/ 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?

Comments
n marrison says:
2 June 2013

Who regulates BAD SERVICE from opticians ?

Jan says:
1 July 2013

Yes please, I too would like to be able to contact the body who regulates opticians.

From the NHS link in this thread arrived to the General Optical Council (to complaint about an optometrist) and there is a warning about Vision Express

http://www.optical.org/goc/filemanager/root/site_assets/hearings/warnings/vision_express_-_warning.pdf

Jan says:
1 July 2013

Regarding independent opticians………..I was until about six weeks ago, a supporter of these as I have been all my life since I began wearing glasses in my early teens. I WILL NEVER ENTER ONE OF THESE AGAIN.

I went to my local Independent Opticians, in good faith. First during the test (obviously on instruction from the owners of the practice) I was pressurized to accept varifocals which I did not want to have. When I agreed to go for bifocals instead, it was to be told, that ‘I would never be able to wear varifocals’. This is not true as I have since found out. I still refused varifocals.

During the dispensing of them, I was asked for my reading glasses. I didn’t have any. Until now I had no need for them, even though as I was then told, I was well over the age of needing them. I also had to convince the dispenser that I had not, ever, had reading glasses, bifocals varifocals before………and the only pair of glasses I had, I was wearing.

When the bifocals came back, one seg in one of the lenses was not only placed higher than the other and more than what was needed, but on a slant and was nowhere near my requirements. I did go back as I was unable to get on with them, only to be told to more or less clear off and wait a week and get used to them. This was impossible so I went back the next day and saw someone else. They agreed to replace the lens and reposition the wrongly placed seg. Again reference was made to my having had bifocals and/or reading glasses previously. More pressure this time from the receptionist, was put on me to accept varifocals.

When the glasses came back it was to to discover that one lens was smaller than the other and had gaps around the edges (I had chosen a half frame style). It was apparent that the lens had been cut and refitted. When I returned them it was denied that cutting a lens down was possible (this is untrue as lenses can be cut down to refit into different frames). I have at this point, asked for a refund of the whole amount and walked away but I gave them a chance to rectify the situation.

I had to telephone for a progress report as the reading part was needed for something important. The response was that they were in the next day, but no one was available to fit them so I could take them and if any tweaking was needed I was to bring them back later on. Instead hearing nothing I telephoned to be told by the other receptionist they have, that I ‘can’t have them’. Going into the shop I demanded them, only for her to ring up the manager who was not in and tell him I was ‘anxious’ (I wasn’t I was furious). He explained the situation and I was allowed to take them.

I had to return to have them tweaked, I saw the guy who had initially dispensed them and he had a good b***h at me for ‘not waiting a week for me to get used to them’. I replied that I had had no wish to have continual headaches!

I did try to wear the bifocals and finally getting tired of headaches, eye aches, tripping over and being able to read through both prescriptions at once, I gave up. Instead of letting me see someone, when I returned to the shop to request separate pairs of glasses, I had to undergo a ten minute battle (truly) with the receptionist while she did her utmost to force varifocals upon me, and no matter how many times I said no, she came back at me with another argument for them.
Eventually she saw that she was not getting anywhere and allowed me to venture further and see a dispenser. Who put the reading prescription into frames more suitable for everyday wear!

When I collected them I was expected to spend more money, instead I refused and asked for a refund of the outstanding money.

Before going any further I had the prescription checked and it was good that I had as they had given me something I did not need. Therefore I had to pay out again on more readers.

I have given these bunch of clowns the chance to refund the now redundant lenses as well as the prescription that is not required, but they have simply ignored my recent letter to them.

You have obviously had a very unfortunate experience, but why condemn all independent opticians because of a bad experience with one of them?

Snafu says:
19 August 2013

Sounds like a case for the Small Claims Court. Send a written demand for refund of monies paid allowing 28 days to pay, advise on the demand that failure to receive full compensation in 28 days will trigger issue of a Small Claims Court action. I love these people; when the summons arrives on the recipients doormat the cheque is in the next post. The clerks of the court are not supposed to complete the form for you but you can ask as many questions as you wish at the counter, the end result is the same. Very helpful people.

Jan says:
1 July 2013

‘I have at this point, asked for a refund of the whole amount and’

Should read:
‘I should have at this point’

(Apologies, my internet connection keeps dropping out).

