Optometrist vs Optician

Optometrist vs Optician

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Discussion

Simbu

Original Poster:

1,792 posts

174 months

Thursday 21st March
quotequote all
Which should I see? Plenty of opticians in my area, some seem to have optometrists as well as dispensing opticians. Some have only the latter as far as I can tell. I understand they are differeent qualifications. Should I be seeing one over the other? Will one be more expensive? I understand I should be getting an OTC scan included. Can both qualifications do this?

It's hard to find guidance that doesn't sound like sales patter!

I've decided to re-evaluate my approach to my eye health, especially since learning there is a family history of glaucoma to consider. I'm in my late 30s and have moderate (~ -6) myopia and a mild astigmatism in one eye. Historically Specsavers have been 'fine', but perhaps I can do better now?

Interested to hear anyone's views / experiences, thanks.

HelenT

263 posts

139 months

Thursday 21st March
quotequote all
From the College of Optometrists

https://www.college-optometrists.org/qualifying/a-...

Previously known as ophthalmic opticians, optometrists are trained to examine the eyes to detect defects in vision, signs of injury, ocular diseases or abnormality and problems with general health, such as high blood pressure or diabetes. They make a health assessment, offer clinical advice, prescribe spectacles or contact lenses and refer patients for further treatment, when necessary.

Now Dispensing Opticians are often known as just Optician.
Dispensing opticians advise on, fit and supply spectacle frames and lenses after taking account of each patient's lifestyle and vocational needs. Dispensing opticians are also able to fit contact lenses after undergoing further specialist training.

As an Optometrist an OCT is a fantastic bit of kit, it is non-invasive, using light to produce a detailed image of the retina, making it much easier to detect changes which is important in detecting glaucoma, With OCTs you are paying for two things the cost of the equipment (£40k plus) but also the time for a trained professional to look at the images and hopefully explain them to you. My average appointment is 45 minutes and at least 10 minutes of that is OCT.

Fastpedeller

3,872 posts

146 months

Thursday 21st March
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From what I've seen (no pun intended) a lot of opticians use locum optometrists and as a consequence you may not be tested by the same person when you next visit for an eye test. Some may consider this as a negative, but in my opinion it could be a positive because a different optometrist may identify an eye condition another may miss - seeing the same examiner year after year may not be the best. On my most recent visit to Specsavers I saw the same optometrist as 2 years previous, and the test seemed to be very rushed and my eyes weren't examined using the 'manual look into the eyes with the light and magnifier' but I did have the OCT scan, so maybe that is enough? My WIfe on the same day saw a different Optometrist, who also did the OCT test, but did the 'manual look' as well.

turbomoggie

148 posts

104 months

Thursday 21st March
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All opticians practices will have an optometrist to test your vision, calculate your prescription and examine your eyes for health problems.

A "DO" or dispensing optician, will work in an opticians on the shop floor. Their specialty is different to the optometrist in that they are the expert in dispensing the spectacles based on the prescription calculated by the optometrist. The dispensing optician will choose which lenses and frames to order, take measurements, make adjustments to spectacle frames and may sometimes alter the prescription amongst many other things.

The Gauge

1,878 posts

13 months

Saturday 23rd March
quotequote all
Interesting reading. When I went to Specsavers for my eye test the other day I paid extra for an eye health examination.

I first had a lady conduct an eye examination, I can’t actually recall what this involved. Then I saw a guy for the eye test, who also examined my eyes before performing the eye test. His examination involved me resting my chin on a device, with his face on the other side and him looking into my eyes. There was a green light that I had to look away from, to each side and up and down. He told me he had recently graduated from university and was on a placement with Specsavers.

He then asked the lady to perform an additional eye examination where I had to look into a device and stare at a dot, then press a button when I saw areas in my peripheral vision appear to vibrate.

I then chose a pair of frames I thought suited me, another lady confirmed they’d be suitable for varifocals and took some measurements, and I paid for a pair of glasses to be made which I collect next week.

So who were these three people, what would their titles or positions be please?

turbomoggie

148 posts

104 months

Saturday 23rd March
quotequote all
The Gauge said:
Interesting reading. When I went to Specsavers for my eye test the other day I paid extra for an eye health examination.

I first had a lady conduct an eye examination, I can’t actually recall what this involved. Then I saw a guy for the eye test, who also examined my eyes before performing the eye test. His examination involved me resting my chin on a device, with his face on the other side and him looking into my eyes. There was a green light that I had to look away from, to each side and up and down. He told me he had recently graduated from university and was on a placement with Specsavers.

He then asked the lady to perform an additional eye examination where I had to look into a device and stare at a dot, then press a button when I saw areas in my peripheral vision appear to vibrate.

