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NHS eye care services

NHS opticians FAQ

The following health professionals may be involved in looking after the health of your eyes. 

Opticians

NHS optician is still the term most of us associate with their eye healthcare professional. However, the term is being used less and less within the profession and it is important you know who you are dealing with when you have your eye care appointment. When you visit an optician, you'll have your sight tested by an ophthalmic practitioner, which can mean either an optometrist or an ophthalmic medical practitioner.

Dispensing opticians

Dispensing opticians fit glasses and contact lenses working from the prescriptions written by an ophthalmic practitioner or ophthalmologist. They also fit and dispense low vision aids such as magnifying glasses or telescopic spectacles. They don't test eyes. A dispensing optician can give you advice on types of lenses, such as single-vision or bifocal (lenses with two distinct optical powers), and help you to choose frames and other optical aids. They also advise patients on how to wear and care for their spectacles. Also read the section about contact lens safety.

Optometrists

Optometrists are trained to recognise, treat and manage abnormalities and signs of some, but not all, eye diseases. Like eye surgeons (ophthalmologists), they examine the internal and external structure of your eyes to detect diseases like glaucoma, macular degeneration, and cataracts. They may also test a person's ability to focus and coordinate the eyes and see depth and colours accurately. Optometrists do not perform surgery. If necessary, the optometrist will refer you on to your GP or an eye clinic for further investigations.

Optometrists can prescribe and fit glasses, contact lenses and low vision aids. They can also prescribe eye exercises, undertake vision therapy, and, if trained to do so, prescibe medications to treat eye diseases.

Ophthalmic medical practitioners

Ophthalmic medical practitioners are medically qualified doctors specialising in eyecare. Like optometrists, they examine eyes, test sight, diagnose abnormalities and prescribe suitable corrective lenses.

Ophthalmologists

Ophthalmologists (eye surgeons) are doctors that specialise in the medical and surgical care of your eyes and the visual system. They also look into the prevention of eye disease and injury. An ophthalmologist treats patients of all ages, from premature babies to the elderly. The conditions dealt with in ophthalmology can range from eye trauma to cataracts, diabetic eye diseases, such as diabetic retinopathy, congenital and genetic eye problems.

Orthoptists

Orthoptists form part of the eyecare team and generally work closely together with ophthalmologists, ophthalmic practitioners and vision scientists. Their main role is to investigate and identify problems relating to the development of the visual system, including:

  • squint and lazy eyes in children
  • adults with learning difficulties
  • adults with double vision

Orthoptists also investigate, diagnose and assist in the treatment of conditions such as glaucoma, cataract, retinal disease, stroke and other neurological disorders.

Some orthoptists perform vision screening of children in schools and community health centres.

How often should I go to the optician?

It is recommended that you visit an ophthalmic practitioner every two years (or more frequently if advised).  This is important because an eye examination can detect potentially blinding eye conditions that, caught early, may be treatable.

An NHS sight test is free of charge if clinically necessary. It is up to your ophthalmic practitioner to decide whether a sight test is neccessary. If you request a sight test and it is not considered clinically necessary, you may have to pay for it, even if you are usually entitled to a free NHS sight test. For more information visit the entitlements and cost section.  

How do I claim my NHS sight test or optical voucher?

NHS sight test

If you want to claim your free NHS sight test, you'll have to apply for it by filling in the relevant form (GOS1) when you visit your ophthalmic practitioner. A member of staff can usually help you with that. You may have to show some proof of your entitlement. If you are not sure about your entitlement read the section about eye care entitlements and costs. Once you've filled in the form you can have your free NHS eye test. Your ophthalmic practitioner will claim any costs involved from the NHS.

If you have a valid HC3 certificate (an NHS certificate for partial help with health costs), show it to the optician and ask if it will apply for the cost of your private sight test. If so, you'll be asked to fill in another form (GOS5) to claim it. Again, you can do this at the optician. Even with the HC3 it is likely you will have to pay a contribution towards the cost of the private sight test.

NHS optical vouchers

If you are entitled to an NHS optical voucher, you will receive your voucher immediately following your NHS sight test. There are currently eight voucher values. The values are dependent on the strength of your prescription; the stronger your prescription, the higher your voucher value. You can take the optical voucher to any supplier of your choice providing they accept NHS optical vouchers. If your glasses or contact lenses cost more than your voucher value, you will have to pay the difference.

