Features

Six months after the law on contact lens supply was changed, the Optician team undertook a major mystery shopper exercise to test how the new regulations were working in practice. Emma White, Rob Moss, David Challinor, Rory Brogan, Alison Ewbank, Chris Bennett and Bill Harvey recount their experiences

New legislation that took effect from June 30 last year marked the biggest change in the UK contact lens market in recent times, when changes to Section 60 of the Opticians Act effectively deregulated contact lens sales.

The legislation required practitioners to provide patients with contact lens specifications once fitting was completed, opening the way to supermarket and pharmacy sales.

On June 30, 2005, Tesco became the first national retailer to offer contact lenses through its instore pharmacies, online and by phone via a dedicated call centre. Asda followed in August with its own online contact lens offer and last month Sainsbury's announced that it too was to sell contact lenses.

Under the new legislation, contact lenses can only be fitted by a registered optometrist, contact lens optician or medical practitioner, as before. Lenses may then be sold either by a registered practitioner or under the 'general direction' of a registered practitioner.

The principal requirement for contact lens sales is that the seller must have an in-date specification before supplying lenses or must verify the specification with the prescriber. Contact lenses for use by children under the age of 16 must be sold by a registered practitioner or under his or her supervision. A further change is that plano cosmetic contact lenses are now regulated in the same way as powered lenses.

'General direction' is taken to mean that, unlike a supervised sale, the physical presence of a qualified practitioner is not required. However, this term is yet to be established in case law. The legislation also states that the seller must make arrangements for the individual to receive aftercare, although again what these arrangements should entail remains unclear.

All businesses in the UK supplying contact lenses must comply with the new regulations. Sales occurring outside the UK, including internet sales, cannot be regulated under this legislation.

Our method

Six months after the law was changed, Optician began a mystery shopper exercise to investigate how the new supply routes operate. The aim was to test whether businesses are complying with the new regulations and to find out how they deal with their customers.

A total of 120 calls were made by members of the Optician team, spread over a six-week period between February 13 and March 29. Each member of staff was instructed to select eight internet suppliers from a given list (see panel) - Asda and Tesco (Sainsbury's was yet to launch its offer), three optical group/practice-based suppliers and three websites - and test out a series of given scenarios.

As consumers might be expected to do, we selected suppliers with .co.uk domains or, in the case of Tesco and Optical Express, recognised UK companies.

Examples of lens types and parameters were provided for each scenario and each mystery shopper visited the website before making a call to check whether the lenses were stocked and what information the supplier asked for.

 In each case, the shopper called the order line given on the website. No lenses were purchased. Detailed notes were kept on each call, including overall trends in responses and individual comments.

Here are the 15 scenarios and what each mystery shopper found.

NO SPECIFICATION

'I wear contact lenses and want to order them from you from now on. I've got the box my last lenses came in with all the details. Will that be OK?'

Four of the eight companies I contacted agreed to send me Acuvue Advance lenses based on the prescription details I read out from my existing boxes of lenses.

Lenscatalogue told me that as long as I didn't live in the US she could send me lenses without verifying my prescription, while Contactlenses went one step further and, as well as sending me Acuvue Advance, was willing to send me Acuvue Oasys to try.

The customer services representative recommended that I visit an optician since 'the base curve is different' but as long as I accepted I couldn't return the Oasys lenses she was happy to send them to me. Visiondirect also agreed to supply me with lenses but advised ordering online, rather than by phone, for a cheaper deal.

Secondsightonline expressed more caution and said that, by law, she would have to contact my optician to verify my prescription but then backtracked and said she would only do so if there was a 'discrepancy' in the prescription details I read out.

'If for example you'd asked for Acuvue Advance with an 8.5 base curve rather than 8.3 then I'd know this product wasn't available so would call your optician. But in your case I'd be happy to send the lenses to you,' she explained.

Among the suppliers who turned down my request was Onestopcontactlenses, run by the 20/20 Optical Store, which insisted I fax or email a scanned copy of my prescription before it would agree to send lenses out. The company also insisted that the prescription must be under 12 months old and that the specification must match my lens order request.

