Eye test differences by nation?

[Wm]

I booked a sight test and noticed the following on the confirmation e-mail.

===
Please note, if you are over 60 and visiting a Scottish store for a
sight test or Contact Lens Initial appointment,
it is likely that our Optometrist will administer some eye drops in
order to dilate your pupils. The eye drops
may affect your vision for a short period of time following your eye
examination (usually up to 6 hours) and it is
recommended that you do not engage in any activity which requires good
vision until the eye drops have worn
off completely. We therefore recommend that you do not drive to your
appointment or that you are accompanied
by someone who can drive you home following your eye examination.
===

The blurb is from a major retailer opticians (don't mind mentioning
their name as I am not moaning) but I am wondering if there are
different rules for sight tests within the UK particularly considering
how easy it is to cross the borders of Scotland, England and Wales.

--
Wm ...

[Janet]

In article <ktk0ol$37p$1...@dont-email.me>, tcn...@tarrcity.demon.co.uk
says...

In Scotland, all residents are entitled to free NHS sight tests paid
(UK residents living outside Scotland don't qualify). AFAIK, NHS
Scotland determines what tests are carried out.

In England and Wales, the provision of free NHS sighttests is not
universal; those who don't qualify have to get a private eye test and
pay for it. Charges for private eye tests vary considerably, which can
reflect differences in the tests performed.

Janet.

[Iain Archer]

From "A comparison of Scottish and English General Ophthalmic Services:
a preliminary evaluation of the impact on patient care"
<http://www.optometryinpractice.org/filemanager/root/site_assets/13-4/610
9_oip_vol_13_issue_4-2012_1_p139-150_interactive_henderson_d5.4.pdf>
[PDF, 1.5MB]

"In 2006, the Review of Community Eyecare Services in
Scotland highlighted the importance of the role of community
optometrists in the management of eye conditions and, in
response to this document, statutory changes within the NHS
(The National Health Service (General Ophthalmic Services)
(Scotland) Amendment Regulations 2006, 2010) in Scotland
provided for GOS (community) eye examinations that are
universally free and flexible with regard to patients’ needs.

"In Scotland a GOS eye examination includes additional key
elements such as dilated slit-lamp biomicroscopy for the
over-60s and those with suspected posterior-pole conditions
such as glaucoma, diabetic and macular disease. Tests such as
slit-lamp examination, pupillary assessment and ocular motor
function are also now mandatory for all Scottish primary eye exams,
whereas other tests, such as GAT, depend on the
presence of suspect glaucoma or raised intraocular pressure.
Free digital fundus imaging was also introduced in April 2009
for patients aged 60 and over.

"In addition to the tests themselves, optometrists in
Scotland are limited to performing a maximum of 20 eye
examinations per day. The funding required for additional
equipment and training necessary to implement these changes
is provided by NHS Scotland. Optometrists in Scotland are
also entitled to NHS fees for supplementary tests introduced
for reviewing patients in certain clinical circumstances."
--
Iain

[Wm]

uk.legal.moderated <MPG.2c687bf1b...@news.individual.net>

On 04/08/2013 16:00, Janet wrote:

> In Scotland, all residents are entitled to free NHS sight tests paid
> (UK residents living outside Scotland don't qualify). AFAIK, NHS
> Scotland determines what tests are carried out.
>
> In England and Wales, the provision of free NHS sighttests is not
> universal; those who don't qualify have to get a private eye test and
> pay for it. Charges for private eye tests vary considerably, which can
> reflect differences in the tests performed.

Tesco Opticians (who I visited) offer free eye tests to everyone

http://www.tescoopticians.com/
===
10 Second Summary

Tesco Opticians has been established for over 10 years and you can now
find us in over 190 Tesco Extra stores UK-wide and even in Europe and
Asia. We sell prescription glasses from just £15 and contact lenses
from £6.75 per box, with free p&p. All our prices are transparent, so
you know what you're paying for and don't get any nasty surprises. We
also offer first class eye care including free eye tests for everyone,
and contact lens assessments.
===

I was very, very pleased with the ladies who did the pre-test and actual
test and the gentleman I saw today when I went back to choose my frames
(I dithered as this is only my second pair of glasses).

