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Duplicating spectacles

U2.1.2 Duplicating spectacles (2015)

There has been some discussion as to when a dispensing optician may duplicate a pair of spectacles; and indeed, should a DO duplicate spectacles?

There are certain things a registered, qualified DO may do that an unregistered seller may not under the Opticians Act; one of them is duplicating a pair of spectacles without a prescription. So there is no doubt as to the legality of the action: you may do so but the professional conduct question is, should you? There has been no Case Law, no Fitness to Practise hearing to guide us; we must simply decide each case on its merits.

A scenario might be that a patient, not known to you, comes into the practice with a broken pair of specs. They are well beyond repair but you have a workshop on the premises, you can neutralise the lenses, copy them and cut them into a suitable frame. That surely is good patient care? Precisely so, except with a small proviso: you would naturally record your actions with the prescription details that you had found (including the optical centres I would suggest), the frame style and measurements but also the advice given.

You would have asked the patient when they last had an eye examination, was there any family history of ocular disease, indeed, did the patient themselves suffer any eye disease, and record their replies. If you consider that they ought to be re-examined quickly, you would also note that advice and the reasoning behind it. It would be sensible to replace broken glasses as quickly as possible on the understanding that an eye examination would be booked (with yourself or their own practitioner) at a reasonable time. It should also have been pointed out that the replacement specs might well then have to be upgraded at further cost. All good professional care, with the patient making an informed choice.

There are numerous similar situations we have all come across when the actions of the qualified practitioner would be equally professional, but are there any circumstances where a DO should not duplicate spectacles?

Suppose a patient had an old but much loved and used pair of specs and having broken them, asked you to replace them, despite them being not the same prescription as the latest eye examination. Would that be professional action? It would be my opinion that if the patient was advised clearly and unequivocally that the replacement spectacles were not of the same power as the latest prescription and, as such, would not perform to the same standard – with all the ramifications of that statement if the legal standard for driving might be compromised – it may be done professionally and legally.

We are not policemen; it is not for us to tell patients what they may or may not wear in the form of spectacles. Providing the patient has sufficient facts to make an informed choice, you may supply duplicate spectacles and record very carefully on the patient’s record that they have been told the limits of such spectacles, even going to the lengths of getting them to sign to that effect. Life will have taught you that such a patient, who feel they know best, is rarely satisfied with whatever you do; despite your best efforts they will claim the duplicate spectacles are ‘not right’ or not as ‘good’ as the broken ones. You can only do your best, record your actions and be polite in the face of provocation.

My opinion is based on the patient being an adult with sufficient mental powers to understand your advice. The situation is entirely different if the patient is a child and they, or their parents, wish to have a ‘different’ prescription dispensed. That, as they say, is a different ball game altogether.

#dispensing #prescriptions #repairs