/ 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
izziej says:
28 September 2014

I have just got new varifocals from specsavers. I’ve had varifocals from various opticians for the last 14 years with absolutely no problems. With these new ones however, nothing I see is sharp, and looking through the lower 2/3rds of the lenses is only marginally better than plain glass. I said so 4days ago when I was picking them up and was told to give them 2 – 3 weeks to get used to them. However, i am wearing my old specs to write this as its impossible to use my tablet with new ones. I’m 62, in Scotland and had an NHS voucher. What would be my best course of action be in dealing with this ? In the event of having to ask for a refund, would that include the value of the voucher ? The cost of another eye test ? I had to ask for a copy of my prescription which I have never had to do before and which doesn’t fill me with confidence when I go to deal with this. If I give it the time suggested, will I see clearly or will I simply have adjusted to soft focus vision? I am short sighted.

Martin says:
23 October 2014

Maybe it’s because they are not aligned properly or fitted correctly. Even so you need to return to them to sort it out. If you need a refund, the voucher must be part or that refund as it cannot be ‘re issued.

Rob says:
13 March 2015

I had exactly the same problem with specsavers last year. Specsaver’s eye test is inaccurate and I think they sell bad quality varifocals. I complained but they ignored. I asked them to change the new lenses for my old ones and they damaged the frame. I threw the frame/lenses away and bought a frame and lenses (with my old prescription) online. Cheaper and good quality products.

I once had problems with Specsavers and have avoided them like the plague since. The coating on my glasses became streaky and the optician said it was my hair spray. But I have never used hair spray. I wonder what excuse they give men! I complained to the shop but was ignored. I then complained to their head office but they said that as it was a franchise they could do nothing. The optician ducked and weaved for some time and in the end I had to give up the ghost. Hope you get a better outcome than me, Rob.

idoc says:
18 October 2014

Glad you find it interesting, I enjoy posting here. I’m just about to start another day sitting in a little dark room with the store manager breathing down my neck – apparently my ” conversion rate” is poor so far this week and today and tomorrow are my last chance to improve it or else I may be called in to a disciplinary meeting next week. ( yes, I have to work on Sundays against my will. I would rather start my Sunday going to church with my family but I was told in no uncertain terms that if I didn’t work Sundays there were plenty of other optometrists who would.) like many optometrists I am desperately unhappy. I studied for 4 years to learn how to examine people’s eyes and identify eye disease but now my skills are being given away for free and I have to earn my living prescribing glasses to people who mostly don’t need them in order to increase the already enormous wealth of the company owners. I would love to be able to earn my living from examining eyes. If I got a bank loan for my equipment, rented a room and charged about 30 quid for a half hour examination I could earn my daily bread without having to sell any glasses at all, and my advice would be totally impartial, but no one would pay me. They don’t mind paying a plumber 30 quid for a half hours work but they expect me for free. Well, I’m not free. The price you pay is new or changed glasses which you probably don’t need.

Martin says:
23 October 2014

Then be honest with you customers. If they have no clinical change tell them how great it is that their eyes are stable. How many people wear the same clothes, shoes, hats, watch, handbag every day, all day for two or three years! Offer them a nice new pair for a change of style and maybe they’ll have a new pair anyway. If not they’ll return to you for their next pair because you were honest with them.

Move to Cornwall, great place to live and much better pay rates for opticians.

Gre Morors says:
15 November 2014

Great and a very informative post for me. I like reading this blog. Thanks a lot for sharing.

Specsavers in Cowley Centre, Oxford – poor advice
I have just been told that specsavers won’t sell me 3 months of daily disposal contact lenses because my glasses perscription is 2 years old. They want me to have a new eye test for my glasses probably to upsell me something I don’t need.

I have only recently had an eye test for contact lenses – but apparently for “legal” reasons they cannot sell me the contact lenses without a glasses eye test.

When I questioned the bogus “legal” reasons, there was backtracking about it being company policy. So you need a “valid” glasses eye test and a valid contact lense test in order to buy contact lenses.
I am taking my custom elsewhere. I just hate it when people try to use “legal reasons” to justify a rip-off. It’s a form of bullying that may work with vulnerable people but not everyone.

