interpret and
explain normal and abnormal plots from a Henson, Humphrey, Friedmann or
Dicon visual field instrument, or an Amsler chart. They should be able to
interpret Ishihara or City University (3rd edition) test results.
When reading through the case scenarios, the candidate will be permitted to
make notes. These must be taken along to the viva examination. A calculator
will be provided, along with a current Norville lens catalogue for reference. The
oral will be based around structured questions on each of the six scenarios and
will address the appropriate GOC competencies.
4.3.4
Ocular Disease and Abnormality
Fitness to Practise: In optometric practice practitioners must be able to detect
abnormal ocular conditions at an early, as well as a late stage in their course,
and to differentiate the abnormal from the normal eye. They must be able to
recognise the need for referral or reporting, to judge the relative urgency and to
be familiar in every case with the appropriate method of referral or reporting.
Assessment: The station examinations will emphasise ocular examination
techniques, and recognition and interpretation of clinical signs of common
ophthalmic conditions.
The stations will include:
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•
One station requiring the use of a binocular indirect examination
technique. (For the purposes of the examination this will mean
the use of a slit lamp, not head-mounted, and not the Welch and
Allyn Panoptic ophthalmoscope) The station will have an
observation tube and/or video observation system available.
•
One station acquiring and assessing the cover test results and
ocular motility of a patient with an anomaly of binocular vision
•
At least four conditions from the following list:
- A contact lens related condition
- Maculopathy
- Glaucoma
- Cataract
- Retinal vascular disease
- Anterior eye abnormalities
The oral examination will place an emphasis on competencies that deal with
patient management.
Candidates are reminded that the above Guidelines must be read in conjunction with Section
5 of the Regulations for the Scheme for Registration document following.
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