Contactsdirect - a division of James Murray Wells's Glassesdirect - said it needed the name and address of my optician before placing an order, 'to verify your prescription and check your aftercare appointments are up to date'.

Supermarkets Asda and Tesco also refused to supply lenses without a valid prescription or my optician's contact details.   EW

PLANO LENSES WITHOUT FITTING

'I don't need contact lenses to see, so I don't need to go to an optician, but I want to change the colour of my eyes. I know the type of lens I want so can I order them from you?'

I received mixed responses from companies to this question. Of the supermarkets, Asda was willing to take a telephone order for CIBA Vision FreshLook Colors without prescription or suggested I visit the website to place my order.

Tesco, meanwhile, gave me a firm 'no' and insisted on a valid prescription.

Visiondirect told me it wouldn't be a problem to send me plano coloured lenses without fitting by a practitioner because I had said I didn't need a prescription pair. But if I had a problem with the lenses I would need to supply a prescription in order to return them.

Coastalcontacts recommended that I visit my practitioner to check the base curve of the lenses fitted my eyes but was still happy to sell the lenses to me without verification. AC Lens also agreed to send out lenses without prescription.

Contactlensestoday - the online division of the Nottingham independent, Kings Walk Contact Lenses - explained that I would need to make an appointment with the practice 'to have my eyes looked at' and to check whether I needed prescription lenses.

Onestopcontactlenses and Secondsightonline also declined to take an order without a valid prescription or my optician's contact details.   EW

SUPPLYING BEYOND EXPIRY DATE

'I've just had my contact lenses checked and my optician has given me my details but the prescription runs out in six months. It's cheaper if I buy a year's worth of lenses. Is this OK?'

The two supermarkets appeared to be at odds as to whether this would be legal. Tesco told me firmly that it would only be able to supply me with lenses for the next six months and that if I wanted more I would have to have a contact lens check- up.

Asda, however, was only too happy to supply me with one year's supply, although the call centre advised me to supply an address where someone would be there to receive the order as it would be quite a big box.

Specsaversdirect could not supply me with a year's worth of daily lenses, but could do six months: 'Yes, we're allowed a 28-day buffer, so that would be fine.'

Postoptics told me that it 'shouldn't be a problem'. When I said that another company had told me they couldn't give me a year's worth because the prescription expired before one year was up, the operator sounded less sure and asked me which lenses I needed. I told her SofLens One Day. She put me on hold to double check before returning to tell me, 'Yeah, that's fine.'

I told Secondsightonline I wanted to buy a year's supply but that I was worried I might not be able to because my prescription expired in August.

She said: 'We do have boundaries but we don't have to be as strict as the high street, so yes, we would be able to do that.' Contactlensestoday said that as long as I had my current prescription, a year's worth was fine.

AC Lens responded, 'No problem' to my request, whereas Visiondirect went one better: 'No problem at all.'   RM

SUPPLY AFTER CHECK-UP IS DUE

'I have a prescription for my contact lenses but apparently I was due for a check-up last month. Can you still sell me some lenses?'

Asda's policy this time was pretty robust. I was immediately told that I would have to have a check-up, either at Asda or at any other optician.

Tesco told me the same, as did Specsaversdirect. But once I called the contact numbers of .co.uk websites that are not based in the UK, an out-of-date prescription did not present a problem.

Coastalcontacts in Canada had processed my order in two minutes - 'Sure, I can do that for you', while Yourlenses in Sweden said it was best to go through its website but that it was fine.

Ohio-based AC Lens was quick to tell me that if my prescription was out of date I would need to see my doctor. It was only when I queried 'doctor' and asked her if my optician would do, that she realised I might not be in the US. 'Oh, well, if we're shipping to the UK then we wouldn't need to see your prescription. If we were shipping in the US, you would need to see your eye doctor.'

Similarly, US-based Lenscatalogue said: 'Because we're in the US, we don't have to verify opticians' details, so yes we would be happy to supply you.'

Back in the UK, Contactsdirect told me that all orders were checked with the customer's optician, so it could not supply me. For Contactlenses, based in Bristol, though, it didn't matter that my prescription was out of date. 'It matters for yourself, for the health of your eyes, but as an internet company we don't have to see your prescription.'

