Optician negligence: claims and complaints when an eye test goes wrong

If you suddenly notice new floaters, flashes of light, a dark shadow moving across your vision or blurred vision, the NHS advises getting help from NHS 111. If you develop symptoms of glaucoma suddenly, call 999 or go to A&E.

This guide explains what opticians must do during a sight test, when a mistake may amount to negligence, how to complain about an optician in each part of the UK and the time limits for a claim. It is general information, not legal or medical advice. We are an independent information service, not a law firm.

What an optician must do

A person who is not a registered medical practitioner or registered optometrist must not test the sight of another person, apart from limited exceptions (section 24 of the Opticians Act 1989). When a doctor or optometrist tests someone's sight, regulation 3 of the Sight Testing (Examination and Prescription) (No. 2) Regulations 1989 makes it their duty, for the purpose of detecting signs of injury, disease or abnormality in the eye or elsewhere, to:

• examine the external surface of the eye and its immediate vicinity;
• carry out an intra-ocular examination, by ophthalmoscope or other appropriate means;
• carry out any additional examinations that appear clinically necessary; and
• immediately after the test, give the patient a written statement that those examinations were done and whether they are referring the patient to a doctor, with the reason for any referral.

The General Optical Council, the UK regulator, sets Standards of Practice for optometrists and dispensing opticians. They include conducting appropriate assessments, examinations, treatments and referrals, maintaining adequate patient records, responding to complaints effectively and being candid when things have gone wrong.

When a mistake may be negligence

Claims about clinical care are judged by asking whether what was done was accepted as proper by a responsible body of medical opinion, and that opinion must be capable of standing up to rational analysis (Montgomery v Lanarkshire Health Board, 2015). You also need to show causation, usually on a "but for" basis: that with proper care, the harm would not have happened. Situations that can lead to a claim, depending on the facts, include:

• Missed signs of eye disease. The NHS says glaucoma does not usually have symptoms at first, is usually picked up during routine eye tests and can cause vision loss if it is not diagnosed and treated early. The General Optical Council gives failing to notice signs of eye disease as an example of poor professional performance.
• No referral, or a slow one. The NHS says anyone told they have glaucoma should be referred to a specialist eye doctor for further tests, and that a detached retina needs to be treated quickly to stop it permanently affecting sight.
• Symptoms you reported but that were not acted on, such as new floaters, flashes or a shadow in your vision.
• Examinations or a written statement missing, where the regulation 3 checks were not carried out.

Problems with glasses that did not cause an injury are usually consumer issues rather than negligence claims: the General Optical Council points people wanting help with consumer issues, such as a refund for faulty glasses, to the Optical Consumer Complaints Service.

Evidence and records

• The written statement you were given after the sight test, which should say whether you were referred and why.
• The practice's records of your sight tests. Anyone can make a subject access request, without a solicitor, and organisations usually have one month to respond.
• The later diagnosis and hospital eye clinic records showing what was found and when.
• A note of symptoms you reported, and when, to the optician or to your GP.

For a claim in England and Wales, the clinical disputes protocol applies to healthcare providers, NHS and private, and says copy records should be provided within 40 days of a request.

How to complain about an optician

1. The practice. Raise the problem with the practice first.
2. NHS sight tests. In England, everyone who provides an NHS service must have a complaints procedure. You can complain to the practice or to the commissioner, which for opticians is your local integrated care board, but not both, normally within 12 months of the incident or of it coming to your attention. The health service ombudsman is the final stage. In Wales, you can ask the practice or your health board to look into a concern under the Listening to People process. In Scotland, the NHS complaints procedure covers primary care providers, including those delivering ophthalmic care, and does not provide for financial compensation. In Northern Ireland, complaints about an optician go first to the practice or practitioner for local resolution.
3. Optical Consumer Complaints Service (OCCS). Funded by the General Optical Council, the OCCS is a free and independent mediation service for patients and optical professionals. It can help with complaints about goods such as glasses and contact lenses and about the service provided.
4. General Optical Council. The regulator investigates only serious concerns that may mean an optician is not fit to practise, such as poor professional performance. It cannot arrange refunds, compensation or apologies, or give legal advice.

The General Optical Council's guidance on the professional duty of candour says registrants should be open and honest when things go wrong, and that an apology does not of itself amount to an admission of negligence.

Time limits

A negligence claim for an injury must usually start within three years of the negligent sight test, or within three years of the date of knowledge if later: the date you first knew that the injury was significant, that it was attributable to an act or omission, and who was responsible (sections 11 and 14 of the Limitation Act 1980). With a missed diagnosis, that can be later than the sight test. Scotland (section 17 of the Prescription and Limitation (Scotland) Act 1973) and Northern Ireland (article 7 of the Limitation (Northern Ireland) Order 1989) also have three-year rules. For a child, time usually starts at 18 in England, Wales and Northern Ireland, and at 16 in Scotland.

Frequently asked questions

Related guides: eye injury claims, medical negligence claims, GP misdiagnosis claims, medical evidence and time limits.

Official sources used for this guide: Sight Testing (Examination and Prescription) (No. 2) Regulations 1989, reg. 3; Opticians Act 1989, s.24; General Optical Council: Standards of Practice; Montgomery v Lanarkshire Health Board [2015] UKSC 11; Limitation Act 1980, s.14. This guide is general information about the law in the UK, not legal advice; the law can change, so check your own position with a regulated solicitor.