OA Corner Part 28

Reading glasses purchased from an optical practice are classed as optical appliances

In OA Corner this month, we will consider some of the legal issues encountered in practice, beginning with a look at the Opticians Act of 1989.

The Opticians Act 1989 covers the sale of optical appliances, and states that anyone is allowed to sell spectacles as long as the recipient is not under 16 years of age, or registered partially sighted. For under 16s, the Act covers all aspects of the dispensing process – from frame and lens selection and measurements, ordering the spectacles, checking the spectacles when they arrive back from the lab, fitting the spectacles on collection and performing any subsequent adjustments.

It is important that the optical assistant (OA) is aware of these requirements, as the law is there to protect these vulnerable patients. OAs are not required to be registered with the General Optical Council (GOC), however, in order to comply with GOC regulations anything connected to the eyecare of children under 16 years of age must be under the supervision of a qualified dispensing optician (DO) or optometrist. Supervision means that the DO or optometrist is on the premises and in a position to intervene if necessary.

Low vision patients, those registered sight impaired or severely sight impaired, must be dispensed by a qualified optometrist or DO or, as for children under 16 years of age, dispensing and follow-on care must be under their supervision. For all other patients, the optometrist or DO should ideally be on the premises and in a position to oversee any dispensing undertaken and ready to intervene and support if necessary.

For an OA to dispense a prescription, the following criteria need to be met:
• The prescription must be given by a registered ophthalmic medical practitioner (OMP) or registered optometrist following a sight test. It should be signed and dated
• The prescription should be in date, i.e. within the recall period. Usually this means not more than two years old
• The prescription must be presented at the time of dispensing
• The patient must not be in one of the protected categories above (unless a DO or optometrist is supervising)

Although advisable, these rules do not necessarily apply to qualified DOs and optometrists as it can depend on the circumstances. An up-to-date eye examination should always be recommended, as the health of the eyes as well as the correct prescription can be checked. However, there may be a case for making a patient a pair of spectacles to an expired prescription.

For example, a patient may be in a nursing home and suffering from severe dementia – has lost their spectacles and may be too distressed to undergo an eye examination. In this case, it may be decided that it is in the patient’s best interests to make up a replacement pair of spectacles without performing an eye examination.

This is a decision only a qualified eyecare practitioner can make, but as an OA you should be aware of this possibility. If you encounter a situation similar to this in practice, you should check with the registered eyecare practitioner before telling the patient (or their relative) that it is not possible to dispense to an out-of-date prescription.

Ready readers are sometimes sold in optical practices, and can be sold in retail outlets including supermarkets and online. There are no rules governing the sale of ready readers at these non-optical retail outlets, apart from they must be no greater than +4.00DS, and both lenses must be the same power, and only to correct presbyopia.

There are different regulations, however, when they are purchased from an optical practice, as they are classed as an optical appliance. It is expected that an optical practice will have greater knowledge than a retail outlet, and so advice needs to be given on the suitability of the appliance.

You should create a record card for the patient, and include the power of the lenses provided – together with the patient’s near centration distance, as this may differ from the ready readers. If prismatic effect is induced as a result, this needs to be explained to the patient.

In this article, we have touched on a few common legal issues encountered in practice. As an OA, the rule should be that if you have any doubt at all, refer to the qualified eyecare practitioner who has overall responsibility.

In next month’s article, we will look at infection control within an optical practice.

Sue Deal FBDO R is a practising dispensing optician, ABDO College examiner, senior tutor and supervisor for dispensing opticians. She is also a practice visitor and external moderator for ABDO. She was recently awarded the ABDO Medal of Excellence for her outstanding services to the profession.