/ Health

Are opticians losing sight of our needs?

Our investigation into opticians found that some are failing to provide proper eye tests, with those customers who have the most serious eye conditions getting the worst service. How would you rate your optician?

I had a horrible experience earlier this year: I had an episode of acute glaucoma – unusual for someone in their 40s – and had to have laser surgery on my eyes.

Luckily my optometrist (optician) knew her stuff and referred me to the hospital, and I suffered no lasting problems. But our latest investigation into opticians makes me wonder if my experience was even luckier than I thought.

Opticians fail the Which? eye test

We sent researchers with a range of eye conditions to 40 optometrists from large and small chains, as well as some independents, and found that just under a third weren’t up to scratch. Moreover, only one visit was rated excellent by our experts.

Perhaps more worryingly it was the researchers with the most complicated eye problems – arguably those who most needed the skill of a tip-top professional – who got the worst service. Twelve out of 40 prescriptions were rated “poor” and in five cases staff even struggled to get an accurate result from the machine that measures the prescription of your current glasses.

We also surveyed our members and found that 40% thought the final cost of their optician appointment was more than they expected, and 18% didn’t consider the glasses or lenses they bought to be good value.

Your health or your wallet?

The above survey makes me think about the relationship between the optician as a provider of a health service (one that’s vital to keep your eyes fundamentally in check) and the optician as retailer (the guy has to sell you your glasses). In order to trust our optician, we have to be sure that he or she is doing both of these jobs well – diagnosing a potential eye condition, and selling us a product that’s right for us.

Our research throws some doubt on both. Our researchers visited a relatively small number of opticians, but our expert panel that rated those visits (from hidden recordings) saw some very poor practice.

Thankfully, we saw good practice too, but perhaps we need to question what opticians are really there for?

UKOptom says:
7 September 2011

Actually within our first lecture in Optometry we were told that “everyone in this room is training as an Optometrist, anyone who thinks they are training as an Optician please leave this university and present yourself to the local technical college.” So this was instilled within us right from the beginning.

I don’t think you have understood the arguement i am presenting: It is not the position of “Which consumer magazine” to assess the clinical competencies of Optometrists. This is well outside the Which remit and I would like to see the GOC take action against Which.

It is up to the Department of Health/GOC/College of Optometrists to asses the clinial competencies of Optometrists and not journalists with no scientific or medical background. Which magazine should be reviewing lcd tv’s and air conditioners etc not professions – who will be next Dentists? Pharmacists? Social Workers? It is ridiculous and insulting!

All UK qualified Optometrists have passed 9 professional qualifying examinations that are both costly and stressful and we adhere to a code of ethics which have many principles in common with the hippocratic oath. The A Levels required for Optometry are very similar to those required by Medicine and Dentistry and attract a high calibre of student.

You seem to make a very unusual arguement by drawing up eye examinations against boiler servicing. How often does boiler servicing detect aneurysms, tumours, serious systemic disease such as hypertension/cardiovascular disease or diabetes?! Servicing of a boiler is not within the “professions” and my point is that Which should not be interfering within professions.

Incidentally I have capitalised Optometrist as a proper noun in the same way that the College of Optometrists capitalise it on their website, not enitrely necessary but shows respect for a profession; if you have issues with that why not take it up with them. Since you refuse to capitalise then it shows you have no respect which doesn’t exactly surprise me.

Hi UKOptom, I’m sorry to hear your concerns about our research. I’d like to reassure you that all our investigations are carefully planned beforehand. In this instance the research was approved, and the visits assessed, by three qualified optometrists of high standing within the profession. We are also in communication with the regulator about those visits that rated poorly. I hope this clears up your concerns.

One of the best ways to command respect is to show humility.

If Which? has acted illegally then yes, the General Optical Council (GOC) should take action; otherwise it might be better to devote their efforts into establishing if there is any truth in the findings reported in the September 2011 issue of Which?

Which? has already reported on various aspects of services provided by doctors, dentists and pharmacists, though I can not remember any reports on social workers.

I believe that it is useful for Which? to investigate professional services and to present their findings to the public using non-technical language and a journalistic style to inform and involve their readers. If no problems are detected there is nothing to report. The fact that we rarely see Which? being sued or issuing public apologies suggests to me that their team of lawyers are keeping their work on the right side of the law.

