Reply to Andrew Matheson

Andrew Matheson makes some good points in his letter, Postcode lottery causes confusion, and I agree that it is wholly unacceptable for the NHS to interpret the guidelines differently in different areas, the Memorandum of Understanding on Sight Test Intervals should be reviewed urgently and incontrovertible advice agreed between the Optical Confederation and Department of Health.

However I would take issue with his claim that patients choosing to pay for interim examinations would thereby forfeit their NHS entitlement, this would only be true if  private 'sight test' was undertaken. If we remember that the Opticians Act defines the sight test as investigation to see if vision correction is required and with the intention to prescribe for that purpose, then we can quite happily see our patients privately for any number of examinations (of their soft drusen or VMT or for any other reason) and simply avoid refraction, an examination to see if the eyes are healthy is not a Sight Test. Surely this is the basis of NHS England's gripe about too frequent use of GOS, but they can't have it both ways, and so it would be quite legitimate to use the GOS for the sight test when due/needed..