Updates

Background

Optometrists and ophthalmic medical practitioners are best placed to decide whether a patient needs to be tested and how frequently.

It is a longstanding and agreed clinical principle then that sight test/eye examination intervals should be a matter of clinical judgement based on an assessment of the patient's needs [1-4]. 

When examining patients eligible for an NHS funded General Ophthalmic Services (GOS), clinicians should also be mindful of the Memorandum of Understanding (MOU) on sight test intervals.

MOU on sight test intervals - England and Wales

A working party comprising FODO, AOP, the College of Optometrists and the Department of Health reviewed and reported on good practice on sight test intervals in 2002 [5]. The working party recommended the minimum intervals between sight test for which GOS claims would not normally be challenged:

• Under 16 years, in the absence of any binocular vision anomaly, 1 year
• Under 7 years with binocular vision anomaly or corrected refractive error 6 months
• 7 years and over and under 16 with binocular vision anomaly or rapidly progressing myopia, 6 months
• 16 years and over and under 70 years, 2 years
• 70 years and over, 1 year
• 40 years and over with a family history of glaucoma or with ocular hypertension and not in a monitoring scheme, 1 year
• Diabetic patients 1 year [6].

It was noted that practitioners would still have to satisfy themselves that a sight test at whatever interval was clinically necessary and that these intervals did not automatically apply to all patients in each category.

If an NHS sight test is clinically necessary more frequently than these intervals, any GOS claim form has to be coded to explain the reason for the earlier test [6].

Read the MoU and the Optical Confederation's reminder on the MoU following new Scottish contract guidance in 2012.

Northern Ireland

Read MOS/275, which sets out the minimum GOS sight test intervals in Northern Ireland.

Scotland

In Scotland, the intervals between primary eye examinations are specified in Appendix B of PCA(0)(2019)02 and if an early test is required the relevant reason code must be recorded. Read Appendix B.

Other guidance

College of Optometrists Guidance for Professional Practice has recommended sight test intervals in the absence of clinical indications to help inform decision making. Read the College's recommendation on the frequency of eye examinations [7] and clinical circumstances which may justify an earlier recall [8].