When I told her that Specsaversdirect wouldn't supply me, she repeated, 'Yes, but because we're an internet company we would be able to do that for you.'  RM

SWITCHING BRANDS

'I wear Acuvue lenses but I've noticed that they're more expensive than other lenses. Is it OK to switch to something else?'

Tesco told me that it was alright to switch to another brand as long as I made an appointment with my optician and tried the lens type I'd like to wear, 'just so the optician knows they're OK to use in your eyes'.

She told me that opticians liked to trial new lenses for three months. 'Once you've completed that trial and you tell them the new ones are OK, they can change your prescription for you.'

Asda broadly gave the same message, telling me that its website offered other monthly lenses at £27.92 for six pairs. Asked whether it was OK to switch to something cheaper than Acuvue, a customer advisor told me: 'No, you need to wear them before we can supply them for you. If you're only wearing Acuvue lenses other lens types might not come in the same base curve and diameter, so you might not be suitable to wear them. Also the lens material would be different.' Specsaversdirect also said I would have to consult my optician first before I could have cheaper lenses.

Stockholm-based Yourlenses told me - in very broken English - that switching lenses might irritate my eyes, so it would be best to contact my optician to try the lenses before I buy. However, she added, I could choose to go ahead and buy, but 'it's your risk and you don't have return rights if they are not good for you'.

When I asked Optical Express's call centre worker whether it was alright to switch to something cheaper than Acuvue she told me: 'Unfortunately, that's not advice I could give you over the phone. You would have to make an appointment to see an optician to find out what other types of lenses you might be suitable for.'

Optical practice-based Contactlenses-today suggested that the company refitted me with 'more budgetable' lenses or the other option was to pay by direct debit to bring the price down more. Visiondirect also said that I could not switch brand, and suggested I see an optician.

The customer adviser for Secondsightonline said there were 'a couple of pitfalls' to switching brands'. She said that Acuvue was the top brand and that was the reason for the higher price. 'Maybe [with] a CIBA or Bausch & Lomb [lens] the quality may not be as good,' she added. I was also warned about suitability of lens fit. 'Jumping brands is even more difficult in your case because Acuvue is J&J. If you were using an own brand, such as Specsavers, we know they're compatible to CIBA, but with J&J that's a little bit different.'    DC

SWITCHING FROM OWN BRAND

'I wear Boots Near and Far contact lenses and want to order some more lenses. Can you supply me with these?'

In terms of switching from own brand, OKvision said it could supply me with Boots Near and Far lenses, and asked for a number to call back. They did but another representative insisted I have an appointment with my regular optician before I placed an order.

Tesco replied: 'It depends what the equivalent of [Boots Near and Far] is. I think it's CIBA but you need to double check with your optician, because I'm not sure. You could place an order for CIBA because we'll double check [it's the right one] with your optician anyway.' In response to a final question: 'So I can't do this over the phone and just give my prescription and you send them along,' the adviser gave a firm 'no'.

Asda advised me to mark the order as 'own brand' and said once it was received the company would contact my optician to confirm the lens type.

Specsaversdirect said it couldn't supply a Boots own-brand lens, but when quizzed if it could supply an equivalent lens, such as a CIBA lens, for continuous wear (although Near & Far is a daily wear lens), replied: 'Yes, we do a CIBA Night & Day'. You can order this if your contact lens prescription is valid.'

US-based Lenscatalogue had never heard of Boots Near and Far, but responded positively when asked about CIBA Vision Focus Progressives.

When I asked whether I should send my prescription, I was told: 'You don't have to send your prescription in because we're sending out to the UK.' Another US company, AC Lens, did not stock Boots own brand but also said I could order Focus Progressives via its website using my prescription.   DC

RE-USING DAILY DISPOSABLES

'My optician says I have to throw my Focus Dailies away each day. Is it OK if I sometimes wear them for more than a day?'

Reassuringly, all eight companies contacted said that they would not recommend that I wear my daily disposables for more than a day, as the lenses were only designed for one-day use.

Tesco commented that on taking my daily disposables out before going to sleep I should throw them away as 'they would damage your eyes after the one-day period because they are not made for more than that'.

