C 4.1.1 Although the GOC has ceased to issue rules on publicity, ABDO takes the view that any advertising by a dispensing optician should not bring the profession into disrepute.
C 4.1.2 Items for sale should be clearly marked with their price. It is very important that members of the public who might purchase the product or service are fully aware of prices and fees charged. Registered dispensing opticians should encourage the public to use eyecare and eyewear services and may employ acceptable publicity.
C 4.1.3 It is universally recognised that the success of the practice depends upon the public reputation it enjoys for the quality of the services and product provided. The public is the only true guide in this matter, since no registered dispensing optician can be competent to claim, directly or indirectly, that his/her quality of service is superior to that of professional colleagues. Any claim of superiority therefore carries a serious risk of being misleading and should not be made.
C 4.1.4 Registered dispensing opticians should observe their professional obligation to avoid publicity or advertising which could bring the profession into disrepute or which their colleagues or the public could find distasteful.
C 4.1.5 Considerable care has to be exercised when offering discounts or special offers to ensure that the public is not misled in any way. Complete details of any conditions connected with an offer or discount must be included in any advertising material and prominently displayed in the practice. Failure to do so results in prosecution being brought by Trading Standards Officers and involves GOC fitness to practice procedures. False claims of ‘sale’ items will incur similar action and penalties. (See Consumer Protection Act 1987 Part III)
C4.2.1 The dispensing optician should ensure that all patients are fully advised of their needs for spectacle frames and lenses and that all spectacles are properly measured for fit and are fitted to the patient and are checked against relevant standards.
The dispensing optician should ensure that, when dispensing or supplying spectacles to a patient, all appropriate measurements are taken for the lenses and frames, that checks are made against the relevant standards and that the spectacles are fitted to the patient to ensure that the lenses are fitting in the correct plane, at the correct height, and that the frames are adjusted to hold the spectacles in the correct position.
C4.3.1 Registered dispensing opticians, optometrists, and medical practitioners are allowed to dispense spectacles to a prescription that is more than 2 years old. They may also make up spectacles without a prescription e.g. by duplicating an existing pair of spectacles. Practitioners should be aware that if the patient has not had a recent eye examination, they may – by making up spectacles to an out of date prescription – inadvertently encourage patients to delay having another eye examination. This should only be done in exceptional circumstances and the practitioner should consider what is in the best interests of the patient, and the reasons recorded on the patient’s record card.
C4.4.1 The Association believes that the dispensing of all spectacles or other optical appliances sold or supplied should be carried out by or under the supervision of a registered optician; this applies even if the sale could otherwise be conducted by an unregistered person. The practitioner should decide what is in the best interests of the patient. Dispensing opticians/ optometrists should ensure the following when dispensing or supplying spectacles to a patient:
C4.5.1 Practices should note that the Medical Devices Directive does not cover spectacle frames already owned by a patient. Therefore new lenses can be put into a patient’s existing frames (even if they do not have a CE marking). For more information on ophthalmic products as medical devices click here
C4.6.1 The Opticians Act 1989 (at s2A) places an express duty on the General Optical Council to protect the public. The GOC has specifically considered the issue of patient health and safety regarding the sale and supply of optical appliances. In doing so it has taken detailed advice, and is now able to confirm its position in relation to three main categories of appliance.
All spectacles other than those which are exempt under s27(2) of the Act or the Sale of Optical Appliances Order of Council 1984 must be sold by or under the supervision of a registered optometrist, dispensing optician or medical practitioner. The supervisor must be able to exercise their professional skill and judgement as a clinician. Sellers will need to prove they meet the necessary requirements for supervision. The Council will determine on a case by case basis whether supervision can be deemed
to have taken place with reference to expert clinical opinion where appropriate. The GOC considers that legislation regarding sale and supply of spectacles is clear. In order to consolidate the guidance available regarding the meaning of supervision, the professional optical bodies are being asked to review and update their guidance as soon as possible.
C4.6.2 When supervising dispensing, the actual work of supplying the spectacles can be delegated but the supervising practitioner remains responsible for the whole process of supervised dispensing. The supervising practitioner must be on the premises at key stages of the dispensing.
C4.6.3 The registered dispensing optician should ensure, when supervising a person who is dispensing or supplying spectacles to a patient, that the supervisee is aware of the need to :
• take appropriate measurements for the lenses and frame
• check the lenses against the relevant Standards,
• fit the spectacles to the correct plane and height The supervising practitioner should satisfy themselves that any person under their supervision is able to carry out these measurements or adjustments, or where this is not the case intervene as necessary to ensure these are carried out correctly.