What happens after my NHS sight test?

Following your NHS sight test the optician is legally required to give you your optical prescription which you should take away and keep safe. This may include a statement to say you do not need glasses or that you are being referred to your GP or an eye clinic for further investigations.

An NHS optical voucher (if you are eligible) will be issued to you immediately following your NHS sight test. You will need to show proof of your entitlement to the optician or a member of their staff.

There are currently eight voucher values. The values are dependent on the strength of your prescription. Basically, the stronger your prescription, the higher the value of your voucher will be. 

No one should ever feel obliged to purchase glasses from the practice where their sight test was conducted. You are entitled to redeem your NHS optical voucher at a supplier of your choice, providing they accept NHS optical vouchers. We would advise patients to shop around for the best value and to only purchase glasses or contact lenses when you are happy with the product and the price.

Why won’t the optician give me my pupillary distance?

An optometrist is not required by law to include details of the horizontal distance between your pupils (the inter-pupillary distance) in your optical prescription. The responsibility for ensuring that your lenses are properly centred in your frames lies with the person dispensing your glasses (dispensing optician).

Providers of glasses need to comply with the Sale of Optical Appliances Order of Council 1984, which requires any provider to ensure that each lens is situated so as to be aligned when the appliance is in use to the centre of the customer’s pupils. Therefore, only the person supplying the glasses could be responsible for all the relevant measurements. 

Any provider of glasses, whether shop or internet based, should have arrangements in place to be able to satisfy this requirement. 
 

What are eyedrops used for during sight tests?

Some children, especially younger ones, might need eyedrops for their eye test. These will be given either by an ophthalmic practitioner, orthoptist or ophthalmologist. Once put in, the drops will need a while before they work. On average it takes about 30 minutes for children with blue eyes, but it will take longer the darker the eye colour.

Eyedrops make the pupils larger so that the back of the eye can be seen properly. They also relax the focusing mechanism in the eye so that the prescription for glasses (if needed) can be as accurate as possible.

Once the drops start working your child might complain that the light is too bright. You could bring sunglasses or a brimmed hat or cap to use afterwards. Some children may also feel that their vision is blurred or fuzzy. Again this is because the drops stop the focusing mechanism working. Unfortunately, it is not possible to reverse the effect of the eyedrops, but they will start to wear off after about six to 10 hours and are usually fully worn off within 16 to 24 hours.

About one in 10,000 children react to the drops with hyperactivity. This effect is only temporary and will wear off as soon as the drops wear off. If your child does have a reaction to the eyedrops, your optometrist, orthoptist or ophthalmologist should inform your GP. They will add a note to your child's medical records so that similar medications are not prescribed in future.

What are NHS-funded mobile sight tests?

An NHS-funded mobile sight test is where an optometrist comes to visit you in your own home or at a day centre.

If you are eligible for an NHS-funded sight test you may also be entitled to a mobile sight test. If you meet one of the criteria listed below then you may have your sight test at

  • home
    If you are unable to leave home unaccompanied because of physical or mental illness or disability
  • a residential or care home
    If you are a resident and you are unable to leave the home unaccompanied because of physical or mental illness or disability
  • a day centre
    If you cannot get a sight test at an optician's practice because of physical or mental illness, disability or because of difficulties in communicating your health needs unaided.

Tip: You may find more advice and support in our sections about adult social care and caring for someone with communication problems.

How do I complain about an optician?

If you are not happy with the service or treatment provided by your eye care team then you have the right to make a complaint. Wherever possible, complaints should be made directly to the optician, as it may be possible to sort out the problem straight away. If you would prefer to talk to someone who is not involved with the optician concerned, you can complain to NHS England. Read in more detail about the NHS complaints procedure.

Alternatively you can write to either the:

Optical Consumer Complaints Service (OCCS)
6 Market Square,
Bishop's Stortford,
Hertfordshire CM23 3UZ

or if the complaint is about an optometrist or dispensing optician:

General Optical Council (GOC)
41 Harley Street
London
W1G 8DJ

If you are unable to complain for yourself, then someone else (usually a relative or close friend) can complain for you. The OCCS will require a written authority from you or the authorised representative before the complaint can be registered. It is also important that any complaint is made as soon as possible after the event.

If the complaint is about an ophthalmic medical practitioner, it should be made to the General Medical Council

Page last reviewed: 09/09/2014

Next review due: 30/11/2016

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