I then chose a pair of frames I thought suited me, another lady confirmed they’d be suitable for varifocals and took some measurements, and I paid for a pair of glasses to be made which I collect next week.

So who were these three people, what would their titles or positions be please?
The first person you saw would most likely have been an optical assistant (OA) who performed the pre-test examinations. Optical assistants, do not normally hold any professional qualifications (not to say that they don't know what they're doing). Pre testing normally consists of auto refraction, tonometry, fundus photography and depending on the practice they may have OCT (most now do). If you're at a high end independent they may have a variety of other machines also.

You then saw, what sounds like a pre-reg optometrist. So an optometrist who has graduated from uni but they must practice under supervision and still have exams to complete before they're qualified. They performed your eye test and checked the information taken during the pre test.

You then had a visual fields test on Zeiss Humphrey FDT. Visual fields testing is normally delegated to an optical assistant.

The person dispensing your spectacles may have been an optical assistant or a dispensing optician.

The Gauge

1,878 posts

13 months

Saturday 23rd March
quotequote all
turbomoggie said:
The Gauge said:
Interesting reading. When I went to Specsavers for my eye test the other day I paid extra for an eye health examination.

I first had a lady conduct an eye examination, I can’t actually recall what this involved. Then I saw a guy for the eye test, who also examined my eyes before performing the eye test. His examination involved me resting my chin on a device, with his face on the other side and him looking into my eyes. There was a green light that I had to look away from, to each side and up and down. He told me he had recently graduated from university and was on a placement with Specsavers.

He then asked the lady to perform an additional eye examination where I had to look into a device and stare at a dot, then press a button when I saw areas in my peripheral vision appear to vibrate.

I then chose a pair of frames I thought suited me, another lady confirmed they’d be suitable for varifocals and took some measurements, and I paid for a pair of glasses to be made which I collect next week.

So who were these three people, what would their titles or positions be please?
The first person you saw would most likely have been an optical assistant (OA) who performed the pre-test examinations. Optical assistants, do not normally hold any professional qualifications (not to say that they don't know what they're doing). Pre testing normally consists of auto refraction, tonometry, fundus photography and depending on the practice they may have OCT (most now do). If you're at a high end independent they may have a variety of other machines also.

You then saw, what sounds like a pre-reg optometrist. So an optometrist who has graduated from uni but they must practice under supervision and still have exams to complete before they're qualified. They performed your eye test and checked the information taken during the pre test.

You then had a visual fields test on Zeiss Humphrey FDT. Visual fields testing is normally delegated to an optical assistant.

The person dispensing your spectacles may have been an optical assistant or a dispensing optician.
Thank you for the explanation, as I really had no idea who was doing what.

The pre-reg optometrist was very helpful and explained everything he was doing. He showed me how the retina can be seen and examined but one of the other examinations I had could show deeper into the back of the eye and see things that the other examination couldn't. I recall him showing me some images on the screen of the back of my eye, and how that examination could see more. Hope that makes sense.

For the the pre-reg optometrist to ask for a further eye examination, would that mean he saw something in the results of one of the results? Just that when he checked over the eye examination results he told me everything looked healthy, but then he suggested the additional examination.


Turn7

23,610 posts

221 months

Saturday 23rd March
quotequote all
I have a question about this profession….

Are they becoming the latest Dentist says you need a filling ?

For the last 4 years, EVERY single annual test, it’s been “ there’s a small change, you need new
Specs”..


turbomoggie

148 posts

104 months

Saturday 23rd March
quotequote all
The Gauge said:
turbomoggie said:
The Gauge said:
Interesting reading. When I went to Specsavers for my eye test the other day I paid extra for an eye health examination.

I first had a lady conduct an eye examination, I can’t actually recall what this involved. Then I saw a guy for the eye test, who also examined my eyes before performing the eye test. His examination involved me resting my chin on a device, with his face on the other side and him looking into my eyes. There was a green light that I had to look away from, to each side and up and down. He told me he had recently graduated from university and was on a placement with Specsavers.

He then asked the lady to perform an additional eye examination where I had to look into a device and stare at a dot, then press a button when I saw areas in my peripheral vision appear to vibrate.

I then chose a pair of frames I thought suited me, another lady confirmed they’d be suitable for varifocals and took some measurements, and I paid for a pair of glasses to be made which I collect next week.

So who were these three people, what would their titles or positions be please?
The first person you saw would most likely have been an optical assistant (OA) who performed the pre-test examinations. Optical assistants, do not normally hold any professional qualifications (not to say that they don't know what they're doing). Pre testing normally consists of auto refraction, tonometry, fundus photography and depending on the practice they may have OCT (most now do). If you're at a high end independent they may have a variety of other machines also.

