The NHS General Ophthalmic Service is provided by eye care professionals who carry out eye examinations, provide eye glasses, repairs or replacements. ISD collects information on NHS General Ophthalmic Service activity in Scotland, as performed by eye care professionals.
These data are collected on a series of forms referred to as GOS (General Ophthalmic Services) forms.
If a patient is entitled to free or subsidised eye care (excluding eye examinations), they must present evidence of this to the optician (Exemption categories).
The optician submits a claim form for the services provided, which is signed by both the optician and the patient. This form is sent to Practitioner Services for processing the payments. The forms are scanned and their information is stored in a database called OPTIX. ISD then collates these data to provide annual tables of eye examinations and vouchers claimed under GOS activity. The data exclude NHS Hospital Eye Services and optical service provided privately.
On 1 April 2010 the NHS (General Ophthalmic Services) (Scotland) Regulations 2006 were amended to provide that primary eye examinations should only be undertaken in line with set frequencies for different categories of patients, i.e. 1 or 2 years. Other eye examinations required at shorter intervals than these frequencies are undertaken as supplementary eye examinations.
On 1st April 2006, a new NHS eye examination was introduced and free eye examinations were extended to all in Scotland. The traditional NHS sight test has been replaced by a comprehensive eye examination appropriate to the patient's needs. An initial eye examination is carried out (primary eye examination) and where necessary a second eye examination (supplementary eye examination).
In October 2003, a new category of "pension credit guarantee credit" was introduced.
In April 2003, "Working Family Tax Credit" and "Disabled Person's Tax Credit" were replaced by new tax credits. Those named on, or entitled to, an NHS tax credit exemption certificate are entitled to a free NHS sight test and voucher towards the cost of glasses or contact lenses.
Further legislative changes in 1999 created further categories for the provision of free sight tests, including "Aged 60 and over" and "At risk of glaucoma".
On 1st April 1989, the provision of free sight testing under the NHS was restricted to certain eligible groups of people, including children, students, and low-income adults.
On 1st July 1986 the NHS spectacle voucher scheme came into effect. Entitlement to a voucher is, with the exception of children and those who require complex lenses, based on income.
General Ophthalmic Service (GOS) forms are completed by the optician for services rendered. Detailed information on the form types used in the production of the data on these web pages is provided below.
- GOS(S)1 and GOS(S)5 forms are used for eye examinations and domiciliary visits. Domiciliary visits are available for people who are unable to visit an optician due to illness or disability. House-bound patients are liable to pay the statutory lens and frame charge but may be entitled to claim exemption, depending on their circumstances.
- GOS(S)3 forms are referred to as vouchers and are used to provide eye glasses.
- GOS(S)4 forms are used for repairs to and replacement of eye glasses.
- HES(S)1, HES(S)3 and HES(S)4 are used for hospital eye services. The Hospital Eye Service is responsible for meeting the ophthalmic needs of hospital outpatients and, where necessary, for making arrangements for this work to be undertaken by general practice opticians. The Hospital Eye Service will normally sight test and provide optical appliances from within its own resources. Where this is not practical, hospital administrators may be asked to contact the local Area Optical Committee, which represents general practice opticians, to ascertain whether a local optician or opticians would be willing to visit the hospital concerned and undertake sight testing and dispensing of glasses for patients requiring them. A hospital outpatient is not required to pay statutory charges for lenses and frames.
Exemption Categories (up to 31st March 2006)
Prior to the introduction of free eye examinations for everyone on 1st April 2006, there were several exemption categories for those who did not need to pay for their sight test.
- Those under 16 years old.
- Full-time students aged 16 to 18.
- Those aged 60 and over.
- Those on income support.
- Those on income-based job seeker's allowance (JSA).
- Those named on, or entitled to, an NHS Tax Credit Exemption Certificate.
- Those with pension credit guarantee credit.
- Those registered as blind or partially sighted.
- Those with diagnosed glaucoma.
- Those aged 40 or over who are the parent, brother, sister, son or daughter of a person with diagnosed glaucoma.
- Those with diagnosed diabetes.
- Those at risk of glaucoma.
