All guidance and regulation on the issuing of prescriptions state that if the power is over + or -5.00D, a vertex distance must be included. Sadly the real world often falls short of this standard – so what can be done?
First, you are perfectly within your rights to refuse to dispense a prescription without a vertex distance, but that doesn’t help the patient or your sales figures. Practically, and simply, the easiest option is to phone up the prescriber and request the information. Try to do this in front of the patient so they understand that you are being professional, and the prescriber remiss. If the prescription is from a hospital eye clinic, it is nigh on impossible to speak to someone who can answer your query, let alone understand what you are talking about. Prescriptions from outside optometrists may be equally difficult to verify; they, or their staff, may be annoyed that a patient has taken their prescription elsewhere and so be less than helpful.
The way forward may be to take the patient to the consulting room and put the prescription in the trial frame and see what they can see. If you measure the vertex distance and note the acuity on the record, you can proceed with the dispense knowing the resulting spectacles will be accurate. The records would show something like: “02/02/10: Rx from Bloggs Opticians brought in, no VD stated. KD phoned to check info but Mr Bloggs unavailable and OA not able to give information out. In the consulting room, the prescription set at 12mm VD gave 6/5 acuity R&L. On dispensing, frame set at 14mm
VD Rx modified to…”
This approach involves more work for the DO, but the patient has been treated professionally and is more likely to return to a practice where staff take the time and trouble to accurately dispense their spectacles.