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Making spectacles to a contact lens specification

U2.1.3 Making spectacles to a contact lens specification (2017)

Usually I write about member queries in this column but this month I thought I would recount an experience I had in my practice recently.

The patient, a woman of a certain age, is a long-standing contact lens wearer. I have been seeing her for contact lens check-ups for many years. She is less good at attending for eye examinations. Why, I can’t imagine, but manoeuvring her into an eye examination takes a lot of doing.

This lady did finally come for her test: there was a bit of a change and her specs were very old. True to form, the optometrist recommended a new pair, not unreasonably as they were eight years old. Well, we had the usual, “I’m in a hurry” and “I can manage perfectly well with these”, which may well be true, but she escaped without ordering new ones. That was a few weeks ago.

Last week, she was back in for her contact lens checkup: no real change, all looking well, but probably wearing them rather more than she admitted. After the slit lamp examination, my usual practice is to ask the patient to read the chart in their specs.

As I’m sure you can guess, she put on a brand new, rather trendy pair of specs and read the 6/5 with ease. I was rather surprised, I admit, and asked her how long she’d had them. “Just since last week,” she said. “I broke those old ones so got these – very cheap. I was desperate.”

Now we all know that patients may take their prescriptions and get specs made up wherever they choose, but I was amazed she’d actually gone and done it. What amazed me even more was when she said she’d broken the specs in town so went into a local “bucket shop” to see what they could do. She didn’t have her prescription with her but the unregistered seller made the specs to her contact lens specification, which she happened to have with her. Yes, hard to believe anyone would think that this was acceptable, although perhaps nothing should surprise me anymore.

The patient, of course, wasn’t breaking any law by buying her glasses from anywhere she chooses; she was rather proud of her bargain and was probably telling all her friends how good they were. But the unregistered seller most certainly was breaking the law – the Opticians Act 1989 to be precise.

You all know as well as I do that unregistered sellers may only supply spectacles (we won’t grace the procedure by calling it a dispensing) to an in-date prescription, to an adult over 16 years of age and not to a patient who is sight impaired or seriously sight impaired.

To say I was speechless gives you some idea of the shock I felt. I did manage to blurt out: “But that’s illegal!” To which she replied, “Well I won’t tell anyone.” She had absolutely no comprehension of the insult I felt. I had thought she appreciated the care I’d given her and her family. Apparently not.

What to do? The feeling of helplessness can be overwhelming. You may, of course, report the matter to the General Optical Council as it is part of their remit to protect the public from illegal sales. However, this is unlikely to succeed; the patient certainly won’t complain because they got a bargain. Would prosecuting the unregistered seller be cost-effective? Is it a sensible use of your registration fee? Probably not. Amazon sell over-the-counter specs in all powers, plus and minus, and prosecuting internet sellers is too difficult we’re told. So I did nothing – and it still annoys me.

#dispensing #prescriptions