Googled says:
2 July 2013

Dear All,
Two different optician companies have given me two different prescriptions. Can anyone advise which I should accept?
thanks in advance.

idoc says:
2 July 2013

You usually do get slightly different opinions from different practitioners, whether they work at different practices or at the same one. The difference is unlikely to be clinically significant ie you probably cannot tell any difference, so it is not important which one you get made up, but I would always get your glasses and prescription at the same optician. As has been mentioned above, it is not clear in law who has to pay if you cannot get on with glasses from one optician which have been made up to a prescription from another optician. It has not been tested in the courts yet. If you get a private prescription for drugs from a doctor and have it made up at a pharmacy and they don’t cure your ailment the doctor does not pay, the pharmacist does not pay, so I’m afraid you do. One day this will be tested in the courts and it may well be decided that the same principle applies to spectacle prescriptions. However if you get your prescription and glasses at the same optician the issue does not arise.

Googled says:
3 July 2013

idoc thank you for your reply

Mark says:
8 July 2013

My advice as an Optometrist would be to choose an independent practice. I work for an independent and I have no ‘conversion targets’ to reach. All multiples, the likes of Specsavers and Boots and so on have massive advertising budgets and also place their professional people under great pressure to meet sales targets. In fact so much so that when I worked in one of these practices the optometrists were reviewed and appraised only on sales and not on anything clinical. There are a large to of very poor Optometrists in these companies but only because the ‘machine’ and protocols they work to, dictated by the middle managers (all not professional / sales rep type people). It is an awful environment for them and most would leave if they could. In my business we provide good customer care to loyal people who come back year after year and choose to buy glasses from us because we provide good service. We don’t tell them there is a prescription change if there isn’t or fudge the numbers to make it look different. Also I take a good 30 minutes or longer with repeat visits if required in complex cases or if I suspect anything. There really should be some whistleblowing going on in the big companies and I think it is only a matter of time before it happens. Despite working the way we do, we still make a good living out of our business. People leave to go to Specsavers etc, but not for long. Fortunately the customer care they receive means they usually come back. What is more, we don’t have massive advertising budgets to fund or middle managers and head offices. We therefore actually aren’t any more expensive. It’s an altogether more ethical way to do business. Unfortunately for the professional the big boys are taking over and paying lip service to the clinical side of the job. It is rather odd how the general public would be suspicious of a national chain of dentists or doctors, yet they trust their sight to a commercial machine which only has interest in them buying expensive products. Also don’t separate supply and testing of glasses. It often leads to problems and the consumer is left in limbo. I think Which should do some more in depth reviews into the employment practices and structures in place in the multiples.

jane says:
18 July 2013

i had some glasses done with an optician, who obviously took my PD measurement. i now want to get new glasses made, but i need my PD from previous glasses.
Under the freedom of information act, are opticians able to withold this information from me?

The FOI Act refers to information held by government departments and public authorities, so has no relevance here, Jane.

Hi. I currently work for a large branch of optometrist’s….my previous employer charged £60 to have this PD measurement given to clients. The reason being dispensing optician’s go to college/uni for 3 years to learn the trade including how to measure this accurately. And if its taken by the optometrist then as you will appreciate he/she studied for years also. The required info by local authroity regulations will be on your prescription. Optometrists are not obliged to give you this measurement and probably won’t want to as it means you are taking your business online. There is a reason people train in this industry. If you have a complex prescription and you enter an incorrect PD this can cause all types of prismatic effect ie double vision/headaches. Then no doubt the consumer would soon be back to the optometrist who tested their eyes expecting them to deal with the matter when most probably it was the consumers fault for not measuring accurately. Then your supplier online won’t care you are disappointed because they will have made their profit.

Martin says:
25 June 2014

Not the whole truth. Your P.D. needs to be taken by the supplier of the frame because it may need to be different from your static P.D. depending on the position of your eyes in the frame or any more unusual curvature or angling of the frame. Near P.D. can be calculated only if the correct reading distance is known as well as the aforementioned variables. There can be other reasons to amend the static P.D. and if you didn’t see correctly through the lenses who is to blame and accept the expense of remedying? You could not be provided with all the different possibilities with one number.

andy says:
8 August 2013

I recently done a regular eye test after 2 years. I was having a perfect sight in the last tests unfortunately not in this one. There was a slight difference even if it was not a major one. The optician has prescribed to me a reading or watching tvs occasionally. I bought the glasses from them. After trying it on sight I have informed them that I am not feeling well with the glasses as it feels better with out them and got a head ache feeling as well. The opticians gave me another appointment for an eye check. After taking the second check the new optician has got a slightly higher prescription on the first one and tell me to wear the glasses as they won’t bring any problem. Accepting the advice I took the glasses and tried for few days on pcs and tvs. even if i feel a strain on my eyes like a head ache at first it left me as I get used to it. After seeing these problems i returned back them and made another instant eye test and this one also confirms it is slightly higher and prescribed another one. Now the problem worsens my sight becomes blurry more often, especially on one eye. It is getting more blurry day by day plus reading and writing becomes a hard work for me I’m a bit confused to go for another appt of eye test to the same optician or seeing my GP. What would you advise me? shall I go and check with them?