You then saw, what sounds like a pre-reg optometrist. So an optometrist who has graduated from uni but they must practice under supervision and still have exams to complete before they're qualified. They performed your eye test and checked the information taken during the pre test.

You then had a visual fields test on Zeiss Humphrey FDT. Visual fields testing is normally delegated to an optical assistant.

The person dispensing your spectacles may have been an optical assistant or a dispensing optician.
Thank you for the explanation, as I really had no idea who was doing what.

The pre-reg optometrist was very helpful and explained everything he was doing. He showed me how the retina can be seen and examined but one of the other examinations I had could show deeper into the back of the eye and see things that the other examination couldn't. I recall him showing me some images on the screen of the back of my eye, and how that examination could see more. Hope that makes sense.

For the the pre-reg optometrist to ask for a further eye examination, would that mean he saw something in the results of one of the results? Just that when he checked over the eye examination results he told me everything looked healthy, but then he suggested the additional examination.
There may have been a risk factor present for eye disease which could affect peripheral vision. Don't be alarmed by this. Visual fields testing is a relatively routine thing. If the result was normal then normally this means nothing to worry about for now - just remember to keep up with your appointments normally every 1 to 2 years.
Possible reasons for checking peripheral vision: It could be that you complained of headaches. Glaucoma risk. Family history of glaucoma. OCT analysis isn't always the most reliable and can flag up false positives when it does glaucoma related analysis. Many other reasons. Some optoms just like having visual fields tests performed on most of their patients as screening tool especially pre-regs who are normally more cautious

turbomoggie

148 posts

104 months

Saturday 23rd March
quotequote all
Turn7 said:
I have a question about this profession….

Are they becoming the latest Dentist says you need a filling ?

For the last 4 years, EVERY single annual test, it’s been “ there’s a small change, you need new
Specs”..
Not really...

It's normally quite straightforward: you can either see better through the new prescription or you can't. The optometrist should show you the difference between your old prescription and the new one. Else there would be lots of patients coming back saying that their new spectacles are no clearer than their old pair. (Most practices have some type of money back guarantee period).

Following their advice is your choice. Just be mindful of things like driving standards if you wear distance spectacles and don't wish to update your glasses when there's a change.

The Gauge

1,878 posts

13 months

Saturday 23rd March
quotequote all
turbomoggie said:
There may have been a risk factor present for eye disease which could affect peripheral vision. Don't be alarmed by this. Visual fields testing is a relatively routine thing. If the result was normal then normally this means nothing to worry about for now - just remember to keep up with your appointments normally every 1 to 2 years.
Possible reasons for checking peripheral vision: It could be that you complained of headaches. Glaucoma risk. Family history of glaucoma. OCT analysis isn't always the most reliable and can flag up false positives when it does glaucoma related analysis. Many other reasons. Some optoms just like having visual fields tests performed on most of their patients as screening tool especially pre-regs who are normally more cautious
That makes sense, thanks.

He did ask me about my health, and I told him I'm always of good health other than recently being diagnosed with high blood pressure having had a 5 day migraine, so that will probably be why he was keen to conduct a further examination?

Somebody

1,184 posts

83 months

Sunday 24th March
quotequote all
turbomoggie said:
The first person you saw would most likely have been an optical assistant (OA) who performed the pre-test examinations. Optical assistants, do not normally hold any professional qualifications (not to say that they don't know what they're doing). Pre testing normally consists of auto refraction, tonometry, fundus photography and depending on the practice they may have OCT (most now do). If you're at a high end independent they may have a variety of other machines also.

You then saw, what sounds like a pre-reg optometrist. So an optometrist who has graduated from uni but they must practice under supervision and still have exams to complete before they're qualified. They performed your eye test and checked the information taken during the pre test.

You then had a visual fields test on Zeiss Humphrey FDT. Visual fields testing is normally delegated to an optical assistant.

The person dispensing your spectacles may have been an optical assistant or a dispensing optician.
A few years ago now but a doctor friend from uni who has become a consultant ophthalmologist used to test eyesight at weekends at a branch of opticians after qualifying as a doctor. Not sure if it's a common thing to do for an eye doctor.

turbomoggie

148 posts

104 months

Sunday 24th March
quotequote all
The Gauge said:
turbomoggie said:
There may have been a risk factor present for eye disease which could affect peripheral vision. Don't be alarmed by this. Visual fields testing is a relatively routine thing. If the result was normal then normally this means nothing to worry about for now - just remember to keep up with your appointments normally every 1 to 2 years.
Possible reasons for checking peripheral vision: It could be that you complained of headaches. Glaucoma risk. Family history of glaucoma. OCT analysis isn't always the most reliable and can flag up false positives when it does glaucoma related analysis. Many other reasons. Some optoms just like having visual fields tests performed on most of their patients as screening tool especially pre-regs who are normally more cautious
That makes sense, thanks.

