If your optometrist feels that you do not need glasses or contact lenses and that your eyes are healthy, he or she will give you a note that explains this. You should then be encouraged to have another eye test in two year's time.
If the optometrist thinks you need glasses or contact lenses, they should give you a prescription, an explanation of the kind of glasses you need and why you need them, and a paper copy of the prescription.
This prescription will enable the optometrist to arrange for a pair of glasses to be made for you.
You are under no obligation to have the glasses made by the optometrist who tested your eyes. You could take the prescription to another optometrist and they should be able to make the glasses for you.
If the optometrist thinks that you don't need glasses then they should also give you a statement that says this.
If the optometrist has detected signs of an eye condition, they should refer you for more tests, usually to an ophthalmologist in a hospital.
Referrals on to the other eye care providers
There are three ways the optometrist can refer you on for further examinations:
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directly to your local accident and emergency department as an emergency
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directly to the hospital eye department
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to the hospital through a letter to your GP.
Emergencies
If the optometrist is very concerned about the health of your eyes, or notices anything they think needs urgent treatment, they may write you a letter to take to your local accident and emergency department (A&E).
In some cases, the optometrist may phone the hospital and ask them to see you. This kind of referral is not very common and would only happen if the optometrist thought you were at risk of losing sight in a short space of time.
If you suddenly lose sight or experience very blurred vision in one or both eyes, or experience severe pain in your eyes, then you should attend your local accident and emergency department (A&E) rather than an optometrist.
You should also attend A&E if you have an accident that involves your eye.
This could include cuts to your eye or eye lids, heavy impacts around your eye, accidents where dangerous chemicals spill into your eye or the eye area or accidents where large foreign objects penetrates the eye.
Each local A&E department will have an ophthalmologist on call that will be able to examine your eyes. If treatment is needed straight away, you may be transferred to another, probably more specialist, hospital where this can take place.
Referral to your GP
The most common referral that an optometrist will make is to your GP. The optometrist will write a letter to your GP telling them what condition they have detected in your eyes.
This letter may also include their recommendation of which clinic you may need to be seen at.
Your GP can then refer you on to the hospital. Many conditions need to be seen at the hospital but there is no need for them to be seen straight away. This would be the case for conditions such as cataracts.
Follow-up appointments
Sometimes the optometrist may ask you to come back in a few months so that they can see if there has been any change in the condition of your eyes.
An example of this would be where eye pressure is slightly raised. While not necessarily a sign of an eye condition, the optometrist may want to observe change in the eye over a period of time to rule out related conditions such as glaucoma.
What if I'm not happy with my treatment?
There are a number of reasons why you may not be happy with your visit to the opticians.
You may not be satisfied with the advice you have been given, with the glasses or contact lenses you have been prescribed or the conduct of the optometrist who saw you.
In all cases the first thing to do is to talk with the manager of the practice and explain your problem.
Optometrists are encouraged by their professional bodies to try and resolve problems in a friendly face-to-face way. No one wants to have to deal with an official complaint.
The most common complaint is that someone feels the glasses are not working as they expected.
The practice will offer a retest free of charge to try and understand the nature of the problem. It is quite common in some cases to need to adjust the prescription after it has been worn and problems become apparent.
If you are not confident with the advice you have been given or the conduct of the practitioner you need to ask the manager to address this.
If you cannot reach an amicable agreement with your practice, you can refer the matter to your local Trading Standards Officer if your complaint is commercial in nature, for example if the frames have broken.
Your local Primary Care Trust will have a complaints procedure through the Patient Advice and Liaison Services (PALS) aimed at resolving clinical issues.
Alternatively, you can ask the advice to one of the following bodies:
Optical Consumer Complaints Service
PO Box 4685
London
SE1 6ZB.
The final arbiter of serious professional misconduct is:
The Registrar
General Optical Council
41 Harley Street
London
W1N 2DJ
If you would like a second opinion, this is not available to you under the NHS. You will need to find another practitioner and pay for this service.
What happens next
If your optometrist feels there is a problem with your eyes and refers you on for further tests, there may be some time to wait before your hospital appointment.
Your feelings
Being told that there is something the matter with your eyes, but not being given much detailed information can be worrying. It is natural for you to feel upset, frightened or uncertain at this time and talking over your worries with your family and friends may be helpful. RNIB has an emotional support telephone service for people struggling with coming to terms with their sight loss.
Finding out more
One reaction to this uncertainty is to get information. In some cases this may be easy, particularly if the optometrist has told you that you may have a particular eye condition.
However, if the optometrist is not certain what condition is affecting your eyes and has only given you a vague description, it may not be easy to find accurate information until you have been given a diagnosis by a hospital ophthalmologist.
Obviously, gathering as much information as possible before your hospital appointment is natural and understandable. However, it is always worth bearing in mind that, until the ophthalmologist has given you a diagnosis, the information you have gathered may not all be relevant to your case.
It may be useful at this time to plan your visit to the ophthalmology department - our information on visiting a hospital offers gives some useful tips. In particular, working out some of the questions you may want to ask the ophthalmologist about any eye condition they may find.
If you are unfamiliar with how hospitals work, Who's who in eye health explains the roles of different health professionals.
Sources of support
For advice and support with coping with your eye condition and with leading an independent life, see our Sources of support pages.