idoc says:
11 August 2013

Sounds like you have been given a low +ve prescription (for low long sightedness) I would guess somewhere around +0.75 ? +1.00?
you obviously cannot adapt to this.
If you were symptomatic (ie getting headaches etc) it may have been worth trying to see if it helps, but it seems that it does not, and you cannot tolerate this prescription.
If you were seen at a large multiple opticians the main reason you were prescribed glasses was probably that the optometrist you consulted was terrified of losing his / her job because he / she had been bullied by head office about his / her “conversion rate.”
I would probably think the best thing is to get a second opinion at a different optician.

Sharon says:
14 September 2013

My left eye prescription -5.25 – 2.25 100 in one optitions another prescription in different optitions left eye -4.25 -1.75 110. Is this a huge difference

No that isnt a huge difference thats quite common indeed.

Sorry I misread the question sharon. Yes that is quite different. Did you have the tests close to one another? I would guess that one is a mistake by the optician who entered it into the prescription. Its a whole dioptre different. I would get a recheck.

TEDDY says:
30 December 2013

I have just been for an eyetest today and I am just querying my eyetest prescription. Not long ago I had one done at Conlons, but the one today at Specsavers seems to be completely different, please advise? (first figures are Conlons the second figure is Specsavers)

r = sph -2.00 vs -0.75 cyc = +1.25 vs -1.25 axis 95 vs 5.0

l = sph -0.50 vs -1.00 (please note I have limited vision in left eye)

Streak says:
30 December 2013

Sorry you haven’t written that out very clearly.

This is an example of a prescription for the right eye

Distance RE -1.00 -2.00 90
Near RE +1.25 -2.00 90

Pls post again, remember there are 3 numbers for each eye, the SPH, the CYL and the AXIS

TEDDY says:
30 December 2013

I have three readings for my right eye, but only one reading for my left eye, as I have limited vision in the left eye, so the lens is only for balance.
Right Left
conlons -2.00 +1.25 95 -0.50 blank blank

specsavers -0.75 -1.25 5.0 -1.00 blank blank

Streak says:
30 December 2013

These two prescriptions for the right eye are exactly the same.
One is written in a different mathematical notation to the other.
Spectacle prescriptions can be written in either the “plus cylinder transposition” or the “minus cylinder transposition.”
To convert them you first add the sph to the cyl being careful about the sign convention, then change the + in the cyl to a – or vice versa, then add or subtract 90 from the cyl axis to leave a number between 0 and 180

eg

+3.00 -2.00 35

is exactly the same lens as

+1.00 +2.00 125

Hope this helps, it’s nice to have something to do, I’m working nights!

Katy Sewell says:
8 May 2014

I feel that eye doctors are still well aware of our needs. I go to my optometrist quite often in order to make sure my contacts are up to date and that my prescription is right. I like making sure that I can see properly.

mike says:
28 May 2014

my eyes needed testing specsavers was my choice. glasses given, kept going back and was told i must get used to them, but it came to a point the just did not work and it was to late for my money back. So a new place of call Boots (one year on) this was the same as specsavers,but this time they told me my right eye has lazy eye a condition young children sometimes have this was found by them to a pin hole test.glasses given and paid for, but still no good (this is now 2 years),i now have 6 pairs of glasses that are no good. by chance i see a third optician who diagnosed cataracts. in my lefteye that needed extraction and my right eye poss extraction and could not give me a eye test this must be sorted first. I have had the extraction done and told i just need glasses for driving and having a test soon. By the way specsavers and boots dont want to now and my eyesight is better than longtime without glasses

