19.2.1

19.2.1	Explain how the following factors may influence the examination process: age, culture, language, physical ability, cognitive ability

Age = with increased age come other health concerns (HBP / arthritis / neurologic issues) which would affect the the ability to take photographs (head position prohibit a picture being taken on a desk mounted camera)(limitation of cognitive ability ie dementia / Alzheimers / Parkinsons) or even the quality of photographs might be affected (inadequate pupil dilation / media opacity / high astigmatism)

Cultural = this could be construed as a language barrier; in certain middle eastern cultures female patients will insist on being examined / screened by a female optician / screener; during the weeks of Ramadan, strict Muslims would be worried about the drops in the eye draining into the mouth & being construed as drinking fluids

Language = is a language interpretter required ? if so is this provided by the patient, by the practise and where does this fit in tieh GDPR limitations. In the instance of a deaf person using sign languages all instructions would need to be issued/ conveyed to the patient in a well lit room.

Physical ability = I refer back to how AGE could be a factor in use of a table mounted camera (or a even a slit lamp in the Slit lamp clinics) due to age but any physical limit that would prevent them to be successfully examined as per the DRS pathway

Cognitive ability = in occasions any body who would have trouble understanding the instructions to comply with the screener to take fundus photos (ie Dementia / Alzheimers) are more commonly associated with age of a patients but would also influenced by person with learning disabilities. (I can think of one case where a mental disabled patient who was accompanied by a carer was new to our clinic after a recent diagnosis of diabetes wouldn't even into the pretest area for the pre-dilation check before even being seen for having dilation drops instilled. Said patient was escorted out by her carer to help calm her down but didnt return that day)