Call for more transparency within the uk optical industry

[Seenow]

This article has been bugging me for years (sorry Daily Mail but the topic is important)

https://www.dailymail.co.uk/health/article-2100778/So-thats-new-specs-giving-headache.html

What do people think of sending a letter such as this to the GOC?

Dear Sir/Madam,

Re: Request for Transparency in Optical Prescriptions and the Inclusion of Visual Acuity Information

I am writing to raise an important concern regarding the transparency of optical prescriptions, specifically the inclusion of visual acuity achieved with the prescription provided to patients.

As you are aware, myopia is becoming an increasingly prevalent condition, particularly among children and young adults, and has significant long-term implications for eye health. With myopia rates on the rise, it is vital that optical prescriptions are accurate and that patients have a clear understanding of how well their lenses are correcting their vision. Recent concerns among patients and optical professionals about prescription discrepancies—including those involving a variance of up to 1.5 diopters—have prompted discussions about the need for greater transparency in the optical prescription process. These discrepancies can lead to symptoms such as headaches, eyestrain, and visual discomfort, and may even contribute to the worsening of myopia over time.
An important part of this issue is the lack of information on the visual acuity achieved with a given prescription. Currently, optical prescriptions do not routinely include this information, leaving patients unaware of how effectively their lenses are correcting their vision. I believe that including visual acuity on optical prescriptions would greatly benefit both patients and eye care professionals, particularly in light of concerns about myopia progression, pseudomyopia, and over-correction.

The Importance of Visual Acuity Information for Myopia, Pseudomyopia, and Over-Correction:

1. Myopia Progression:
2. As myopia progresses, it is critical that patients receive the appropriate level of correction. Under-correction or over-correction can lead to discomfort and potentially accelerate the worsening of myopia. If a prescription is not achieving the expected visual acuity, it may indicate that the patient is being under-corrected or over-corrected, both of which can contribute to increased strain on the eyes and may accelerate myopia progression.
3. Pseudomyopia:
4. Pseudomyopia refers to a temporary condition where the eye exhibits myopic symptoms, often due to accommodation stress or overuse of near-vision tasks. In these cases, an accurate prescription is crucial for differentiating between true myopia and pseudomyopia. Without knowing the exact visual acuity of a prescription, it is difficult to ensure that a patient’s lenses are not contributing to unnecessary accommodation strain, which could lead to worsening pseudomyopia.
5. Over-Correction:
6. Over-correction of myopia can occur when a prescription provides too much correction for the eyes. This can cause visual discomfort, including blurred near vision and eye strain, and may result in a phenomenon known as "lag of accommodation", where the eyes struggle to focus on close objects. By including the visual acuity achieved with a prescription, patients and professionals would have a clear indication of whether the prescription is appropriate, reducing the risk of over-correction and the associated negative effects.

Request for Action:
In light of the above, I respectfully request that the General Optical Council (GOC) consider advocating for the standard inclusion of visual acuity on optical prescriptions. By including this information, patients would have a clearer understanding of their visual correction, and optical professionals would be better equipped to identify potential discrepancies in prescriptions that could affect myopia management.

I also encourage the GOC to explore the development of best practice guidelines that ensure consistency and transparency in the prescription process, particularly for individuals with myopia or other refractive errors. These guidelines could help reduce the risk of inappropriate corrections that contribute to myopia progression or cause unnecessary strain on the eyes.
By adopting such measures, the GOC could greatly enhance patient outcomes and contribute to better long-term eye health, particularly in a time when myopia is becoming an increasingly widespread issue.
Thank you for your time and attention to this matter. I look forward to hearing your views on this issue and would welcome the opportunity to discuss it further.

Yours faithfully,

If there's one thing an optical industry really should be, it's transparent.

@TimetoPour, putting the corrected visual acuity on prescriptions would make a difference in terms of raising awareness on issues regarding the implications of over/under correction in terms of data collation and collection. It would allow more statistical evidence to be available.

In terms of an individual patient it would allow them more clearly to see how their own myopia is progressing (even if they change practitioners) and make more informed decisions with regards of whether to choose and under / over or full correction in relation to their own particular needs and lifestyle. This is better than simply being asked lifestyle questions by the practitioner without knowing the reasons or how the answers would affect the advised treatment.

Isnt that what a prescription is?

@soupyspoon, no a prescription is for the lenses of your glasses. These lenses could be correcting you to normal vision (20/20 feet or 6/6 metres) or greater than normal vision or slightly less than normal vision.

A lot of opticians do put visual acuity on their prescriptions as standard, including big multiples. Getting a patient to have a better visual acuity than 20/20 is a good thing and not overprescribing. It is getting them to see more detail, smaller letters therefore giving them the best vision possible. To not do so would be effectively blurring someone’s vision from its potential.
Opticians are not hiding anything, any if asked would quite happily add it to your prescription. It is your information to have.
I feel some of your comments are like trying to understand optometry without an optometry degree.

So basically, you believe that opticians over prescribe to make money out of progressive myopia. You think you are better equipped to make up your own prescription based on VA and Daily Mail articles. Crack on.

I bet you don’t do vaccines either

So you think that "over-prescribing" for myopia will lead to higher visual acuity, this will show up on the new prescription, and patients will see this and object?

You have absolutely no idea how optics works, do you?

Over-correcting myopia will not increase acuity. That's more-or-less by definition - if the increase in minus improved your acuity then it wouldn't be an over-correction.

