This project is developing the evidence base to make the case for orthoptists to be able to prescribe glasses within hospital eye services. Extending the role of orthoptists in this way would improve the patient experience by improving efficiencies and providing more timely care.
Background
Orthoptists have been taught to refract for a long time, but they do not have the right to prescribe glasses or perform a sight test according to the Opticians Act 1989. While orthoptists do test sight, being unable to write a prescription for glasses, means that patients are required to separately see an optometrist if they require glasses, prolonging the patient journey.
Recent developments in the profession including the rights to administer and supply medicines are changing how orthoptists work. As their autonomy has increased the ability to refract and prescribe glasses has been a notable omission in orthoptic practice. Orthoptists can add prisms and optical lenses to glasses to change their function, but being able to prescribe the final correct prescription would enable them to do this autonomously and not via other professionals such as Ophthalmologists or Optometrists. This would benefit patient care and improve service delivery.
What is the law regarding refraction?
The General Optical Council (GOC) was created by the first Opticians Act in 1958, and provides the current governing legislation for opticians/optometrists and dispensing opticians under the Opticians Act 1989 (“the Act”).
The Act gives the GOC powers to make rules and regulations in specific areas of eye care practice, subject to approval by the Privy Council. These include rules concerning the optical industry. The Act sets out the rules and laws governing sight testing and refraction. The Act originally gave opticians the right to prescribe glasses and conduct sight tests, something that only medical practitioners had been able to do before the act was formed. The Act sets out the law with regard to spectacle prescribing, refraction, sight testing, sale and supply of glasses, conduct of optical businesses as well as regulation of the professionals registered by the GOC. Orthoptics are not included in this legislation even though we were a recognised profession as far back as 1937. Ophthalmic medical practitioners are mentioned within the Act as are optometry and medical students.
We are now creating a business case to have an amendment made that would allow registered orthoptists to conduct sight tests (refract and prescribe glasses in the hospital eye service) as part of the Opticians Act.