Sean says:
8 February 2015

hi i just saw your post and found the need to reply.
It is true and a legal issue, in the UK, that contact lenses can only be supplied to a valid sight test and contac lens prescription. So in the case you mention they can only supply upto the date on the sight test and not over, so ie if you had a month left on your sight test then they can legally sell you a month of contact lenses. Now most practitioners would err on the side of caution and request you have a sight test as you may wear the lenses after that period and then so leave them open to prosecution for not having duty of care. This is in theOpticians act 1989, you may well be right that they may want to sell you spectacles as well and unfortunately this does happen. Im a Contact Lens Optician and have been in optics for 30 years and it has changed drastically and not, i feel always for the good. I pride myself on giving the best customer service i can and never over sell but with deregulisation in 1989 of the supply of spectacles and now contact lenses over the internet i see a dramatic rise in contact lens issues and infections from improper care and poor advice. I hope you find a practitioner you can trust

Go online and buy your contact lenses with any prescription – stuff the opticians whose main concern now is profit and greed?

m.amos says:
22 November 2014

i am not very happy with the glasses i had from boots optician when i went back they did not want to know they were more interested in the frames after having two cateracts done i am a bit worried

P Gonzalez says:
28 November 2014

I was wrongly diagnosed by a Boots Optician which caused emotional stress and financial cost by an over-eager Optician. Turned out I didn’t have Glaucoma but lived with the diagnosis for over 3 months before I managed to see a qualified consultant. Looking for a complaints procedure now.

Glaucoma is notoriously difficult to diagnose. Even eminent ophthalmologists sometimes disagree on a diagnosis. Your optometrist will presumably have carried out the 3 tests for glaucoma which are as follows.
1. Measurement of the pressure inside the eyes. If this is consistently above 21 then according to NICE guidelines the patient must be referred for further investigation, the optometrist has no discretion, and failure to refer could leave him or her open to being sued for clinical negligence and perhaps struck off by the General Optical Council as well, thus losing his or her livelihood.
2. Examination of the optic nerve head also known as the optic disc, with assessment of the cup/ disc ratio which is the ratio of the the size of the disc to the area of any cupping within that disc. This is a little bit subjective and even experienced clinicians may vary in their decisions although a very high CD ratio eg 0.8 should always be referred.
3. Assessment of the visual fields. Suspicious loss of areas of the peripheral vision if repeatable need referring.
Also, OCT scanning of the nerve fibre layer near the optic disc may be undertaken, but an OCT machine costs about 30 grand and the NHS doesn’t pay a penny towards one, so your optometrist may simply be unable to afford to buy one.
Most hospital eye departments have one.
I really cannot understand why on earth you are talking about making a complaint since this seems totally unreasonable to me.
Your optometrist was only looking after your sight to the best of his or her ability and presumably in accordance with NICE guidelines.
However if you feel that the situation was not adequately explained to you I feel it would be well worth writing in person to the optometrist who referred you, marking your letter private and confidential, so that he or she can review their communication skills and perhaps offer an apology if he or she feels that you were not fully informed that your referral was not a diagnosis of glaucoma but simply a precautionary measure to exclude glaucoma.
There are hundreds of optometrists working for Boots I expect that some have better communication skills than others.

Disclaimer – I do not work for Boots and am not in any way connected with Boots.

P Gonzalez says:
28 November 2014

She told me ‘I HAD Glaucoma’ – She told me it was not so bad that I couldn’t drive at night YET. Hospital consultant was annoyed. She didn’t take into account Corneal thickening. Have been told by someone else (eye surgeon) that she was not qualified to diagnose it, just to refer me for further tests in case. She told me the only side effects were getting longer eyelashes. I understand they are on the look out for things, but they shouldn’t diagnose serious issues. They should refer you in case of. It was distressing.Yes, you could say her communication skills regarding possible desease needs improving on.

Oh dear if you heard her correctly she was outside of her expertise and should definitely not have said that.
Optometrists are very good at deciding who does and who does not need to take up expensive NHS eye clinic time but they do not make final diagnoses in complex matters such as glaucoma, although they now can in simple conditions such as cataract, ingrowing eyelashes and conjunctivitis.
I agree about the importance of corneal thickness measurement when the pressures are borderline.
A typical cornea is about 555nm thick at the centre. A very thick cornea will give pressure readings a few mmHg higher than the pressure actually is, conversely a thin cornea may give falsely low readings. It is not of great importance except when the pressure readings are borderline for example 19 mmHg. When someone has borderline pressure readings I always measure the corneal thickness before deciding whether or not to refer. I use an instrument known as a pachymeter which is a small hand held ultrasound instrument used in association with local anaesthetic drops to numb the cornea.
It is worth enquiring if your optometrist has measured the corneal thickness before deciding on referral.
As always, there is a funding issue here.
I paid £2300 out of my own pocket for my pachymeter and the drops used (a minim of Oxybuprocaine) costs about a quid per patient.
The NHS does not contribute a penny towards either, so, as with all optometric equipment, it has to be paid for from the profits on the sale of spectacles.
I have never liked this dishonest cross subsidy of eye care from the sale of glasses.
I would happily work as a salaried public sector employee of the NHS for a salary similar to that of a senior nurse or pharmacist ie about 40K from an NHS clinic.
That way my advice would be totally impartial, but I cannot see this on the horizon in the near future.