While Asda and Contactlensestoday simply remarked that they should only be worn once, Postoptics advised that if I wanted something that lasted longer, I should think about a two-weekly or monthly lens.

Similarly, Onestopcontactlenses suggested I try fortnightly lenses and advised me not to wear daily disposables for more than 14-16 hours a day.

'Dailies are good to pop in and throw away, without solutions, if you want to wear them for sports or casual wear.

'It's probably best to speak to your optician. If you want to keep a lens or wear for more than a day you need to look at monthly or fortnightly lenses.'

Another company to recommend speaking to one of its optometrists or to one of its stores was Optical Express, while also pointing out that it would not advise anything other than daily wear of daily disposables.

Secondsightonline suggested I could take the lenses out and re-wet them during the day, but not to try to keep them longer as they would start to deteriorate after a day. 'Dailies really wouldn't be wearable as they are so much thinner than monthlies.'

Again, Visiondirect commented on the fact that daily disposables were a different technology, when saying that they could not be worn for more than a day.

'They're not designed for that and if you put them in solution overnight they would change shape and might break down as Dailies could not sustain being cleaned.'     RB

SWITCHING BASE CURVES

'It says on my specification that I need an 8.5 lens but I gather my lenses are only available in an 8.6 fitting. Will this be OK for me?'

The first of three US companies contacted, Coastalcontacts, was quite happy that I change the base curve of my CooperVision Proclear lenses, saying that 8.5 and 8.6 were close enough. 'If you are in the UK you can order pretty much what you want - 8.5 is pretty close to 8.6.'

However, AC Lens explained that 'in this situation only your doctor can determine if that fitting will be okay for you', and Lenscatalogue said that they could not advise me.

'We direct all our customers to their eye doctor. Within the US we can only fill the order directly as listed, as it might not fit you. We don't verify that, so it is better that you check.'

Again, Secondsightonline, which said it was 'having a big run on Proclear', said that I would have to go for a contact lens check-up if I wanted to change the base curve.

Specsavers explained that I would have to have a prescription for the exact lens, saying that to change from one lens to another would result in a different fit. I could go to an optician and have a trial of the 8.6 base curve. OKvision simply said: 'You can't just choose which lenses you want. You go with what you've been prescribed.'

Contactsdirect said I could only order the same make and brand, which would be checked with my optician, but added that if the information was incorrect they would not necessarily be told what the difference was.

Contactlenses suggested there was not a huge difference between 8.5 and 8.6, adding that there were not many other lenses with a 8.5 base curve. 'I cannot say 100 per cent that you will be okay with the fit, but most people are able to swap between the two.'   RB

CHANGING WEARING MODALITY

'I wear CooperVision Frequency 55 lenses. I want to keep them in all the time rather than taking them out each night. Is this OK?'

Of the eight suppliers contacted, only one, Postoptics, assumed that I had bought lenses from them before and asked for my postcode so they could look up the details. The other seven offered advice regardless of whether I was an existing customer, although Tesco subsequently asked if my prescription came from Tesco Opticians.

All the suppliers gave similar responses, each explaining that it was up to the prescribing optician to recommend whether lenses could be worn overnight, and advising me to return to my optician.

Some went further in offering advice than others. At Asda, the operator looked up Frequency 55 and said that, as far as he knew, it was 'a 10-hour or 12-hour lens'. After putting me on hold, he came back with the advice that the lenses could be worn for a maximum of 9-10 hours per day.

Tesco's customer services operator said that he was not an optician and only had information about products, but that the answer was 'probably no'. He added: 'We usually have a resident optician here but he's at college today,' and suggested calling back to speak to the optician another day.

The optical mail order companies and websites were generally better at explaining why the lenses should not be worn overnight. Specsaversdirect said that they might damage the eyes and Contactlensestoday took time to explain the regulations governing contact lens supply. OKvision was among those pointing out that lenses needed to be individually prescribed. 'It's a question of fitting as well as suitability,' it said.

Coastalcontacts' response was less reassuring. 'We just sell the contacts, we don't prescribe them, so we can't really say,' said a helpline operative somewhere in north America. 'It's up to the doctor - if he recommends that it would be OK.'  AE

CHANGING THE REPLACEMENT SCHEDULE

'I wear Acuvue Bifocal lenses and replace them every two weeks. Can I wear them for a month at a time to save myself some money?'