Obviously I don't know about other branches but I can recommend Tesco
Opticians, Surrey Quays, London as it was just such a different,
enlightening and altogether educational experience compared to my last
eye test and glasses fitting experience. To give you an idea, it is 6
years since I last had an eye test, having said that my rate of decay is
quite slow.

I'll see if I can match any of IanA's additional tests to my experience
in a separate posting but it is probably better reported on by someone
that has had eye tests, glasses fitted, etc a number of times over a
number of years.


--
Wm

[Wm]

uk.legal.moderated <3txaBKMsSl$RF...@gmail.com>

OK, IainA, you found something to quote. That is nice.

Now what? I don't know what each of those tests are. Do you?

I know what happened to me (quite willingly) when I had my eyes tested
but I can't see you providing a reference to what these tests are.

For all I know they happened and you were merely defending the Scottish
NHS (which seems a fine thing to do).

Let me put it a different way: do Scottish people really have different
eyes to other people in the UK?

I think not.

If someone has a sensible explanation for this I'll read it.

--
Wm

[Wm]

uk.legal.moderated <87iozfj...@news2.kororaa.com> On 08/08/2013
22:35, August West wrote:

>
> The entity calling itself Wm wrote:
>>
>> Let me put it a different way: do Scottish people really have
>> different eyes to other people in the UK?
>

> No. But they do have a different government, and NHS.
> And Scotland is (still) in the UK.
>
Why? As far as I can tell Scottish people don't actually benefit.

What was this bit of legislation for?

Does anyone really know?

--
Wm

[Percy Picacity]

Yes. Most people do know, in fact.

--

Percy Picacity

[Janet]

In article <ku5aut$huf$1...@dont-email.me>, tcn...@tarrcity.demon.co.uk
says...

[Nightjar]

On 08/08/2013 18:55, Wm wrote:
> uk.legal.moderated <3txaBKMsSl$RF...@gmail.com>
> On 04/08/2013 14:20, Iain Archer wrote:

....

>> "In Scotland a GOS eye examination includes additional key
>> elements such as dilated slit-lamp biomicroscopy for the
>> over-60s and those with suspected posterior-pole conditions
>> such as glaucoma, diabetic and macular disease. Tests such as
>> slit-lamp examination, pupillary assessment and ocular motor
>> function are also now mandatory for all Scottish primary eye exams,

....

>
> Now what? I don't know what each of those tests are. Do you?
>
> I know what happened to me (quite willingly) when I had my eyes tested
> but I can't see you providing a reference to what these tests are.
>
> For all I know they happened and you were merely defending the Scottish
> NHS (which seems a fine thing to do).
>
> Let me put it a different way: do Scottish people really have different
> eyes to other people in the UK?
>
> I think not.
>
> If someone has a sensible explanation for this I'll read it.

If you had to rest your head against a device that shone a bright light
into your eyes, that would have been a slit lamp. However, in England,
it is unusual to dilate the pupils to use it unless there is reason to
suspect disease. If the optician shone a bright light into your eyes
then turned it away, that was pupillary assessment. It checks for a
number of neurological conditions by the way your pupils dilate and
contract. If the optician asked you to look up, down, left and right,
you had an ocular motor function test.

Colin Bignell

[Percy Picacity]

Some (English) opticians make a point of doing more tests than the
minimum. One does routine retinal photographs. As you say, it is more
free enterprise in England, while all these tests are prescribed, and
funded, by the Scottish NHS. No doubt there is evidence either way as
to whether this is a good use of money. But there is no reason why a
different health service should exactly duplicate the policies of the
English NHS. Wales is doing routine abdominal aortic aneurysm
screening, for instance.

--

Percy Picacity

[Janet]

In article <874naxh...@news2.kororaa.com>, aug...@kororaa.com
says...

>
> The entity calling itself Wm wrote:
> >
> > uk.legal.moderated <87iozfj...@news2.kororaa.com> On 08/08/2013
> > 22:35, August West wrote:
> >>
> >> The entity calling itself Wm wrote:
> >>>
> >>> Let me put it a different way: do Scottish people really have
> >>> different eyes to other people in the UK?
> >>
> >> No. But they do have a different government, and NHS.
> >> And Scotland is (still) in the UK.
> >
> > Why? As far as I can tell Scottish people don't actually benefit.
>

> The ones I live among think they do.