Hi idoc. I am a pre-reg optometrist and completely agree with everything you have said on this forum. I was thinking of speaking to my local councillor to notify them about the huge conflict of interest between eye care and spectacle sales, and also how the NHS system is abused when it comes to dispensing to those on benefits even if there has been no prescription changes. And don’t get me started on the conversion rate. What advice would you have for me, and what action do you think is possible, because I don’t like the way the industry is at the moment and would gladly do all I can to reform it.

P Gonzalez says:
28 November 2014

According to the consultant (who was not a junior), no she did not measure corneal thickness. I know the test you are talking about and he did that. I think he said he had to take 7 off the eye pressure readings if that makes any sense? I heard the Optometrists perfectly well on two separate occasions, she had me back for a second appointment to ‘confirm’ the Glaucoma diagnosis which I had read up on in the meantime and become concerned. The second time she told all about how I might now be able to drive at night and will grow long eye-lashes etc etc The eye surgeon I spoke to said right away that she shouldn’t have diagnosed me and the consultant was obviously annoyed and fired off a letter to her on his dictaphone right in front of me pointing out her errors. The problem was, I didn’t get to see him for 3 months, so I had 3 months of worry. I must have a very thick cornea if what you are saying is correct. Either way, I will get my eyes checked regularly from now on, but not at Boots.

I don’t really understand what you mean re the NHS doesn’t contribute? Boots are a company and charge for their services, she certainly sold me some extra features on my new glasses in accordance with my new diagnosis !

P Gonzalez says:
28 November 2014

sorry, typo should read ” might NOT be able to drive at night”

Yes, Boots charge you for your glasses, agreed – and some of the profit on the sale of those glasses goes to pay for their equipment.
To clarify – the NHS does not pay for premises,, equipment or staff, they do pay a small fee for an eye exam for people who are entitled to an NHS test but this fee is below the cost of the provision of the exam.
Hope this clarifies?
A typical high street optician pays about 45K rent per year and business rates and utilities adds about the same again so the place costs 100K per year just to stay open.

Gre Morors says:
8 December 2014

Great and a very useful blog for me. I like reading this blog. Thanks a lot for sharing.

John Green says:
9 November 2015

To Gre Morors

Why do you keep posting the same message every three months? What is your problem?

Gre Morors says:
19 January 2015

Great and a very useful blog for me. I am very much benefited after reading this blog. Thanks a lot for sharing.

Alison Edis says:
6 February 2015

Owing to a misunderstanding, I was sold glasses that I neither want nor need. I have not taken possession of them and have left them at the shop. The sales person said that as they have been made up already I am not entitled to a refund, but he will talk to the factory and see what can be done. There was a long catalogue of misunderstandings in the process. The frames are obviously as new, they have only been to the factory. How much would it have been for the lenses to be made up?

Martin says:
9 February 2015

Hi Alison
It seems that you entered a contract by paying a deposit, thus agreeing the sale. Even if you did, I think you would be able to cancel the agreement and lose your deposit although not doing anything to help you will not do their reputation too much good and that’s bad for business. It is up to the seller to collect a deposit to cover costs should there be a default, it is absolutely nothing to do with any factory. You could ask the OCCS to intervene and I would suggest you offer to pay the wholesale cost of the lenses if you agree that the misunderstanding is partly your fault. The frames could at worst be put back into stock or returned to the supplier if they were specially ordered.

Hi Alison, sorry to hear about your experience at the opticians. The price for the lenses to be made up really depends on the optician, and how your test went. Some opticians make a loss on eye test, so it’s likely they’ll try to keep your custom – including finding you affordable glasses. I hope the matter gets resolved for you, Alison.

Gre Morors says:
18 February 2015

Great and a very useful blog for me. Thanks a lot for sharing.