UKOptom says:
8 September 2011

Humility is not indicated when dealing with cynics and those that would wish to tarnish public confidence within your profession.

I would hope that the GOC will be liasing with the GMC and GDC to see whether they would like to assess their joint positions against Which magazine.

Which is written by journalists after a sensational story – it is in their interests to find some controversial findings from their “researchers”. Their findings are no where near a level of being statistically significant and can be discarded by academics, professionals and those with a modicum of intelligence. That leaves readers of the tabloids and people such as yourself to find significance in the story. I hope the Department of Health and other Optometrists treat the results of the Which survey with the due disregard it deserves.

Within the UK there are approximetaly 30 million eye examinations conducted anually and the Optometry profession has one of the lowest levels of dis-satisfied patients in the healthcare/medical sector, according to the GOC and Optometry professional bodies.

I rather doubt that Which has a “team of lawyers” and this story now needs to be left with the GOC to assess whether there is indeed a case to bring against Which. I would like to press the government in to conducting a review of the ethics and integrity of journalists within Which and within a wider context.

Not only do Which? have lawyers but they offer legal services.

I will try to regain my respect for your profession and then book an eyetest. Unless I am particularly pleased or disappointed, this will be my last contribution to this Which? Conversation.

Vera says:
24 July 2012

I lost my confidence in the profession when I was ripped off by the slick sale side but in the end maybe we are all consumer monkeys trying to look intelligent in snazzy specs.

Optometrist Anon says:
14 September 2011

Personally I welcome the Which report. As an optometrist within a large multiple I all too often see locum optometrists being used to cover holidays etc. While there are many very good locums there are also many who turn up, carry out the bare minimum, and leave the resident optometrist to clear up the cases they haven’t dealt with fully. I’m certainly not saying there are not employed optometrists who may be guilty of the same.

Todays optometrist not only will have a high level of qualification but is subject to a continuing education requirement. More often than not there are internal audits carried out into practice activities as well as the eye exams themselves.

Comercial pressures to ‘perform’ well are now a large part of day to day optometry although this should not stop any good optometrist from advising what is in their patients best interest.

NHS eye exams are poorly funded due to the historic cross-subsidy and things are unlikley to change. With large multiples handing out free/discounted private tests the profession would find it difficult to go cap in hand to ask for an increse in the NHS fee. The only way this will ever change is if the NHS buck up their ideas and only allow eye exam claims of the NHS or private fee, whichever is lowest.
Incidently the true cost of an eye exam is in the region of £40-60 .

I have re-entered this conversation after a few weeks because I noticed there were later posts and I wanted to see what other people were saying about their experiences at opticians. Most correspondents have been restrained and moderate if they have had any criticisms and were ready to give credit where it was due. However, I have been shocked to read the pompous comments of UKOptom who seems to have been working himself up into a personal tirade against Which? to the point that he is threatening all sorts of inquries into its research and reports. It is clear from what people are saying that the eyewear industry is taking us for a ride. It is clear that there is a potential conflict of interest between the prescribing and the retailing sides of the business. And it is clear that, despite their training and qualifications, optometrists do not always get it right. UKOptom’s attitude, and defensive posture, convinces me more than ever that Which? is going in entirely the right direction. As I said in my previous post [18 August], “it’s about time the spectacle trade was shaken up a bit and looked at in detail”, and when professionals attempt to protect themselves from intelligent and diligent research – of a kind that no other organisation in this country carries out in the public interest – I get very suspicious.To assert that people who dignify themselves with the description “professional” have some divine right of exemption from scrutiny is an arrogance of the highest order. I have always received excellent care and attention from optometrists [even when they haven’t got it quite right] but I have been badly let down and overcharged by the companies from which I have bought my glasses. So many others are reporting similar things; we all thought we were the exceptional unlucky handful but it would appear that dissatisfaction is widespread. This must be investigated and Which?’s researchers [please, UKOptom, they are not journalists] have, in my opinion, gone about it in an open and responsible manner. We should be grateful for the helpful contributions made by other optometrists who have joined this conversation. It will be interesting to see whether the trade protection bodies cited by UKOptom take his line seriously and take action against Which?; somehow I doubt it.