Ditto.

Janet.

[Wm]

uk.legal.moderated <BdCdnSziMKE1F5vP...@giganews.com>

On 10/08/2013 19:50, Nightjar wrote:
> On 08/08/2013 18:55, Wm wrote:
>> uk.legal.moderated <3txaBKMsSl$RF...@gmail.com>
>> On 04/08/2013 14:20, Iain Archer wrote:
> ....
>>> "In Scotland a GOS eye examination includes additional key
>>> elements such as dilated slit-lamp biomicroscopy for the
>>> over-60s and those with suspected posterior-pole conditions
>>> such as glaucoma, diabetic and macular disease. Tests such as
>>> slit-lamp examination, pupillary assessment and ocular motor
>>> function are also now mandatory for all Scottish primary eye exams,
> ....
>>
>> Now what? I don't know what each of those tests are. Do you?
>>
>> I know what happened to me (quite willingly) when I had my eyes tested
>> but I can't see you providing a reference to what these tests are.
>>
>> For all I know they happened and you were merely defending the Scottish
>> NHS (which seems a fine thing to do).
>>
>> Let me put it a different way: do Scottish people really have different
>> eyes to other people in the UK?
>>
>> I think not.
>>
>> If someone has a sensible explanation for this I'll read it.
>
> If you had to rest your head against a device that shone a bright light
> into your eyes, that would have been a slit lamp.

Yup, they did that. Also the one that blows a puff of air into each eye
while you keep it open which feels really weird because instinct says an
eye should be closed at that moment.

> However, in England,
> it is unusual to dilate the pupils to use it unless there is reason to
> suspect disease.

I was asked about family history and was able to answer. If I had
answered differently (dishonestly ?) would I have been tested for other
things?

> If the optician shone a bright light into your eyes
> then turned it away, that was pupillary assessment.

They did that.

> It checks for a
> number of neurological conditions by the way your pupils dilate and
> contract. If the optician asked you to look up, down, left and right,
> you had an ocular motor function test.

They did that too.

> Colin Bignell

Thank you for your informative posting, Colin.

--
Wm

[Nightjar]

On 10/08/2013 20:20, Percy Picacity wrote:
>... Wales is doing routine abdominal aortic aneurysm
> screening, for instance.

Certainly in my area of England, it is routine for men over age 65.

Colin Bignell

[Nightjar]

On 11/08/2013 07:30, Wm wrote:
> uk.legal.moderated <BdCdnSziMKE1F5vP...@giganews.com>
> On 10/08/2013 19:50, Nightjar wrote:

....

> Yup, they did that. Also the one that blows a puff of air into each eye
> while you keep it open which feels really weird because instinct says an
> eye should be closed at that moment.
>
>> However, in England,
>> it is unusual to dilate the pupils to use it unless there is reason to
>> suspect disease.
>
> I was asked about family history and was able to answer. If I had
> answered differently (dishonestly ?) would I have been tested for other

> things?...

Either that or the glaucoma test (the puff of air) can lead to more
comprehensive testing. However, in England it is up to the optician
concerned, rather than a matter of statute.

Colin Bignell

[Percy Picacity]

Oh, I didn't realise it was international!


--

Percy Picacity

[rogerbl...@googlemail.com]

As an English resident (born a Scot but that's irrelevant, at least in this discussion!) I receive free eye tests through the (English) NHS and they include the puff test for glaucoma, because I have informed the opticians that I have a sister who is diabetic and suffers from glaucoma.
Hence the questions about family history . . .

[Robin Bignall]

On Mon, 12 Aug 2013 21:45:02 +0100, rogerbl...@googlemail.com wrote:

>As an English resident (born a Scot but that's irrelevant, at least in this discussion!) I receive free eye tests through the (English) NHS and they include the puff test for glaucoma, because I have informed the opticians that I have a sister who is diabetic and suffers from glaucoma.
>Hence the questions about family history . . .