Tomaso Cariboni says:
1 July 2014

On the 19th of May 2014 my eyes were examined by an optometrist called Nadia in the Kilburn branch of Specsavers. I was told that my left eye lost -1.00 SPH compared to my latest visit (which was over three years ago and not at Specsavers).
I went through the usual procedure and also did the Field of vision test (I believe that’s how it is called, the test you do looking at an orange dot whilst you are asked to spot little white flashes in the otherwise white field of vision).
At the end of all the testing I was told I had lost a bit of my left eye and that the inner pressure of the left eye was higher than the right one. That was it.
I have a card where the box “I am referring you to your doctor” is not ticked.
Nadia then thought that it might have been safer to give me a letter for my GP, asking for a check from an eye specialist, but she didn’t mention it was urgent or important.
In the following days I felt that the vision of the left eye was really poor. I managed to get an appointment with an eye specialist through my GP but it was scheduled on the 22nd of September. Therefore I booked privately an appointment at the Moorfields Eye Hospital.
The result of that visit is that I have an extended glaucoma in the left eye. The pressure of the inner left eye was 40 mm Hg! And the field of vision exam clearly showed a very important deficit in the vision.
This was a few weeks after Specsavers told me everything was basically fine.
I am now under treatment and luckily the pressure of both eyes seem to be under control.
My complaint regards the effectiveness of Specsavers standard eye examination. If their optometrist can’t spot an existing and extended glaucoma and an eye pressure of 40 mmHG (the normal mesure would be between 12 and 18 mmHG), then I think they should really think again about their staff’s professionalism!
I was lucky and wise enough to get a private appointment. But what if I didn’t? What if I trusted their optometrist who told me nothing at all was wrong other than a new prescription? What if I waited until both eyes were damaged in an irreversible way?

DON’T HAVE AN EYE EXAMINATION at Specsavers. Go to see a real specialist!

Streak says:
1 July 2014

Out of interest, how much did you pay for your consultation at Moorfields? I guess about £110. and how much did you pay at Specsavers? I guess somewhere between free and £20??

Shane says:
20 July 2014

A big problem is that an optician can confirm their previous prescription in a difficult case easily enough. Even a clearly suboptimal prescription can be confirmed because the snellen chart is not necessarily the best test of either visual acuity when driving or visual acuity when reading a book or from a computer screen. The testing itself can be confusing and feel like the optician is trying to catch you out . I complained repeatedly over 4 months about an over-minus in one eye to an optician who said I’d get used to it. Eventually I got my eyes tested elsewhere, gained just a quarter of a dioptre (+ 0.25 SPH) and it made a big difference. The new optician had said that the previous prescription was beyond the limit of my natural ability to generate plus and should have been adjusted down quickly when it was clear I couldn’t cope with it. No headaches and much less eyestrain now. I’m more productive at my job also. The optician in question is well meaning and knowledgable but the standard eye test is imperfect and they caused me a huge amount of stress over a few months because of the incorrect prescription. It’s important to listen to your patient and not fob them off as our vision is so important to having productive, happy and safe lives.

idoc says:
20 July 2014

Agreed. A glasses prescription is an opinion, not a measurement. The opinion should be holistic, taking into account the entire person, not just their eyes. The measurements taken ( by auto refractor and/ or retininoscopy) are taken into account when formulating the opinion, but are not usually the final prescription. The optometrist should take time to get to know the client and take time over the eye exam. If he or she is working in a high street multiple optician with targets to meet and a manager breathing down his neck, he simply will not have time. This is why I always recommend a good independent optician who you can feel happy staying with in the long term so he or she can get to know you. Be very wary of any appointment which is less than 25 minutes. half an hour is better and 45 minutes is optimal. It may not be “free” but it should be done thoroughly.

anon says:
20 July 2014

I agree completely however it is a shame the vast majority of the public do not see this, nor are willing to pay appropriately for the service.

While there are a select few who are prepared to pay the true cost (£35-50) for an eye examination (not a sight test) there is a large number who expect it for nothing.

Dei says:
31 July 2014

I just had a bad experience with Boots opticians. During my eye examination at boots I felt they are doing a sloppy job. That’s at the London Wall branch in London. Couple weeks afterwards I had my eyesight re-examined at Vision Express (Oxford circus west branch), and to no big surprise the prescription was very different. I actually told the optician I got a different reading from Boots and the optician took extra care to let me compare both prescriptions in the shop. It was so obvious that Boots one was so wrong. Since my contact lenses have changed and I have collected quite some backlog at home, they told they will exchange for me all the unopened boxes for free (it was 4 or 5 boxes). I went back to Boots (I am on both opticians contact lenses direct debit scheme), explained that their eye test was incorrect and I need different lenses. They didn’t care a slightest bit about the job they did with the eye test, no apology, nothing. And they told they can only exchange for me one resent delivery, because of their regulations. The difference in competence, service and attitude is enormous. Needless to say I am opting out of Boots. They so openly do not care about the customers.

idoc says:
31 July 2014

Would you like to post the two prescriptions on here for me to compare them for you. I am an optometrist with 34 years experience.