Concerned Optom says:
30 January 2012

I’m an Optom (short for Optometrist) who wants to share some thoughts – there’s a few so I’ve broken it down:
1. I do not understand why Uk Optom takes offense at optician vs Optometrist; there are much more serious issues being discussed here, plus who cares if it’s in capitols??
2. Colleagues and I were not surprised when the Which report came out, it is a horrible fact, but a fact nonetheless, that poor professionals exist. I think the College of Optoms challenged the report… personally I’m glad there is some conversation about patient and customer experiences – it is important to deal with any problems and the first step is to admit they exist. But… see point 4 please!
3. Patient care should always come first. This is true of any healthcare professional, as patients are putting their trust in you. Hence, bodies like the General Optical Council exist to protect the public. If anyone has any issues with an eye examination or an Optometrist, they should write to the GOC. Eg, this includes things like not being provided with your prescription. All practicing Optoms have to register with the GOC. Part of their code of conduct is that we must provide patients with a copy of their prescription and we are legally not allowed to withhold it.
4. The mistake the Which report and the vast majority of patients make is assuming where you go determines the quality of the sight test, eg Independants vs Multiple. This is not true. The Optom you get is what matters, therefore get recommendations of specific Optoms from good experiences relatives and friends have had and…
5. Ask to be booked in to see that particular Optom and that is really the only definite way of being sure you will get a good, thorough, professional eye exam.
6. Any Optometrist working in the UK has to pass a stringent set of exams and assessments, and they are not easy. Therefore, any Optometrist ‘should’ as a minimum be able to diagnose and appropriately manage all diseases/eye conditions that are common or sight threatening, or we can even come across ocular signs for life threatening/ none life threatening conditions and should be able to recognise and manage these also. Certainly thorough knowledge of common and dangerous conditions is a prerequisite for the exams before qualification. You are not allowed to pass without this knowledge. So this means there is no excuse when people were misdiagnosed etc in the report. On the plus side, it means patients should be aware they will usually be in good hands.
7. There are Optoms out there who just do not use that basic knowledge once they have got their license to practice, either due to pressures of time or sales, and in some cases, due to not caring. This is of course abhorrent and something that any right minded Optom who cares for their profession detests.
8. There are professionals out there – and not just in Optometry, I know a doctor who has commented on similar problems in their profession – who simply fail in their duty of care by not doing what is best for the patient. This is unacceptable.
9. But… I hope people do not lose faith in Optoms, because I also know of many good ones, and thankfully there are many more good than bad.. it’s just that we generally remember the bad experiences over the good ones! (Although I can see why – there is no excuse for a professional you can’t trust with your health or your money!)

As for the problems people have had with the dispensing side of things including things like ridiculous prices and not getting good customer service or having to fight for refunds – anyone with any common sense knows that the only good way to retain your clients is to treat them as you would like to be treated yourself. If it was my business I would go out of my way to make sure things are right in the first place – including staff training, and secondly, if a problem does arise, solve it with grace and compassion.
But, I do not get to tell my employers how to deal with their customers – the patients are mine to protect in the test room, and out of the test room if I am aware of what is going on, but realistically, anything concerning sales etc, where the health of the patient is not at risk, I do not have any power to change 🙁
Hope that helps… If only to provide reading material to help people fall asleep!

UKOptom says:
30 January 2012

Re: ConcernedOptom,

Perhaps you are not concerned with being called either an optician or an optometrist, so where is your professional pride? What sort of response would USA Optometrists make if they were called optician? Why should British Optoms put up with it?

Part of the reason it irritates me is that there are examples of contact lens fitters (and dispensing opticians) who just shorten their title to optician. Why would i wish to be lumped in with these people who frequently have no A Levels or little university education to speak of? They are not allowed to write up spectacle prescriptions or use ocular pharmaceuticals for which we spent much time in study,…does a dentist allow them selves to be called a technician?

I know that there is approx !5-30% of Optometrists who are previously qualified as dispensing opticians and i expect these practitioners couldn’t care less whether they are called optician or optometrist.

