UK Keratoconus Self-Help and Support Association

I'm a patient at Moorfields. I recently went for my annual check-up (everything fine, no changes in the lenses) and had the usual, albeit often throw away, attempt to prescribe me glasses that end up costing £500 after being thinned from the size of a Watermelon.

This time they took a different approach to usual, deciding the right eye (the worse eye) had got so bad that my sight with glasses would be much improved if they only prescribed the left and use its dominance. This worked well, and was a welcome surprise given they want for me to take out the lenses for two weeks before the next scan I have for CXG (only in left eye)

What I'm totally surprised about is that now, given my reduced prescription I am not eligible for a complex lens voucher and so had to pay for my next eye test at Specsavers (I haven't paid for years whether I buy glasses or not). I've been on the phone to the department of health, explaining that my prescription is less because my eyesight is in fact worse and that surely I'm technically still eligible but to no evail!

I appreciate the reduced need for a complex lens voucher given my glasses are cheaper - but I'm totally baffled as to why I no longer qualify for free eye tests on the high street or why the free test and lens voucher are linked?! It's like saying a blind person no longer gets free eye test because they don't need glasses . . (Perhaps that analogy is strong and a bit tactless given the forum and actually I'm aware this would class as a disability and so be free anyway - but I hope people understand my point in that measuring a KC patient's eligibility for free eye tests on their glasses prescription is fundamentally flawed).

Thoughts?

Hi there Steven

First off, a big welcome to the Forum.

Ah, the vexed (and in your case, vexing !) subject of how "benefits" -- to use a very broad term -- can often work against people with Keratoconus. In your situation, the entitlement to a Free NHS Eye Test (and also the optical voucher) is definitely a benefit to you, or at least it was. A complex prescription is one route to obtaining a free sight test, there are a fair number of others. For those unfamiliar with this rather tortuous subject, the full list is here http://www.nhs.uk/chq/Pages/895.aspx?Ca ... goryID=157

The most obvious method of trying to get your entitlement back might be to ask your ophthalmologist if they'd consider registering your as partially sighted. This is usually determined by your visual acuity (and field of vision) rating but as has been pointed out here before, reading a line on the Snellen chart isn't everything -- especially if that ability is based on very specific lighting conditions or time of day e.g. only if you've not had your lenses in for more than 4 hours, say. Is that something you'd be willing to discuss with your consultant ? There is definitely some latitude available to ophthalmologists on that one.

Apart from that, it's pretty limited what you can do about this. It's no consolation, but I'm in the same situation -- post graft I'm left with residual astigmatism but it's too soon for the NHS to consider providing me with glasses or contact lenses. So to avoid being left with pretty much no usable vision, I had to have a pair of glasses made up (as you mention, this isn't cheap). They help, but I'd certainly not say I get what I'd call decent vision. Yes, I also lost the "complex prescription" entitlement after my graft. My vision continues to fluctuate so I really need a new prescription now compared to one which was issued only three months ago and I do now get a eyestrain if I try to do detail work of any kind. But I'm not coughing up another £300 only to be, in all probability, in the same position again in another three months or so. To be asked to have to pay for the sight test too, this only adds insult to injury.

So all in all, just another of the joys of living with Keratoconus... but do check through the complete list I've included above just to check if you're covered under any of the other reasons.

Best wishes

Chris

Chris,

Thanks for the knowledgeable reply.

I'm still totally surprised by this whole situation - I suppose I'm know trying to work whether it's morally correct for me to have free eyetests.

Is it your understanding that the eye tests are free because, like the lens voucher, the cost of glasses is raised - or because in general people with high prescriptions should have free eye tests and we just don't fit the system?

I think a stern letter to my MP is needed.

Hi, yes, it's the latter. People with high prescriptions do have free eye tests but as you say we don't fit the system because it's a binary choice for the optometrist -- if you're not over the threshold value for eligibility then "computer says no". A fundamental unfairness because our prescriptions might not be over the line for eligibility but they can and do change much more frequently that a comparator (someone without Keratoconus). We're left with no choice but to pay up or do without...

I can't end this post any other way than with the words "what a bummer".

Cheers

Chris
(who is trying to see this through a pair of glasses with a prescription that is now noticeably "out", the glasses are my second this year, I'm not forking out for another sight test and lenses, but as I can't be fitted with contact lenses as it's too soon after my graft stiches came out, it's either manage with these way-y-yyy less than optimal glasses or see nothing at all. I know now why Victor Meldrew ended up the way he did !)