April says:
9 August 2014

Hi I just had my eyes examined and I was not happy with the doctor who examined my eyes. is there anyway I can have them re-examined even thought I already had them examined this year. any help would be appreciated please and thank -you

idoc says:
9 August 2014

Yes, you can easily get a second or third opinion. The NHS will not fund a second opinion though. The fee varies from about £20 with an optometrist (sometimes free on special offer) to £120 if you go and see a consultant ophthalmologist.
My advice is to be very, very wary of so called “free” tests.
Eye examinations cost a lot to provide and to offer them for free often means that you will be prescribed glasses or new glasses which you do not really need.

Harry says:
31 August 2014

I am an optometrist myself and can relate to a lot of the comments in this post. I currently work for a multiple. In my last post, also working for the same multiple, if my sales figures weren’t satisfactory for the previous day I would have a “performance report” waiting for me on my desk the next day then an ear full from the director about how it wasn’t good enough. In my most recent post everything is about sales and that is what we are bonused on but the bonus scheme allows you to earn reasonable reward for prescribing ethically, and there is no ther major pressure on conversion.
The truth is, optometry is a profession ruined by big multiple chains. How can they possibly afford to pay a highly skilled professional to do eye tests for £10 or worse for free? Well the answer is, they can’t. That’s why they depend on over selling glasses. And for all the people out there who turn up waving their free eye test vouchers, how would you feel if you had spent 4 hard years studying just to give people free tests. You get what you pay for.
If you want a good eye test go to a reputable independent opticians and pay for it.

If businesses offer free or discounted eye tests there is obviously going to be pressure to push sales of glasses etc. If staff are payed bonuses for sales, the public may be steered to spending more than they need to.

Perhaps these practices should be forbidden. We need the government to tell businesses how to run a business and stop playing the silly games that go on in car dealerships.

I think the only answer is to separate eye tests and sales.

BruceLondon says:
8 September 2014

I have been going to an independent for three years now, one that received very high quality reviews, and who I have enjoyed. They set me up with a good pair of lightweight Lindbergs (not cheap, but I like them, as lightweight and good sizing) and three years ago helped me into my first foray into progressive lenses. Yesterday, I went for my annual appointment, and not surprisingly my prescription has changed a quarter diopter. However, what I had not taken into account, is that if I want new lenses, it is not a simple matter of using the high quality frames I originally bought–they need to have the frames for two weeks to put the new lenses in. I don’t want to use my single vision glasses from six years ago for two weeks. Does everyone then essentially have two pairs of glasses! One for ‘backup’ and for when they get new prescriptions made? In the past, it was matter of getting the new lenses made, then coming in with my old frames, leaving them for a day, and licking up the new ones. Now, the process is two weeks. I just dread paying £300 for a second pair of frames when they will ‘sit’ for most of the year in a drawer.

There is a way around this but the Opticians you visit will need to be proficient with Lindberg assembly. Some lens manufacturers are capable of drilling the holes in lenses with just the details of the shape and frame. This allows the assembly to be done in the practice as you have described. The issue is that Lindberg frames are set into lenses using a special glue and a UV light source. Your opticians may not have done this before, and it is very different to other methods for assembling rimless frames, meaning that often for the best results a lens manufacturer is the way to go.

Having said all of that it is not the worst idea to have a spare pair in your current prescription in case of a catastrophe striking your main pair, they don’t have to be anything special, just a decent frame and lenses that will do the job for a few weeks. I venture that your opticians will have something that fits that bill for a lot less than £300, depending on your prescription and visual needs obviously.

opto 17 says:
18 March 2015

Hi
Joining this discussion quite late but I comment as an optometrist with 35 years’ experience. A quarter dioptre change of prescription is hardly significant or worth the effort of reglazing your current frames. My advice in such a situation would be to have the new prescription made up only if you want a complete new pair (say cosmetic change) or carry on with your current pair unchanged. Your choice entirely.

RobbaBanks says:
26 September 2014

Optical Express provided me with several pairs of specs after they failed to get my laser surgery right (disaster but that’s another story). All of these prescription spece were pouts about useless and despite my post surgery vision being very poor I could spy till see better without the glasses they supplied me with.
for all the years I gp have had glassed from local opticians I have Never had to return any due to unsuitability and yet in a relatively short space of time ALL the specs supplied by Optical Express were useless !