But our university lecturers cared and so do the professional bodies, why else would there be a college of optometrists and association of optometrists. hmm, I think i’ve labored the point enough now.

Anyways much of the rest of what you says makes sense.

I would like to see UK Optometry follow USA/Canada/Australia in abolishing the BSc(Hons) and replacing with Doctor of Optometry qualification.

UKOptom says:
14 September 2011

Let me straighten some issues out for you John Ward.

Optometry is a profession not a trade; the GOC is a public protection body not a “trade protection body”.

Your complaints seem to be against dispensing optics and this is not directly related to clinical Optometry. Clincal Optometry involves the assessment of the health of the outer and inner stuructures of the eye and an understanding of the medical and neurological implications of patients presenting signs and symptoms. It also involves the prescription of glasses and contact lenses with an understanding of individual patient circumstances. My concerns have related to a consumer magazine attempting to review these aspects via lay people’s reports.

What my colleague has fairy pointed out is that Optometry as a profession is subject to internal and external audit. Continuous education and training is mandatory. I also agree that English Optometry is seriously underfunded and this has been mainly due to the signicficant commercialisation of the profession which could ultimately be against the public benefit. The NHS fee is in dire need of review, there are some within the profession who would like to see it largely privatised like dentistry; i am opposed to this and would hope to maintain UK Optometry as an essential NHS . The Scottish Optometry model of free eye care for all (with reasonable GOS NHS fees – double English GOS NHS fees) serves now as an example to the rest of the UK.

I maintain that Which? should not be attempting to review clinical compentencies of professions and i would be interested to hear the views of Doctors, Dentists and Pharmacists.

Mary Genovese says:
16 September 2011

Vision Express is touting “Vision Express Optometrists receive positive results in Which? study” on its website.

Gotta ask – exactly what were the results for them? I only ask because of my recent experience with that organisation at its Bristol, Cribbs Causeway store. First eye test was wrong as the new distance lenses I got were almost worse than no glasses at all and, although unconvinced, I did give them a couple of weeks to “get used to the new prescription”. Didn’t work, of course! Had another optician check that the distance lenses were made up correctly to the prescription and also discovered that the new reading lenses were the same as my existing ones (i.e. I shouldn’t have been told that I needed new reading glasses!).
After a failed attempt to get my money back on the unnecessary reading glasses because of their “No Refund Policy” I finally agreed to let them do a re-test. Turned out the first one was wrong so I agreed to have the glasses redone. Happened to notice a huge discrepancy in the left eye axis measurement and called them to ask that they check this wasn’t a typo on the prescription. After TWO calls they finally told me that it was correct.
Went to collect the remade glasses and they were SO WRONG that I could see nothing. The left eye axis figure WAS wrong because of a typo made by the 2nd optometrist (i.e. 172.5 instead of 72.5).
Guess what? Suddenly their No Refund Policy magically disappeared and I got my money back!
Guess what else? I’ve just received a mailing from them thanking me for choosing Vision Express and giving me a £50 voucher to put toward buying my new glasses from them!
Seems their marketing is about good (NOT) as their optician skills!

George says:
21 October 2011

I’ve had two tests at different venues three weeks apart:-
1st test Right +1.25 (SPH) -1.25 (CYL) 85 (AXIS)
Left +2.00 (SPH) -2.00 (CYL) 91 (AXIS)
ADD 2.00

2nd test Right 1.75 (SPH) -2,25(CYL) 90 (AXIS)
Left +1.50 (SPH) -1.00(CYL) 90 (AXIS)
ADD 2.25
I have experienced no change to my sight during this interval.
What should I do? Any suggestions welcome.

Mary says:
21 October 2011

Have you queried these differences with the two venues? They should have a set policy to deal with such a complaint.

Also, were these tests partially or fully funded by the NHS? If they were and neither venue gives a satisfactory explanation or offers a new test then do what I ended up doing. Contact your local Primary Care Trust. It was them who gave me the “heads up” on how to deal with Vision Express. They also then set up an investigation (after I’d got my money back) to question VE about their complaints procedures and questionable no-refund policy.

Sarah says:
1 November 2011

I just paid £81 for new lenses for my glasses at Vision Express due a prescription change – this was the cheapest price I was offered and I didn’t go fo the anti-reflective, scratch resistant, etc., etc, which could have bumped it up to about £150.

