Lambeth, Southwark, and Lewisham LOCal Optical Committee
My Local Optician

General Ophthalmic Services (Sight Testing)

General Ophthalmic Service

What is available under General Ophthalmic Service (GOS)

Under the Sight Testing Regulations 1989, when a practitioner is testing sight they have to carry out:

(1) an examination of the external surface of the eye and its immediate vicinity
(2) an intra-ocular examination, either by means of an ophthalmoscope or by such means as the doctor or optician consider appropriate
(3) such additional examinations as appear clinically necessary for the purposes of detecting signs of injury, disease or abnormality in the eye or elsewhere.

Under the contract, a contractor may not seek to mislead a patient about the availability, quality or extent of services available under these arrangements.  This does not however in any way rule out contractors offering services to the patient privately which are not part of GOS as they have always done.

Frequency of NHS Eye Examination

There are guidelines that determine the minimum interval between eye examinations, when performed as part of GOS.

Recommended Minimum Interval between eye tests are:
Under 16 – 1 year
Between 16 years and 70 years – 2 years
70 years and over – 1 year
Over 40 with a family history of glaucoma – 1 year
are Diabetic or have Glaucoma – 1 year
have Ocular hypertension and not in a monitoring scheme – 1 year

In certain situations an early test may be conducted.  These conditions are: -

1. Patient is at risk of frequent changes of prescription for reasons not requiring medical referral or for reasons already known to a medical practitioner.
2. Patient has pathology likely to worsen, e.g. ARMD, Cataracts, Corneal Dystrophy or Congenital Anomalies
3. Patient has presented with symptoms or concerns requiring ophthalmic investigation
3.1. Resulting in referral to medical practitioner
3.2. Resulting in issue of changed prescription
3.3. Resulting in either no change/referral (patient records should show any symptoms to support this claim)
4. Patient
4.1. needs complex lenses
4.2. has corrected vision of less than 6/60 in one eye
5. Patient has
5.1. Presented at the request of a medical practitioner
5.2. Is being managed by an optometrist under the GOC referral rules. E.g. suspect visual fields on one occasion which is not confirmed on repeat, or abnormal IOP with no other significant signs of glaucoma
5.3. Identified in protocols as needing to be seen more frequently because of risk factors
6. Other Unusual circumstances requiring clinical investigation

Referral & GP Notification

In line with previous Terms of Service, the contract requires a contractor/performer to refer the patient to an ophthalmic hospital, which includes an ophthalmic department of a hospital, on finding signs of injury, disease or abnormality, if appropriate.  However the guidance issued by the Department of Health states:

“Equally, if it is appropriate to refer the patient to a GP or another optometrist then they may do that.  The decision on where it would be appropriate to refer the patient will be determined by the particular case and justified by the practitioner in their patient notes.  Referral should always be appropriate for the particular patient.”

As health care professionals, practitioners should continue to make referrals in the best interest of their patients.

Minor Eye Conditions

Some eye conditions may be investigated under the Minor Eye Conditions Scheme.  Please click here for more information including accredited practitioners and referral guidance.