Aipedia: Optometrists and opticians

AI tools in domiciliary eye care

Aipedia, by the Apex broking team · Last reviewed 2026-10-30

AI-supported equipment and record tools can make domiciliary sight tests more thorough, but the optometrist must still judge every result and protect data held on portable devices. Domiciliary patients are often frail or lack capacity, which raises the stakes for consent, accuracy and follow-up.

Part of: AI in Optometrists and opticians

In short

Domiciliary providers use portable fundus cameras with AI grading, tablet-based records, AI scribes and automated recalls in care homes and private homes. The GOC Standards of Practice apply in the same way as in a practice: valid consent (3), professional judgement on technology-generated data (7.8), clear records (8.1) and secure storage of records against loss or theft (14.7). Patients may lack capacity, may not communicate symptoms clearly and may rely on care staff to act on advice. Indemnity usually responds to domiciliary clinical work if it is declared, subject to the policy terms; lost devices raise data protection issues as well.

How AI is used in domiciliary visits

Domiciliary eye care brings testing to people who cannot attend a practice, often in care homes and often with limited time and equipment. Portable fundus cameras and handheld devices may come with AI analysis that can grade images on the spot. Record systems on tablets auto-populate templates, and some providers use AI scribes or voice notes to write up visits. Scheduling and recall tools plan routes and visit cycles across many homes.

These tools can help when examination conditions are difficult: poor lighting, limited cooperation and no slit lamp. They also create new risks, because a quick AI result can feel like enough when a full assessment was not possible.

The duties that apply

The main duties that apply are:

Standard 3: the GOC Standards of Practice require valid consent. Where a patient may lack capacity to consent, follow the applicable capacity law and record how the decision was made and who was involved.
Standard 7.8: apply professional judgement to data generated by digital technologies, including portable device analysis taken in poor conditions.
Standard 6.1: recognise the limits of what you can assess on a domiciliary visit and refer when needed.
Standard 8.1: keep clear and contemporaneous records, even when writing up later from a tablet or voice notes.
Standards 14.1 and 14.7: keep records confidential and protect them against loss, theft and inappropriate disclosure.

Where an AI tool makes a significant decision about a patient solely by automated means, section 80 of the Data (Use and Access) Act 2025 restricts such decisions on health data.

Consent and capacity

Many care-home residents live with dementia or other conditions affecting capacity. Telling them that a camera and software will look at their eyes, or that the visit is being recorded, needs to be done in a way they can understand, with relatives or care staff involved where appropriate. If a resident cannot consent, the examination and any AI processing should be justified as in their best interests under the applicable law, and the record should show how that was decided. Recording audio with an AI scribe in a shared room also involves other residents and staff.

What can go wrong

Illustrative scenario: on a care-home visit, an optometrist uses a portable camera with AI grading on a resident who cannot sit still. The image is of poor quality, but the software returns "no referable disease". The optometrist records that result and moves on. Months later, care staff notice the resident bumping into things and a significant, treatable condition is found. The family asks why the visit did not detect it and why the record does not mention image quality.

Data risks are just as real. A tablet left in a car or at a home can hold images and records for dozens of patients. If it is not encrypted, a loss becomes a reportable breach.

How cover treats domiciliary work

GOC Standard 12.2 requires adequate indemnity and continuous cover. Domiciliary work should be declared, as some policies treat it differently from practice-based work. A clinical claim involving AI-assisted findings is usually treated as a claim about the optometrist's judgement, subject to the wording. Loss of a device or a data breach may fall outside clinical PI and need data breach cover or cyber insurance. Locums working for a domiciliary provider should check whose cover applies to the provider's tools.

Practical controls

Put these controls in place:

Record image quality and examination limits, not just the AI result.
Record how consent or best-interests decisions were made.
Pass clear written advice to care staff and record it.
Encrypt devices and sync records promptly.
Avoid ambient recording in shared rooms.

How Apex helps

Apex arranges PI for optometrists and domiciliary eye care providers. A broker can confirm that domiciliary and AI-assisted work is declared and covered; see our optometrist PI guide.

Sources

Frequently asked

Can I use AI grading on a domiciliary visit?

Yes, but treat the result as data. Under Standard 7.8 you must apply judgement, and portable images taken in difficult conditions are often of lower quality. Record the image quality and your own assessment.

How do I handle consent where a resident lacks capacity?

Follow the applicable capacity law, involve relatives or care staff where appropriate and record how the decision was made and why the examination was in the resident's best interests. Standard 3 on valid consent still applies.

What if a tablet with patient records is lost?

Treat it as a potential data breach under your data protection procedures and report it as required. Standard 14.7 requires records to be protected against loss and theft, so encryption and prompt syncing are key controls.

Check your PI covers how you use AI

Tell us about your firm and the work you do. A broker will review how your current PI treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.