- Those with an HC2 or HC3 Certificate. These certificates are means-tested, and the claimant needs to apply for the certificate with evidence of their income. They are primarily for low earners who do not fall into any of the other categories. HC3 certificates require an individually determined patient contribution towards the costs.
There are also some patients who are entitled to help with the cost of optical appliances. Those who qualify for help are listed below.
- Those under 16 years old.
- Full-time students aged 16 to 18.
- Those on income support.
- Those on income-based job-seeker's allowance.
- Those name on, or entitled to, an NHS Tax Credit Exemption Certificate.
- Those with pension credit guaranteed credit.
- Those who require complex lens prescriptions.
- Those with an HC2 or HC3 certificate.
Eye Care Professionals
Historically referred to as ophthalmic opticians, optometrists are trained professionals who are able to examine your eyes, give advice on visual problems, prescribe and fit glasses, contact lenses or visual aids and recognise eye disease. An optometrist with the letters FCOptom or MCOptom after their name is a fellow or member of the College of Optometrists and adheres to high standards of clinical practice. It's a mark of quality.
Ophthalmic Medical Practitioners (OMPs)
OMPs are medical doctors specialising in eye care. Like optometrists, they examine eyes, diagnose abnormalities and prescribe suitable corrective lenses.
These are trained members of the healthcare profession who advise on, fit and supply the most appropriate spectacles, after taking account of each patient's lifestyle and needs.
These specialise in eye disease and its treatment. Medically qualified, they work mainly in eye hospitals and hospital eye departments.
Orthoptists work with ophthalmologists, assessing squints, double vision and other abnormalities of binocular vision prior to treatment and are then involved in monitoring the treatment's success.
Eye care professionals review a patient's medical history and use a wide variety of tests and procedures to examine a patient's eyes during routine eye examinations. The tests range from straightforward (e.g reading an eye chart) to complex (involving high-powered lenses to visualise tiny structures inside the eye). Eye examinations tend to last from half an hour to an hour. This can be dependent on the number and complexity of tests required for your eyes. Depending on the results of the tests there are there are three possible outcomes. These are:
- no medical or corrective action needs to be taken
- a prescription for glasses needs to be issued
- a medical procedure may need to be carried out.
On 1st April 2006, a new NHS eye examination was introduced and entitlement was extended to all in Scotland. The traditional NHS "sight test" has been replaced by a comprehensive eye examination appropriate to the patient's needs. An initial eye examination is carried out (primary eye examination) and where necessary this is followed by a second eye examination (secondary eye examination).
On 1 April 2010 the NHS (General Ophthalmic Services) (Scotland) Regulations 2006 were amended to provide that primary eye examinations should only be undertaken in line with set frequencies for different categories of patients, i.e. 1 or 2 years. Other eye examinations required at shorter intervals than these frequencies are undertaken as supplementary eye examinations
Some patients are entitled to receive help with the cost of optical appliances. ISD publishes annually, information on the number of voucher claims made by the type of voucher and also by the type of claimant. Information is provided for NHS Board for financial year ending 31 March 2013.
The cornea bends light rays to give a clear image to the back of the eye - the retina - and also provides protection to the eye. It is the transparent outer coating of the eyeball.
The lens is a transparent body that is behind the iris (the coloured part of the eye). The lens is elastic, and changes shape when viewing an object far away or close up.
The retina is a fine sheet of nerve tissue lining the inside of the eye. Rays of light entering the eye are focused on the retina by the cornea and lens. The retina then produces an image, which is sent to the brain via the optic nerve for interpretation. A simple analogy is of a film in a camera being developed so that pictures can be produced.
The retina consists of light-sensitive delicate tissue, and the macula can be found at the centre of the retina, where the incoming rays of light are focused. The macula is responsible for:
- the ability to see what is straight in front of us
- the vision needed for detailed activities such as reading and writing
- the ability to see colour.
The iris surrounds the pupil and is made up of tissue that controls the size of the pupil. The iris provides the colour of your eyes
The pupil is the dark circular hole in the centre of the iris through which we "see".
This is the white part of the eye and forms about 5/6 of the outer coat of the eyeball.
The conjunctiva is a mucous membrane covering the exposed front portion of the sclera.