If they can offer glasses (with lenses) from £29, then why are lenses on their own so expensive? I’d also like to know how much profit they make on items like these – the companies seem to be fixing the price and surely this could be considered anti-competitive?

Where are the details of Which’s finding?

I remember reading which opticians did well and which and which didn’t but now I cannot find any details – just a summary that most did poorly!

Hello Bob you can find more details of this research in our Which.co.uk news story http://www.which.co.uk/news/2011/08/opticians-fail-the-which-eye-test-263296/

Hello Bob you can find more details of this research in our Which.co.uk news story http://www.which.co.uk/news/2011/08/opticians-fail-the-which-eye-test-263296/

No Patrick! This is the article that is frustrating – it has none of the DETAIL of what was found. The original report had a store by store rating of good and bad visits. I went back to my August edition magazine but the story is not there?? I assume it must be in the September mag – which as Murphy’s law states I cannot find!

Hi bob, it’s in the September issue. If you’re logged into your Which.co.uk account, you can access the feature’s PDF here: http://www.which.co.uk/documents/pdf/p58-61_optometrists-263577.pdf I hope that helps.

Thanks Patrick

Concerned Optom says:
30 January 2012

Optometrists move around; the quality of the sight test itself is going to be determined by your individual Optometrist and their work ethic, not by who they are working for, which is unfortunately how most people choose their Opticians. So really one optician vs another won’t tell you very much, you should get recommendations of a particular person/ Optometrist and book to see that person specifically.
The quality of the customer service will be affected by the business itself, however.

Racheli says:
7 November 2011

l have had my eyes tested at an independent Opticians.l need varifocals, reflector/scratch resistent and colour sensitive lenses, ie the works! – which come in at about £375!! l am considering getting my glasses made up by Boot/Vision Express or Spec Savers…Would the service from a large outlet be inferior from an independent lab – l am obviously hoping to cut down on costs by going this route! Many thanks for responses!

In reply to Racheli
Ask your optician to do a deal for you. I have just bought some Lindberg glass, I shopped around on the internet and then went to my independant optican and got them for £250 (£750 with Eyesite!) with all the bells and whistles. I have tried Specsaves and Vision Express and was ripped off by both of them.

Pauline says:
9 November 2011

I found the Which report highlighting some of the problems patientss/clients face when having an eye test, and trying to find the best varifocal deal. They vary so much and can be totally confusing, i e. Zeiss, Hoya, or SpecSavers Thin and Light. Reactolite, etc. It is about time the industry was investigated, and prices for different lenses became much ” clearer”.!

John says:
9 December 2011

I visited the Which? site because I am about to choose which Hertfordshire optometrist will test my eyes and fit new lenses to existing frames. I don’t think that I have any complex eye problems. What I found on the website did not help me much, although it revealed a highly variable level of service (which is of course shocking, and needs resolution). It was however suggested that I visit the College of Optometry website, where I can see what ought to be inlcuded in my eye test, and what my prescription means. Apart from this the only useful advice is to go where friends and relatives have had a good experience, or perhaps to one of the independent firms mentioned favourably in the comments – if they operate near where I live (only one does). Is it really not possible to offer readers any more practical advice than this?

Hi John, if you are a Which? member then this is exactly the kind of thing you can search for on Which? Local, where members can recommend services in their area.

Michael says:
11 December 2011

I am reading this thread because I am about to embark upon writing a strongly-worded complaint and demand for full refund on behalf of my wife who suffered an unpleasant experience with a Boots opticians subsidiary that ended up costing her more than £200. Some of your commentators ask about the price of lens/frames. For reasons that need not concern, my optician was good enough to let me have eye test plus 2 pairs of glasses, designer frames, etc, at wholesale price. I paid about £200 as against the normal retail price of £500 or so. As others have said, opticians make their profit from selling lens/frames and it’s not necessary to buy the lens/frames from the same O that does the eye-test. t