Specsaver seems to do the puff test as part of its eye test. They never
asked for family medical history, only my own.
--
Robin Bignall
Herts, England

[polygonum]

On 12/08/2013 21:45, rogerbl...@googlemail.com wrote:
> As an English resident (born a Scot but that's irrelevant, at least in this discussion!) I receive free eye tests through the (English) NHS and they include the puff test for glaucoma, because I have informed the opticians that I have a sister who is diabetic and suffers from glaucoma.
> Hence the questions about family history . . .
>

As an English resident, I have had the glaucoma test for quite a number
of years. I have no history of it in my family - think it is standard
now (though maybe there is an age below which it is not done).

It is also possible to have glaucoma towards the low end of the range.

--
Rod

[Janet]

In article <3mri09dh3e9vr19vf...@4ax.com>,
docr...@ntlworld.com says...

If you're over 40, glaucoma in a close relative entitles you to free
eye tests.

Janet

[Wm]

uk.legal.moderated <MPG.2c73f3e04...@news.individual.net>

Are you ignoring the fact that I said early on that at least one major
retailer provides free eye tests for everyone.

Even (some?) foreign people!

Yours was one of the first responses and at the time of writing also the
most recent.

Was there a point in the Scottish legislation that is less necessary now?

The people from England and Wales that have contributed don't seem to
have been complaining that Scottish eye tests are much better and they
are therefore losing out qualitatively.

It seems to me the original issue in Scotland was that ophthalmologists
had to be persuaded, by law, that they should test some people for free
while other jurisdictions were more relaxed.

Times change. One thing I am left confused about is the eye-drops.
Does that only get administered for over 60's in Scotland these days?
If it was necessary in England and Wales wouldn't they have said so to
begin with?

Scottish people: I think you've been humped with a recent old law that
has since been overtaken by commercial and sensible stuff in other parts
of the UK, I'm not seeing any advantage to Scottish people from this
end, unless you think a drop in the eye is per se a good thing a la
Irvin Welsh.

Comments not mod objections this time, please.

--
Wm ...

[Percy Picacity]

On 2013-08-13 20:30:02 +0000, Wm said:

> uk.legal.moderated <MPG.2c73f3e04...@news.individual.net>
> On 13/08/2013 08:45, Janet wrote:
>> In article <3mri09dh3e9vr19vf...@4ax.com>,
>> docr...@ntlworld.com says...
>>>
>>> On Mon, 12 Aug 2013 21:45:02 +0100, rogerbl...@googlemail.com wrote:
>>>
>>>> As an English resident (born a Scot but that's irrelevant, at least in
>>>> this discussion!) I receive free eye tests through the (English) NHS
>>>> and they include the puff test for glaucoma, because I have informed
>>>> the opticians that I have a sister who is diabetic and suffers from
>>>> glaucoma.
>>>> Hence the questions about family history . . .
>>>
>>> Specsaver seems to do the puff test as part of its eye test. They never
>>> asked for family medical history, only my own.
>>
>> If you're over 40, glaucoma in a close relative entitles you to free
>> eye tests.
>
> Are you ignoring the fact that I said early on that at least one major
> retailer provides free eye tests for everyone.
>
> Even (some?) foreign people!

Why not? They buy glasses too! And that's why the opticians offfer the
free tests, to get you in the shop.

>
> Yours was one of the first responses and at the time of writing also
> the most recent.
>
> Was there a point in the Scottish legislation that is less necessary now?
>
> The people from England and Wales that have contributed don't seem to
> have been complaining that Scottish eye tests are much better and they
> are therefore losing out qualitatively.
>
> It seems to me the original issue in Scotland was that ophthalmologists
> had to be persuaded, by law, that they should test some people for free
> while other jurisdictions were more relaxed.
>
> Times change. One thing I am left confused about is the eye-drops.
> Does that only get administered for over 60's in Scotland these days?
> If it was necessary in England and Wales wouldn't they have said so to
> begin with?
>
> Scottish people: I think you've been humped with a recent old law that
> has since been overtaken by commercial and sensible stuff in other
> parts of the UK, I'm not seeing any advantage to Scottish people from
> this end, unless you think a drop in the eye is per se a good thing a
> la Irvin Welsh.
>
> Comments not mod objections this time, please.

I think we have established that there may be some advantages to the
subsidised more extensive examination in Scotland, but deciding whether
these outweigh the cost and other disadvantages probably needs quite a
good understanding of ophthalmology and epidemiology, and a careful
study of the evidence. There may be room for some disagreement as to
the answer. So, really, you're not going to get a better answer than
that without a few weeks' studying the issue in detail. You won't
find a sensible person to say either it is a good thing or bad thing.