The second part of the statement, that the patients will see improved scores and thus object to the prescription, doesn't seem any more likely either!

I actually can't see any problem with putting visual acuity on the prescription, but your reason for it is based on a complete misunderstanding.

@Spamfrit, @TimetoPour, you both misrepresent me.

What I would actually like is for policies to reference myopia progression control programmes such as the ones described in this research:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9213207/

I would like myopia progression control to be available for every patient with myopia without incurring the massive extra costs which the current programmes involve.

@myopinionis, I think you are splitting hairs over definitions. My definition for over prescription is correcting to the level of better than normal vision ( 20/20 or 6/6). I mean someone could go around with binoculars strapped to their face so they could clearly see very small objects on the horizon but that would mean their near vision suffered dramatically.

@myopinionis better than normal vision for distance I mean.

I'm not splitting hairs - the suggestion in your OP is literally that visual acuity is included in a prescription. Seemingly on the premise that this will reveal over-prescribing. That isn't true. The problem isn't that over-prescribing for myopia isn't a bad thing. The problem is that your suggestion to curb it is nonsense.

Increasing or decreasing your spherical correction will not act as binoculars. That would require multiple lenses.

You have no understanding of what you're talking about.

So you want myopia control to be available for all? Misight contact lenses, stellest lenses or their equivalents are available and recommended readily to those that need them.
They come at cost. You want them to be cheaper/free to those that need. Where will this money/subsidy come from?

@myopinionis from your post it would seem you are coming from a professional stance. So as someone in the industry what do you think the implications regarding treating myopia progression with PALs and success being dependent of periodically reviewing and increasing the ADD, as per the study I linked to above? I would appreciate an explanation for all us lay people.

@Spamfrit, the money saved associated with preventing myopia and reducing myopia progression would be massive.

OP I’m curious why you first use a DM article that is THIRTEEN YEARS out of date. Where on earth is this coming from??
Also you might want to change opticians because mine does include what VA they believe you’ve obtained, though that can vary depending on the circumstances.

Also why are you so against myopia progression? I have bad eyesight whether it gets worse or not will not change the fact I need glasses nor prevent me needing glasses.

I’ve lost a lot of money on glasses due to his when I’ve struggled with new glasses - I was told that they are allowed to be out by 1.5 which to me is very noticeable - I think it’s very wrong in all fairness. I need glasses but can’t get an accurate pair of lenses

Not a professional (in this area), no. Just someone who understands enough to grasp your suggestion.

I don't think there are any easy answers. The problem is quite widely understood and talked about; there are products as mentioned above which claim some success in managing it. It probably is driven by too much time looking at screens or other close stuff.

I was more offended by your implication that the industry, and the decent people working in it, are doing this deliberately, and that there is a simple fix for that if we forced it onto them. None of which are true. Also, the idea that getting "better vision than average" might be a bad thing, and a sign your optician is dodgy!

Sorry. No easy answers.

@myopinionis, I know there are no easy answers but lack of transparency within the industry does not help. Yes, I do feel angry that over prescription could very likely be increasing myopia progression on a global scale but I do actually realise the science is still emerging. I also realise that people often simply need to be able to see clearly. However, a lack of transparency within the industry and the professional pride evident in this thread alone will not do any good at all in terms of enabling people to make informed choices concerning their own health.

@TheRoomWhereItHappened,

I have bad eyesight whether it gets worse or not will not change the fact I need glasses nor prevent me needing glasses.

It could prevent you having the other conditions that are associated with high myopia such as retinal detachment, macular degeneration, glaucoma and cataracts.

Can you break down what you mean by ‘lack of transparency in the industry’. Your post is 90% about including visual acuity in prescriptions. A lot of opticians include this information on their prescriptions and if don’t would happily write them down for you.
How is that a lack of transparency?

@Spamfrit inclusion of visual acuity on prescriptions and record keeping as standard is simply what I am asking for. So people don’t need to ask. So that the data can be collected and collated.

Yet there has been much objection to this on this thread. Objection to engaging with the research in the field and wanting to discuss it. Why? The answer to that question is why I believe there is a lack of transparency at the heart of the optical industry. Which needs addressing.

No one has objected to a patient being told their VA. We’ve all said if it isn’t given as standard you can ask and the optician will happily give it.

What is being disputed is the absolute clap trap that it is being hidden so opticians can get away with over prescribing.

@TimetoPour, good, so you’d agree with including corrected VA bring included on the prescription as a professional standard?

Being

Are you being deliberately obtuse? I do not think it is necessary to include a VA on a prescription as standard and you will not get me to agree that it should be.

Should it be available on request- yes.
Do I think patients should be able to request any part of the information on their records - yes
Will giving every bit of information as standard help patients understand their prescription- no
Will giving every bit of information as standard confuse some people - yes
Will giving every bit of information as standard encourage entrenched lunatics in tin foil hats to make crap up that their optician is over prescribing so they spend more money- absolutely.

@TimetoPour including corrected visual acuity on prescriptions as a professional standard does have implications regarding data collection and collation and the statistical analysis resulting from that. Don’t you think that might be useful. It also does have implications regarding quick and simple continuity of care should a patient decide to switch or compare practitioners.

What confusion do you think would be caused by giving corrected VA? How exactly would seeing how their own myopia had progressed over the years encourage the ‘tin foil hat brigade’?