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May dispensing opticians dispense plano lenses without a prescription?

U2.3.3 “May dispensing opticians dispense plano lenses without a prescription?” (2012)

My first thought was, “Of course they may”, but then the doubts set in. Putting the question in context is always helpful. It is a frequent request from patients who have undergone cataract surgery to remove the spectacle lens in front of the newly operated eye; the pre-op prescription can make their vision worse, often causing giddiness. Removing the offending lens may well help with the imbalance (but not always), and glazing a new plano lens for balance of fitting and cosmetic reasons is a very reasonable thing to do, but is it legal?

Registered DOs may dispense spectacles without a prescription, unlike unregistered sellers who may only dispense to a prescription not more than two years old and then only to those over 16 and without serious sight impairment. The circumstances when a DO may dispense without a prescription might be the copying of a broken pair of spectacles in an emergency or replacing a lost pair of spectacles from records while waiting for an eye examination appointment. The difference is that a registered optician can make the decision as to what is in the best interests of the patient.

Concerning the debate over supplying a plano lens, you could argue that they are not covered by the Opticians Act; anyone can supply them, in sun specs for example, and no prescription needed. The argument falls down when it is only one lens that is supplied; the appliance is still a pair of spectacles, with a corrective lens. We wouldn’t wish unregistered sellers to do this work would we?

Thus we are on unknown territory: is this a pair of spectacles or not? After careful consideration and consultation, I am of the opinion that a registered optician has both the knowledge and experience to remove a spectacle lens and replace it with a plano lens for the temporary relief of visual discomfort in the period after a cataract extraction, before a full eye examination can be performed and the final balanced prescription dispensed.

This is a situation that has yet to be tested in law. If a situation such as this were to be questioned, your records would, as always, be your defence. Did you explain to the patient and family that the result may not necessarily be helpful or successful? Did you explain to the patient and their family the temporary nature of the dispensing? If the records show that these questions were raised and answered and that, as our Advice & Guidelines state, the welfare of the patient was met at all times, a charge of unprofessional conduct would be difficult to prove.

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