Trevor Mclnnes says:
22 February 2015

I have just collected my new glasses from Boots . ln spite of me telling them that my last test at Boots 9 months ago the glasses did not give me distance vision .My new glasses are the same.
Reading a number plate at 30 ft,my left sight is clear, but the right is not .
Do l give them a week and hope my eyes get use to them…..l tryed this last time nothing changed.
Or take them back.

Cecilia says:
15 March 2015

I am taking my glasses back to Boots this week, after 2 weeks of trying to get used to them, they altered shape, now my iPad is boat shaped!! Cannot wear them. See what options I am given.

Having recently worked in a large multiple I am worried by the fact they are telling all their optometrists to recomend lens coatings to protect against blue light to all patients, and then when they don’t get the figures they want they sit in on the eye examination to make sure it happens.

Davey Hiltzs says:
11 March 2015

I didn’t know that some opticians would give a poor result for an eye exam. How do you think you could combat that? Maybe go see another Optician? I don’t like making more than one doctor appointment than I have to, it’s not cheap to pay for those visits.

John Black says:
17 March 2015

I’ve purchased my glass’s from Boots & found numbers etched on the lens. On both sides and am told this is usual ?????? Help

Hi John, thanks for your comment. It seems all varifocals have ‘invisible’ markings and depending on the make, they could be logos or circles with numbers. They are impossible to see when being worn, but on some lenses they are slightly more visible. In your position, I would certainly contact Boots for further advice:

http://www.boots.com/en/Help/Contact-Us/

Hi I was feeling very under the weather, getting bad heads my eye sight getting worse so I went for an eye test at specsavers. The optician had had an inspector or assessor in with her all day, by the time I went in he had left for the day and she was an hour and a half behind. My test was the quickest I’ve ever had she said my prescription had change a lot in less than a year but everything was ok. I did not get new glasses that day as I was feeling unwell. 3 weeks later I went t my GP who sent me for a MRI it came back that I have fluid on the brain which has caused optic nerve damage all this five weeks after having an eye test which according to the optician was ok. Do you think I have grounds to complain, I did tell them two days after my results but they say it was clear. They were false very rude.

Hi Angela, I’m sorry to hear about your experience. It’s difficult to comment, however, in your position, I would certainly get in touch with the General Optical Council for further advice:

https://www.optical.org/

Thank you for your reply, I just find it hard to believe that within the space of five weeks I have everything’s ok to a doctor with a torch say you have optic nerve damage. Again thanks for the reply and the link.

Hi Angela, thanks for the reply – I really do hope this matter gets resolved for you. Please bear in mind that the General Optical Council is more for issues of possible professional misconduct e.g. negligence.

If it’s more of a service issue, you should try and resolve it with your optician first, and also contact the Optical Complaints Service if no joy:

http://www.opticalcomplaints.co.uk/what-we-offer

Bevey 76 says:
2 April 2015

I did homework to find the best value for my new glasses, settling for Boots as the tag on the frames I wanted said £210 with single lenses and £290 for varifocal. After the sight test, it was recommended by the Optician that I had the Platinum varifocal lenses in a lighter weight. The ‘Consultant’ priced my glasses at £450. When I asked about the £290 offer I was told that those lenses were not an option and Head Office were aware. How did £290 get to £450?. I chose Boots because, although the frames were overpriced compared to other opticians, the varifocal option was good value. I felt mugged! Very misleading AND they have posters saying their pricing is transparent….

Martin says:
6 April 2015

The only transparent pricing is from ASDA who say they charge £40, £70 or £100 for their glasses with ALL coatings included and thinner lenses if you prescription warrants it. Of course others will say the frames are inferior and the lenses poor quality but they come from the SAME suppliers and you can have the new design ‘freeform’ varifocal if you need it for the same price. Now that’s transparent pricing. If you really want you can take them up with their offer for two pairs too. Worth checking out I think.

Gre Morors says:
4 April 2015

Great and a very useful blog for me. I am very much benefited after reading this blog.

Gre Morors says:
6 April 2015

Its a very useful and informative blog for me. After reading this blog, I am very much benefited. Keep sharing.

colin says:
8 April 2015

I’ve had a pair of rimless varifocals for 2 years. I lost the little metal cap on the screw through the lens and had it replaced after a half hour wait. Three Boots staff members managed to do it eventually! However a week and a half later little cracks appeared around the screw. I took it back to Boots and was told that it had been tightened too much. However he could not send it back to get the lens changed until I had an eye-test. Is this a way of trying to sell me another pair of spectacles? All I wanted was my old pair made good from damage that Boots were responsible for.