This guide describes the four regulated professions that contribute to eye care in the UK.
It is important to note that optical professionals do not self-regulate. Regulators are statutory bodies created by government, which work in the interest of public safety and not in the interests of health care professionals.
- The General Medical Council (GMC) regulates ophthalmologists
- The General Optical Council (GOC) regulates optometrists, dispensing opticians, students and optical businesses
- The Health and Care Professions Council (HCPC) regulates orthoptists
Each of these bodies has a public protection responsibility and may suspend or remove professionals from their registers. This could be for a breach of professional ethics or a failure to comply with rules on continuing professional development.
The NHS also plays a part in monitoring the professions, either directly, as the employer of many optical professionals and by overseeing optometrists and OMPs on their ophthalmic lists, or indirectly, in monitoring claims made for delivering services to patients who qualify for free NHS sight tests and optical vouchers.
The work and scope of practice of optometrists and dispensing opticians is governed by the Opticians Act 1989.
Ophthalmologists are the doctors in eye care. They specialise in diagnosis, treatment and prevention of diseases of the eye and visual system. There are around 2700 ophthalmologists in the UK, most of whom work in hospitals.
Optometrists are trained to examine the eyes to detect defects in vision and can prescribe corrective lenses (glasses or contact lenses). They are also able to identify eye diseases and problems with general health and refer patients for further examination as well as treating minor eye conditions. They are responsible for supervising some dispensing, as set out in the Opticians Act, 1989. They normally qualify for this work by completing an undergraduate degree in optometry (normally three years and four years in Scotland) followed by 1-2 year’s pre-registration training in practice, before undertaking final stage examinations to enter the General Optical Council’s register.
There are around 16,000 optometrists working in the UK, the majority of whom work in community optometric practices (high street opticians), although around 800 work in hospitals. Around 370 optometrists have undertaken further training in Independent Prescribing (IP), and a large number of optometrists are accredited to provide locally-commissioned primary eye care services like Minor Eye Conditions Services (MECS) and this number is rapidly increasing.
Dispensing opticians advise on and supply glasses and other vision aids. They have specialist knowledge in the appropriate lenses for a range of purposes including night driving or sports and safety eyewear. Dispensing glasses to children, or the visually impaired, can only be undertaken by, or carried out under supervision of registered medical practitioners, dispensing opticians or optometrists. Some dispensing opticians qualify as contact lens opticians and are able to fit contact lenses.
There are a variety of routes to become one of the UK’s circa 6000 dispensing opticians; from work-based distance learning programmes, diplomas and foundation degrees up to more recently a degree level course.
Orthoptists specialise in diagnosing and treating visual problems involving eye movement and alignment, and treatment of amblyopia. Most of the UK’s circa 1400 orthoptists work within NHS hospitals alongside ophthalmologists. It is a degree profession.