Baz917 says:
19 December 2011

My father in law is in his 50’s. He is a joiner by trade and is not a fusspot in any way. He went and had some glasses done. Bifocals were prepared for him three years ago and he was told at the fitting that they would take some time to work properly. The problems he has had over the last three years are headaches mainly, but his sight has got worse, that he did not complain about but just put down to his advancing years and work. He went in today to get an eye test and on looking at his glasses the opticians noticed that one of the lenses was upside down and that this was probably the reason for his sight appearing to get worse and the headaches he had been having. He went round to the original opticians and they checked, agreed that there was a mistake and told him they would sort the problem out and replace the glasses for free. I don’t think this is much of a reaction to the failure that has occurred. We as a nation put our trust in the services provided and he has been let down. He has paid for a job to be done and has suffered due to a lack of attention to detail. Any views or advice of who to speak to about this would be greatly appreciated. Is this a common mistake or is it even easy to do?

Im suprised to see specsavers being so badly moaned about. I recently went due to being unable to read small print at all – and found I needed glasses for reading and for distance . The lady who tested me in Welwyn Garden SpecSavers ,took her time, was very courteous and explained everything as we went along. After figuring out what lenses I needed, I was asked if I wanted to choose any of their frames. There was no pressure – a sales assistant told me what I was able to get on the NHS – or how much each price grade above would cost me. She then left me in peace to browse frames. I chose 2 nice frames. then a couple of days later – they called to say they were ready. The difference to my vision is immense with my glasses. Im pretty certain they got my prescription spot on. All in all – Im over the moon with the service I got and the way I was treated . My vision is great and I will be staying with specsavers in the future based on my experience with them.

Kathryn says:
16 January 2012

I too can only speak very highly of SpecSavers, after a very poor experience with an independent. I always try to support local businesses, so went to a local and long established optometrist, Mark Soper, for my biannual eye test, and I suspected that I needed a stronger prescription. The eye test was rushed and the individual was quite abrupt, but gave me the prescription, and I was quite prepared to purchase glasses from this shop. I like plain rimless glasses, and this seemed to give them a problem, with comments like ‘there’s no call for glasses like that in Hailsham’, but eventually we settled on one pair. I paid a 50% deposit for good quality varifocals, Zeiss lenses, with almost all the ‘extras’ that they could add on. Two weeks on I telephoned to ask whether they were back. We had one of those surreal conversations about them being so busy, and if they weren’t back by the end of the day (Friday) they would chase them up. So I went in to the shop when they reopened after lunch, to discover the receptionist playing with her mobile phone. She then picked up the phone and asked the glaziers what was happening, and my understanding of the conversation was that they hadn’t sent the prescription off until 3 days after my visit, which would account for the delay. Then, on the Monday, I received a call from the optician telling me that the frames had been broken at the glaziers and that they could not offer me another pair. So, two weeks after the initial test off I went to SpecSavers, with some trepidation.
No problem finding frames that I liked, I handed over the original prescription and awaited my new specs. I could not get on with them, a feeling of being drunk and unsteady when I wore them. I eventually went back to SpecSavers, and they checked out the positioning on my face, etc etc. Still not happy, I wondered if it was my fault. They offered me a new sight test, FOC, and it turned out that the original optomestrist had prescribed lenses in the right eye that were too strong for me. As I had not had the test at SpecSavers this was not their fault, and I had to pay £60 for two new lenses for the right eye. The new glasses are fine, as they ought to be, I am not conscious of wearing them.
So what redress do I have? I went back to Mark Soper to tell them that I had been wrongly prescribed, and that I expected them to compensate me for the added expense. As evidence I took the original Mark Soper prescription, and then the newer SpecSavers prescription. It was clear that there was a huge discrepancy on the right eye prescription. Much stronger and no wonder I felt ‘drunk’
I was told in no uncertain terms that the fault lay with SpecSavers (errrr????) and that I should take the matter up with them. I queried why my eye should have changed in a matter of 2 months, and I was told that this was quite normal………..so why do prescriptions normally last two years?

So, beware of getting a prescription in one place and going to another store for the frames and lenses if you can help it. What redress do I have?

SpecSavers spent a lot of time with me and retested my eyes, at no extra cost, and my new prescription is fine. I am unable to fault them.

I believe that Specsavers , like some other “national chains”, are mainly franchises so the service you get will depend very much on the local owner/franchisee .