Asking about changing the replacement schedule elicited a similar response to the previous question. Most of those contacted warned against using the lenses for longer than two weeks.

The exception was Contactlenses who said: Off the record, they're made the same as a monthly lens. If they're chipped or torn you should throw them away but otherwise there's no reason why you can't wear them for three or four weeks - up to a month at the most.'

'A lot of the Johnson & Johnson lenses used to be monthlies but they've changed them to two-weekly. It's really down to sales that opticians recommend you replace them every two weeks,' she said. Visiondirect offered similar advice, explaining that in some countries the lenses were monthly and in others they were weekly. 'It's just marketing really,' I was told.

Among the other suppliers, there were some interesting differences in how the enquiry was handled. At Contactsdirect, the company's dispensing optician launched into a complicated explanation of lens deposits, mentioning 'calcium, protein, fats and lipids in the tear film that attach to the lens surface'.

However, this company was also sympathetic. 'I'm not going to say categorically that you can't use them for three weeks. It's a bit like "how long's a piece of string?". What I can't remember off the top of my head is how long they're licensed for,' he said, adding that his technical knowledge of contact lenses was 'a bit rusty'. The DO's advice was to go back to where the lenses were prescribed and ask for the optician. 'It's no good talking to the receptionist,' he added helpfully.

Asda took a different tack. 'There are monthly bifocal lenses out there, such as Focus Progressives and SofLens Multifocals, but you'd have to try them first,' said customer services. 'Go back to your optician and see if they do any monthly lenses - if not, you could try another optician or go to your local Asda optician.'

Optical Express asked whether I'd ordered lenses before then put me through to my local branch. 'If you wear them longer than two weeks they'll dry out,' they said. 'You'll need to be fitted with a monthly lens.'

Onestopcontactlenses suggested that the lenses could break up in the eye if worn for longer than two weeks and recommended going back to my optician for monthly lenses.
'Just bear in mind you'll need to use more solutions with monthly lenses,' they added confusingly.  AE

SWITCHING THE CARE SYSTEM

'I'm using AOSept to store my contact lenses at the moment. My friend uses Opti-Free Express and says it's easier to use. Is it OK to switch?

With this scenario, it was surprisingly hard to find suppliers who supplied both solutions. Tesco only delivered solutions under their 'Groceries' service and advised me to speak to my optician about switching brands. 'We're only a helpline,' they said. The only multipurpose solution (MPS) stocked by Asda was ReNu MultiPlus. The customer services operative said that it would be OK to switch, although she recommended buying a travel pack to try first.

Specsaversdirect listed only the own-brand Easyvision MPS, described on its website as 'manufactured exclusively for [Specsavers] by the UK's largest contact lens solution manufacturer'. When asked what the solution was, customer services was unsure: 'It's just a general solution. I don't know if it's the same as any other brand.' 

They recommended speaking to my own optician and said switching solutions depended how sensitive the eyes were.

Postoptics, which carries many of the current MPS, was less cautious in its approach. Was it OK to switch to OptiFree Express? 'Yes. That's absolutely fine. It doesn't matter what solution you use. We're out of AOSept anyway,' it replied.

Contactsdirect listed a range of solutions but not Opti-Free Express and said that AOSept was not being manufactured at the moment. 'You just want an MPS? The best one would be AMO Complete - I use it myself,' she said, adding, 'It's fine to switch solutions - I use whatever I've got.' This was the only supplier I contacted who asked what type of lens I was using.

The Optical Express site lists Complete, ReNu and its own-brand Ciel All in One. When I asked for advice I was put through to my local Optical Express who seemed surprised to receive my call. 'It really depends. Perhaps it's best to talk to your contact lens practitioner. They could get you a bottle to try before you order,' she said. 'Ciel is the same as the Sauflon solution - it's a very good make. Some get on well with this and some can't tolerate it, so it's best to try it out first.'  

Despite the company having a mailing address in Oxford, the operator at Lenscatalogue in Ohio said that it wouldn't be cost-effective to ship solutions from the US and was unaware of the UK address on its website. A wide range of solutions is listed, many of which are not available in the UK.

