Is history about to repeat itself? Optometry has, in the past, been guilty of not pro-actively taking the lead in determining its own future, only to find that fundamental changes have taken place and rocked our foundations. For example, the loss of our monopoly on selling contact lens solutions and on supply of reading glasses, and our need to issue prescriptions to patients to facilitate eyewear purchases from a third party.

Each time, we have taken little or no part in the debate on whether these things should happen or not. After being ambivalent in the first instance, we have then done spectacularly well moaning about the outcome. Every time, we bury our heads in the sand and pretend nothing is going to happen or affects us. Why have we failed to learn from history? It is clear from the fact that so few people could be bothered to respond to the GOC’s call for views on the prospective changes that those that seek change have been handed the best argument that they could wish for: optical professionals do not care whether there is change or not, especially the changes that have been aired. The lack of argument against the changes suggests that the optical profession does not see the proposed changes as a threat to the public and, hence, there is little reason why they should not be implemented. Whether we agree with this or not is now a moot point given the evidence would appear to favour the side of those pressing for change and de-regulation.

Due to our apathy, we have firmly placed ourselves on the back foot yet again. What is just as big a worry is that many of the arguments that were made appear protectionist. In the modern age, life is all about giving people choices. It is difficult to argue that optometrists should be the only ones to carry out refractions and issue prescriptions for spectacles when millions of people in the world wear spectacles derived from prescriptions issued either by a non-optometrist or by an autorefractor. Also, given the evidence shown in Optician (22.07.2022) that 2.3% or 500,000 eye examinations resulted in the need for a prescription recheck, it could be argued that a lot of the time optometrists are not that good at getting accurate refractive results either. A further point is that the figure of 2.3% is probably low in that not all prescriptions issued may necessarily result in the person buying new spectacles and, hence, there could be just as many people out there who have wrong prescriptions but avoided problems by just not choosing to buy new spectacles. This further lessens the validity of our argument.

The argument that refraction must be aligned with a full eye health check also does not stack up. In other areas of the world where the two are not linked there is no conclusive evidence that eye health is worse. In fact, linking the two may well be detrimental to the patient in that, as we know from previous research in this country, many people avoid having an eye health check because of the link to refraction and the fear they will be told they need spectacles when they feel they do not or they cannot afford them. This is particularly true at this time of financial crises. In truth, if an eye health check could be obtained free of charge without the need for refraction being linked, there is a strong possibility that more people would come forward and thus avoid the possibility of eye disease going unnoticed.

Given that so few in the optical profession seem bothered by any of this, maybe we should not care as much what the outcome is. However, what is important is that the patient’s best interests come first. Will opening refraction to all really make a lot of difference to the public? It may well bring about a massive fall in the price of glasses, which is a particularly good thing for the public. Will it increase eye disease? There is little evidence for that, if any. There are ways of legislating that refraction must only be undertaken when there is evidence of a recent eye health check. That is not difficult. What patients are entitled to is choice, but that should be an informed choice. Perhaps we should now be concentrating on how best that informed choice should be created and given to the public.

Unfortunately, few of us would seem to care either way according to the recent evidence. Eternal shame on us.