1.2.5 Communicates effectively with any other appropriate person involved in the care of the patient.

Question 1

In H&S: ask

Answer 1

• Child thinks vision ok
• Mum hasn’t reported any visual problems from child
• Is there anything concerning you about his/her eyes?
  
  • Closing one eye?
  • Have you noticed any eye turns?
  • FH squint/lazy eye/CV defect? Siblings?
  • Rubbing eyes?
• Any FH of colour defect or glasses wear? Long or short sighted?

Question 2

Advise

Answer 2

discussed myopia/emmetropia etc with Mum & advised spex & why they need to wear it

Question 3

if child has CV defect,

Answer 3

discuss it’s congenital (if binocular), more common in males, not harmful, may affect occupation later in life e.g. engineer (mostly electrical), pilot, police officer & even doctor, so must advise parent/guardian that when child picks occupation, this is considered

Question 4

Gillick competence is the whole reason for the competency

Answer 4

• Must review it
• The law regards young people aged 16 or over to be adults for the purposes of consent to treatment and right to confidentiality. However, a Gillick competent child refers to a patient under 16 who has sufficient understanding of their treatment allowing them to give or withhold consent. If you decide that a child is Gillick competent, you can refuse to share details with their guardian. However, it’s good practice to encourage the child to involve parents or other legal guardians in any treatment.

Question 5

Random Scenario: - Master Jones is 13 and a myope. You have just finished his sight test and found a change in his prescription for spectacles. His mum is in the waiting room.
- He tells you he wants to come back for a contact lens fitting, but not to tell his mother as he’d like to surprise everyone by wearing lenses at his sister’s wedding next month. Could you proceed without discussing with his mum?

Master Jones is 13 and a myope. You have just finished his sight test a

Answer 5

• Answer -If he is Gillick competent with regard to having a sight test unaccompanied, then you must respect his wishes regarding confidentiality.NB It would be a good idea to check that he is willing and able to pay for his contact lens fitting appointment if mum is not going to pay.

Question 6

Other side effects of cyclo:

Answer 6

• Slurred speech
• Hallucinations
• Lack of coordination
• Seizures
• Rash, fever
• Difficulty urinating
• Tachycardia
• Dry mouth