He did ask me about my health, and I told him I'm always of good health other than recently being diagnosed with high blood pressure having had a 5 day migraine, so that will probably be why he was keen to conduct a further examination?
Yeah, a 'new' headache or migraine can be a reason to check peripheral vision to help screen for neurology related issues.

turbomoggie

148 posts

104 months

Sunday 24th March
quotequote all
Somebody said:
A few years ago now but a doctor friend from uni who has become a consultant ophthalmologist used to test eyesight at weekends at a branch of opticians after qualifying as a doctor. Not sure if it's a common thing to do for an eye doctor.
Not very! There's such a role as an ophthalmic medical practitioner but I've never actually come across one. This is an ophthalmologist who performs a similar role to an optometrist.

Sometimes there's shared care schemes where an ophthalmologist may perform some private/NHS ophthalmology services in an opticians practice. He may have an optometrist (with enhanced training or who is also a prescriber) assisting with their clinic.

I also know of an independent optician practice who have partnerships with ophthalmologists where a patient can have eye tests, glasses etc but they also have operating theatres on site for private surgery etc

FMOB

854 posts

12 months

Sunday 24th March
quotequote all
One thing to be aware of, if you have a family history of glaucoma and fail the peripheral vision test (the one with the dot that moves around) it can affect your driving licence.

I believe you need to pass the Eastman test to get it back.

HelenT

263 posts

139 months

Sunday 24th March
quotequote all
FMOB said:
One thing to be aware of, if you have a family history of glaucoma and fail the peripheral vision test (the one with the dot that moves around) it can affect your driving licence.

I believe you need to pass the Eastman test to get it back.
Not always, you can legally drive a car with just one eye so you can have a defect in the visual field in one eye and if the other eye compensates for it you would still be ok to drive.

Forester1965

1,454 posts

3 months

Sunday 24th March
quotequote all
The UK optical market has for a long time been upside down (you can get glasses for that!).

The expensive bit of the business is the eye test. The cheap bit of the business is the glasses. For the consumer, the expensive bit is the glasses and the cheap bit the eye test.

It should be £100+ for a comprehensive sight test and about the cost you can pay online for a pair of reasonable prescription specs.

For example, I used to do quite a bit of business with Specsavers when they first went to China to make frames. It would cost more in stamps to post them to you than they cost to make. Yet a decent optician has tens of thousands worth of kit floating around to test your eyes and the ophthalmic optician costs a lot more per hour than the dispensing one (at least they did when I was last in that business).

Jon39

12,827 posts

143 months

Sunday 24th March
quotequote all

My last visit to Specsavers, was my very last.

Two pairs of glasses had been ordered, one bifocals for reading and indoor use, the second pair with standard long distance glasses for outdoor use including transition lenses. However, they put the transition on the bifocals, instead of the outdoor glasses.

We all make mistakes, so I was not concerned, assuming they would correct such an obvious error.
Instead though, they decided to tell me that there was nothing wrong with either pair of glasses.
Maybe the employee always wears sun glasses indoors, but never wears sunglasses out in the sunshine.
Must have been either stupid, or ignorant. Certainly lacking in the obvious.

Just shows how easy it is to lose a customer.

Simbu

Original Poster:

1,792 posts

174 months

Sunday 24th March
quotequote all
Thanks all for the comments and insights. It sounds like I just need to ensure I visit an optician with an OCT scanner for the hereditary glaucoma risk, and that I shouldn't necessarily be concerned about a locum optometrist.

I am planning to find a well-rated local independent; it'll be interesting to compare against Specsavers pricing and quality of service.

turbomoggie

148 posts

104 months

Monday 25th March
quotequote all
Forester1965 said:
The UK optical market has for a long time been upside down (you can get glasses for that!).

The expensive bit of the business is the eye test. The cheap bit of the business is the glasses. For the consumer, the expensive bit is the glasses and the cheap bit the eye test.

It should be £100+ for a comprehensive sight test and about the cost you can pay online for a pair of reasonable prescription specs.

For example, I used to do quite a bit of business with Specsavers when they first went to China to make frames. It would cost more in stamps to post them to you than they cost to make. Yet a decent optician has tens of thousands worth of kit floating around to test your eyes and the ophthalmic optician costs a lot more per hour than the dispensing one (at least they did when I was last in that business).
Yes, I agree the pricing structure does need to be updated. The cost of delivering service is astronomical. To pay for: optoms, dispensing opticians, contact lens opticians, optical assistants, admin and reception staff, training, very expensive equipment, IT, insurance and the list goes on.

Maybe suppliers/distributors are able to make/purchase some optical products at pennies but they certainly cost more to the optician practice. Especially higher end varifocal lenses. There's not quite the margin you might expect.