Contactlenses stocked only ReNu MPS, Complete and Opti-Free Express. Here, I was advised not to switch to Opti-Free part way through the lens cycle and to stop using the solution if I experienced irritation.
'Most solutions are pretty much the same now but some of them have preservatives in them. AOSept also has preservatives in it,' I was advised (incorrectly), 'so it shouldn't be a problem.'  AE

A PROBLEM WITH THE EYES

'I buy my lenses from you and want to order some more but I have a problem with my eyes. Can I speak to your optician?'

I called a number of web suppliers and said having bought my lenses from them last autumn, I had a sore eye and wanted to talk to the optician. This was clearly a question none of the suppliers had any intention of handling over the phone. The advice from most of the companies I called was to go and see my optician. Even those with qualified staff on site or with their own practices gave this advice.

After negotiating Tesco's call handling system I was finally connected to an operator. She said that although Tesco did have opticians I should see the practitioner who had supplied the prescription. As its optician had not actually seen my eyes they wouldn't be able to comment on any problems.

At Asda, the operator said although there wasn't an optician available at the moment if I left my number she would get one to call me back in a couple of hours. The optician would be happy to discuss any problems I had.
The Specsaversdirect operator immediately said I should contact my local optician. When I said I had bought the lenses over the internet with a prescription I had got from a non-Specsavers' optician she advised me to go back to the optician that had issued the original prescription.

Contactlensestoday answered my call with a practice name (King's Walk Contact Lenses) and the receptionist explained that it was a practice with a web contact lens service. She immediately passed me over to an optician who identified herself as Annette and started to ask specific questions about my problem. She offered me the opportunity to come to the practice, but when I said I wasn't local suggested I went back to my own practice.

The operator at Contactdirect said I had to talk to my own optician, explaining that the company was not an optician but simply sold the products. 'If you are having any problems with your lenses you have to go to them [my optician]'. She referred me to the care card sent out with the lenses which specifically stated that should a problem arise the wearer should go to their prescribing optician. This, she said, was because I could have an eye infection and the problem might not be anything to do with the lenses.

Contactlenses said the optician [Mr Dreyer] wasn't around at the moment but would be back later that afternoon if I wanted to call him. She suggested it was better for me to go back to my own optician who had seen my eyes before and would be better placed to help.

Despite its UK web address, Coastalcontacts is a US-based site. Getting hold of the right number is not easy and having got a call tone I waited an age for an answer. A nice American lady informed me that I had reached a call centre and they didn't have any opticians on site. She told me to take the lenses out and then proceeded to ask question about redness, discomfort and the onset of the problem. If I wanted I could send the lenses back to see if there was a problem with them and I would get a full refund. She clearly didn't understand the prescribing set-up in the UK.

When I explained the 'problem' to Optical Express, the operator asked where I lived and transferred me to the Shaftesbury Avenue branch. The man who answered the call had no idea where I had been transferred from and asked a few questions about my problem. He suggested I took the lenses out and came to the practice. When I explained I was not local he suggested I saw my own optician.

At Postoptics, the operator said: 'We don't have an optician here, we are an ordering service. We can only supply you with lenses from here.' She said Postoptics' role was supplying people who were already under the care of an optician. If I had any problems she suggested I go and see my optician. That would be the person who issued my prescription, she said.  CB

SUPPLYING CHILDREN

'My daughter is 13 and wears soft contact lenses. She's just had her lenses checked and has all the details from her optician. Can I buy her next lenses from you?'

In almost every case there was much less difficulty in ordering lenses for my daughter than I had expected. The exception to this rule was also the first place I contacted. Tesco assumed a very rigid response. After rechecking the age of my child, the operator said, 'You will have to visit a Tesco optician,' and went on to state that, 'in any case, we do not recommend contact lenses to anyone under the age of 16 as their eyes are still changing'. Asda said there was no problem as long as the prescription details were up to date. They had lenses in stock to her prescription and would be able to forward these in the next couple of days. I would need to fax through a copy of the latest prescription to proceed.