C4.6.4 Where the supply of spectacles is made under the supervision of a registered professional, the supervisor retains full responsibility for the supply. The supervisor must be on the premises, aware of the procedure and in a position to intervene if necessary to ensure that no untoward consequences to the detriment of the patient can arise from the actions of such a person who is being supervised. In the case of General Optical Council v Vision Direct (1989) it was held that supervision by a dispensing optician or optometrist means that the dispensing optician or optometrist is able to exercise his or her professional skill and judgement as a clinician. It does not mean supervision by someone performing a purely clerical or even managerial function, even if the person who is performing that function happens to be a dispensing optician or optometrist.
C4.7.1 The Association believes that a supervisor of a dispensing function which is regulated under the Opticians Act 1989 as amended 2005, e.g. pediatric, is responsible for all of the above at the point of collection of the spectacles.
C4.8.1 The supply of spectacles without practice support or individual consultation regarding patients’ measurements, visual requirements, verification and aftercare can put the patient at risk. A dispensing service should not be provided by a procedure where the aforementioned measurements, requirements, verification and aftercare cannot be ensured. These important patient safeguards should apply to any dispensing or supply of spectacles whether regulated or unregulated. If a registered dispensing optician or optometrist is supervising the dispensing or supply of spectacles s/he must ensure that they are in a position to intervene in the dispensing or supply and exercise clinical skill and judgement if necessary.
C4.9.1 As with any other optical appliance, when selling or supplying a pair of ready- made reading spectacles the dispensing optician has a duty of care to satisfy him/herself that the appliance is suitable for the patient’s needs.
C4.9.2 For information on the power of ready-made reading spectacles, see Opticians Act 1989, section 4: 27.1
C4.10.1 The GOC’s latest statement (December 2017) on adjustable focus spectacles is available via this link.
C4.12.1 Registered dispensing opticians are reminded that under the Sight Testing (Examination and Prescription) (No 2) Regulations 1989 immediately following an eye examination, whether NHS or private, irrespective of whether the prescription is dispensed at the same practice or elsewhere, the prescriber is required to give the patient a copy of any prescription issued (together with an NHS voucher if appropriate) or a statement indicating that no prescription is necessary. Although the onus is on the prescriber, a registered dispensing optician has a moral public duty to ensure compliance. This enhances the reputation of the profession; the prescription is the patient’s entitlement and must be given back to the patient on completion of the dispensing.
C4.12.2 There are many occasions on which a dispensing optician may adjust the power of lenses supplied against a prescription, including for example: change in dispensed power due to a change in vertex distance; change of dispensed addition due to change of working distance. Records must show how and why the adjustment was made.
C4.13.1 A prescription provided in fulfilment of the duty imposed by section 24(2) of the Opticians Act shall include:-
C 4.14.1 The PD is not a required part of the prescription. It is in the patient’s best interests that their spectacles be dispensed by a registered optician and that the patient’s PD is considered to be part of the dispensing, rather than prescribing process.
C 4.14.2 Members might like to use the following information when explaining the issues to patients requesting their PD. The Opticians Act 1984 was changed to permit the over-the-counter sale of simple magnifying spectacles which are made to an average centration distance, and did not plan for prescribed use. The PD is a facial measurement from which the centration distance of the lenses can be calculated when frame fit and prescription usage are taken into consideration. If the public wishes to purchase spectacles on the internet they are free to do so but they must understand the risks of such sales and that all eye care professionals advise against it.
C 4.15.1 When complying with requests from patients for either a copy of an existing prescription from practice records, or the provision of refractive details from an existing pair of spectacles, great care should be taken to ensure that circumstances cannot arise where the practice, or members of staff within a practice, could be alleged to have carried out a sight test and issued a prescription in contravention of the Opticians Act 1989, Section 24. When issuing a copy of the prescription from practice records, particular care should be taken to ensure that any document issued is authorised with the words…“This is a copy of the prescription for spectacles issued by…(name of practitioner who carried out the sight test)…following a sight test on…(date of test)”
The document should also contain the name, signature and GOC number of the dispensing optician providing the details, and the date of issue of the copy. When providing refractive details from an existing pair of spectacles, any documents issued should be authenticated with a similarly worded caveat… “These are the details of the lenses in…(details of frame)…worn by…(name of patient)…on the …(date in question)…”
The document should also contain the name, signature and GOC number of the dispensing optician providing the details, and the date of issue of the copy. Confirmation of prescriptions must be in a written form to eliminate any possibility of error and given only with the patient’s express permission. (Data Protection Act 1998).
C 4.15.1 A duplicate prescription form for members’ use can be downloaded here.
C4.16.1 In order to comply with the sale and supply of spectacle requirements, the equipment in a practice should be sufficient to discharge a registered dispensing optician’s responsibilities effectively and efficiently. The following equipment is recommended:
C4.17.1 Safety spectacles must be supplied in accordance with the use for which they are required. It is necessary to know what job will be performed whilst using such an appliance, be it in an employment situation or at home for DIY. If a patient is unsure what tasks may be performed further checks can be made through the requirements of particular occupations. (See Appendix F) All appliances must be covered by EN166 and EN167. Full records of what has been supplied and for what use they were advised should be maintained.