--

Percy Picacity

[Janet]

In article <kue4ke$knu$1...@dont-email.me>, tcn...@tarrcity.demon.co.uk
says...

>
> uk.legal.moderated <MPG.2c73f3e04...@news.individual.net>
> On 13/08/2013 08:45, Janet wrote:
> > In article <3mri09dh3e9vr19vf...@4ax.com>,
> > docr...@ntlworld.com says...
> >>
> >> On Mon, 12 Aug 2013 21:45:02 +0100, rogerbl...@googlemail.com wrote:
> >>
> >>> As an English resident (born a Scot but that's irrelevant, at least in this discussion!) I receive free eye tests through the (English) NHS and they include the puff test for glaucoma, because I have informed the opticians that I have a sister who is diabetic and suffers from glaucoma.
> >>> Hence the questions about family history . . .
> >>
> >> Specsaver seems to do the puff test as part of its eye test. They never
> >> asked for family medical history, only my own.
> >
> > If you're over 40, glaucoma in a close relative entitles you to free
> > eye tests.
>
> Are you ignoring the fact that I said early on that at least one major
> retailer provides free eye tests for everyone.

No, but I was responding to Roger, not you. Roger went to Specsaver
which does not provide free eye tests to all.

>
> Even (some?) foreign people!
>
> Yours was one of the first responses and at the time of writing also the
> most recent.
>
> Was there a point in the Scottish legislation that is less necessary now?

I'm sorry, I don't understand your question. What legislation and what
timescales are you referring to?

>
> The people from England and Wales that have contributed don't seem to
> have been complaining that Scottish eye tests are much better and they
> are therefore losing out qualitatively.
>
> It seems to me the original issue in Scotland was that ophthalmologists
> had to be persuaded, by law, that they should test some people for free
> while other jurisdictions were more relaxed.

You are mistaken. My children and husband were getting free eye tests
in Scotland decades before 2006.

http://www.isdscotland.org/Health-Topics/Eye-Care/General-Ophthalmic-
Services/

"Exemption Categories (up to 31st March 2006)

Prior to the introduction of free eye examinations for everyone on 1st
April 2006, there were several exemption categories for those who did
not need to pay for their sight test.

Those under 16 years old.
Full-time students aged 16 to 18.
Those aged 60 and over.
Those on income support.
Those on income-based job seeker's allowance (JSA).
Those named on, or entitled to, an NHS Tax Credit Exemption
Certificate.
Those with pension credit guarantee credit.
Those registered as blind or partially sighted.
Those with diagnosed glaucoma.
Those aged 40 or over who are the parent, brother, sister, son or
daughter of a person with diagnosed glaucoma.
Those with diagnosed diabetes.
Those at risk of glaucoma.
Those with an HC2 or HC3 Certificate."

>
> Times change. One thing I am left confused about is the eye-drops.
> Does that only get administered for over 60's in Scotland these days?

No, whatever made you think that?

> If it was necessary in England and Wales wouldn't they have said so to
> begin with?

?? who is "they"?

>
> Scottish people: I think you've been humped with a recent old law that
> has since been overtaken by commercial and sensible stuff in other parts
> of the UK, I'm not seeing any advantage to Scottish people from this
> end,

Perhaps you are shortsighted.

Are all the people living in Wales Welsh, and all the people living
in England English? How times change.

Janet

[Wm]

uk.legal.moderated <MPG.2c74d203f...@news.individual.net>
On 14/08/2013 00:40, Janet wrote:

> Perhaps you are shortsighted.

Long as it happens.

I'm tired of the Scottish Defence Approach as it doesn't seem to offer
anything that contemporary English and Welsh opticians do ordinarily and
seems to cause some discomfort and requires an additional person or time
off work in some circumstances. Why is this better?

You (Scottish people) may have the the last word if you get it right
this time.

--
Wm ...

[Percy Picacity]

It isn't necessarily better. It certainly isn't necessarily worse.
There is not a simple-minded single answer to your question. It is a
different policy in a different nation's health service. You might,
for instance, look at what they do in various European countries to see
the range of different approaches.

--

Percy Picacity