Onestopcontactlenses was very amenable. They instructed me to go to the website, put in my daughter's details and respond to the prompt to fax over her current prescription.

There is no age limit for lenses to be supplied, and they can supply one, six or 12 months' worth of daily lenses. When I suggested that, as the prescription was already over a month old, this might not be a good idea for a child, I was offered the advice that 'a child's eyes do not change that much'.

Visiondirect also suggested 'no problem' in supplying 12 months of lenses as long as I had an up-to-date prescription for my daughter. 'You should fax us over a prescription but, to be honest, all we do is file that away.'

Specsaversdirect said there would be no problem in supplying lenses to me for my daughter as long as I sent them a valid prescription. I asked whether there would be any lenses more comfortable than the Dailies my daughter currently wore, hinting that she was having some discomfort towards the end of her wearing day.

The customer services operator asked me how uncomfortable she was and how long she wore the lenses each day. She then said: 'We don't recommend wearing times for children of longer than 10 hours,' and suggested we consulted our optician for further advice.

Three other suppliers, Coastalcontacts, OKvision and AC Lens, all suggested they could supply on submission of an up-to-date prescription.   BH
 
RGP LENSES

'I wear Boston gas-permeable lenses. Can I buy my lenses from you?'

Four of the eight suppliers contacted (Tesco, Contactdirect, Visiondirect, Contactlenses) came straight back with a firm 'no' to this request. Asda suggested that, were I to send more details, they would try and source some lenses for me. Opticalexpress said it was not sure and transferred me to a practice near home for a talk with one of its professional staff. Specsaversdirect likewise suggested I went in to the nearest of its stores for advice.

Contactlensestoday were very helpful. I was handed over to an optician who stated that soft lens supply was straightforward via the website, but for gas-permeable lenses I would need to fax him more information about the material and size of the lens, such as 'whether they are low permeable or high permeable'.  BH

'PRACTITIONER ONLY' LENSES

'I wear Sauflon New Day disposable lenses. Do you stock these?'

These lenses were generally unavailable through the suppliers I contacted. Asda and Tesco both stated that they 'did not have an account with that company'. Specsaversdirect said it had not heard of the lenses and after a short wait added, 'We do not stock any equivalent lenses - sorry'. Coastalcontacts, OKvision and Lenscatalogue just said 'no'. Onestopcontactlenses said it was not sure whether it could supply the lens and took my details so that an 'IT optician' (sic) could get back to me.  BH

OUR CONCLUSIONS

So what did we learn from the mystery shopper exercise? Although no lenses were purchased by any of our shoppers, our contact with suppliers suggests that some may not be operating within the law, although others take a responsible attitude to the type of products they are selling.

Had we gone ahead and purchased lenses it is possible that, in some cases, the outcome would have been different. Yet even among those suppliers who do appear to be complying with the law, bad practices clearly exist. Some companies are going against the recommendations of the prescribing practitioner and issuing inaccurate, misleading or inappropriate advice.

The supply of lenses without a valid or in-date specification or without verification and unsupervised sales to children are obvious areas of concern. But we were also concerned about suppliers offering contact lens wearers advice on modality, wearing times, replacement schedules and care products, without the recommendation of the prescribing practitioner and, in some cases, contrary to the licence for the product.
Sales occurring outside the UK cannot be regulated under the new legislation but it is difficult for consumers to determine which suppliers come under UK law and which don't.

Our findings suggest that although buying contact lenses from internet suppliers may have perceived cost and convenience benefits for consumers, from the point of view of safety and ocular health they would be far better purchasing from conventional supply routes.

Research in Australia would seem to support this suggestion; daily wear soft contact lens wearers who buy their lenses over the internet have a  higher risk of having a serious eye infection than those who do not use this route. 

The meaning of 'aftercare' arrangements and 'general direction' are among the principal grey areas under the current legislation. The regulations state only that the seller must make arrangements for the individual to receive aftercare 'in so far as and for so long as may be reasonable in his or her particular case'. The legal requirements of a generally directed sale remain unclear.

Last month, the GOC announced that it was looking at ways to address the issues raised by internet and mail order sales of contact lenses. Our view is that, in the interests of patients, a review of current practices among these new supply routes cannot come soon enough.

 

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