C4.17.2 Care must be taken when requests are made to repair safety spectacles. Once supplied and fitted no repairs can be effected to an appliance without rendering the protection of the appliance, guaranteed by the manufacturer, null and void. Even the replacement of a screw could be seen as interfering with the original standards. Safety spectacles must be replaced if damaged in anyway, to maintain the manufacturer’s guarantee and the patient’s ocular protection.
C4.17.3 Pending a Privy Council Order prescription sports eyewear can only be supplied under the same conditions as other optical appliances.
C 4.18.1 Registered dispensing opticians may wish to offer their patients other supplementary services to meet particular needs. If the registered dispensing optician is satisfied that he/she possesses the necessary knowledge, either by existing training and examination or by additional knowledge and skill acquired through continuing education and training, such services could include:
Note: The practitioner should have information available about other services nationally and locally, e.g. local Social Services, Partially Sighted Society, RNIB etc.
C 4.18.2 When supplementary dispensing services are offered it is the registered dispensing optician’s responsibility, to ensure that the precise nature of each service and the reason for it (advantages and disadvantages) are fully understood by the patient, together with the fees or costs to be paid, before the patient is asked to accept the service.
C 4.18.3 ABDO is not able to recommend fees to members. The Fair Trading Act 1973 (incorporated in the Enterprise Act 2002), in seeking to remove anti-competitive practices, prohibits associations and similar bodies from setting scales of charges for members to follow or from recommending fees. Fees are entirely a matter for negotiation between the purchaser (usually the patient’s employer or the patient) and the practice undertaking the work. You should make a reasonable charge for the cost of the time, labour and materials needed to undertake the job.
C 4.19.1 Practitioners are advised that because lenses and frames are viewed as medical devices, practitioners must register with the MHRA if they assemble spectacles. This would apply to practices which carry out their own glazing, as well as those where the frame is traced and the lenses are edged remotely before being sent to the practice for assembly into the new frame. This only applies to new products so practitioners do not need to register if they are simply reglazing patients’ own frames. There is a one-off fee for registration. The registration form can be downloaded from the ABDO/AOP/FODO/ websites.
C4.20.1 Members should inform their patients that 3D TV spectacles may not be suitable for everyone and that they should only be used for the purpose for which they were specifically designed and should not, under any circumstances, be used for ‘general wear’ or other activities. It would be sensible to advise any member of the public who is seeking to benefit from 3D technology, that, prior to purchase, they should have an eye examination to discover if they will be able to enjoy the benefits it offers.
C 4.21.1 The knowledge of a patient’s visual acuity and how this may impinge on their driving ability is a confidential matter, and may not be disclosed to a third party. If a patient is suspected of being below the legal standard for driving, s/he has a legal responsibility to inform the DVLA. Any advice which you give to the patient should be noted on the record. In the first instance talk to the patient, advise them they are unfit to drive and try to persuade them to stop. Remind the patient that s/he is legally responsible for informing the DVLA or DVA if they do not meet the vision standard for driving. However, if the patient has told you that they will not stop driving, you may conclude the public interest outweighs the duty of confidentiality. You may wish to seek the advice of your professional body or the prescriber.
C 4.21.2 From 1 May 2012 the DVLA has changed the visual standards for driving. Information on the visual standards required for driving various classes of vehicle can be found here.
C 4.21.3 Group 1 standards. The visual acuity standard required for a person to drive a private motor car or motorcycle (group 1) is that they should be able to read a number plate in good daylight at a distance of 20m for the new style number plates (AB12 XYZ) and, from 1 May 2012, have an acuity of 6/12. Practitioners should note that it is not always possible to predict from a Snellen test exactly which patients would pass the number plate test that is defined in law. People who have a visual acuity measurement of less than 6/12 are considered to have a ‘relevant disability’, and should notify the DVLA.
C 4.21.4 In addition to the visual acuity requirements, group 1 drivers must have a binocular visual field of at least 120 degrees on the horizontal measured using a target equivalent to the white Goldmann III4e settings, with extension of at least 50 degrees to each side the right and the left. In addition, there should be no significant defect in the binocular field which encroaches within 20 degrees of fixation above or below the horizontal meridian.
C 4.21.5 Group 2 standards. Group 2 (buses and lorries) drivers must have a VA of at least 6/7.5 in the better eye and 6/60 in the other eye. They must also be able to read the number plate at 20m. If spectacles are worn to meet the minimum standard for driving they should have a power of no more than +8.00D.
C 4.21.6 Group 2 drivers must also have a visual field, with both eyes open, of at least 160 degrees horizontally, with at least 70 degrees either side of fixation, and at least 30 degrees above and below fixation. There must be no defect within the central 30 degrees.
C 4.21.7 Tints for Driving