In the United Kingdom, businesses that sell prescription spectacles and contact lenses are referred to as 'opticians', after the profession of that name (see UK Opticians). Total revenue for opticians in the UK was £2.4 billion in 2006 from the two thirds of British citizens requiring glasses or contact lenses.
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UK law requires that spectacles and contact lenses be made to according to an eye test, which must have been administered by a qualified optometrist or ophthalmologist.[1][2] 17.5 million such tests are carried out every year in the UK.[3] However, although an eye test is a requirement, no standard test is defined; with test duration, quality and cost varying considerably.[3]
Once a customer has paid for an eye test, the optician is obliged to present the resulting optical prescription to them, allowing the customer to purchase spectacles at the optician of his choice. Such opticians include retailers employing optometrists, and dispensing opticians; healthcare professionals who are not able to conduct eye tests, but specialise in lenses and wave optics and manufacture that sell spectacles.[4]
Although opticians charge for eye tests, certain groups can receive free eye tests, such as those with free NHS eye-tests, or students at some stores.[1] Individuals who qualify for free NHS eye tests sometimes also qualify for subsidized spectacles or other treatment. Eye tests are free to all residents of Scotland.[5]
The key event in the structure of the modern opticians retail sector was de-regulation of the industry by the Conservative government led by Margaret Thatcher in the 1980s. De-regulation was enacted through two key measures:[6][7]
Opening the door to advertising led to a change from an industry dominated by independents and small chains to one dominated by a few large chains.[8] As of 2007, 70% of the market is concentrated in just four retailers: Specsavers, Boots The Chemist, Dollond and Aitchison, and Vision Express, with Specsavers alone having a 30% share.[9]
De-regulation was motivated by the belief that increased competition would lead to improved value for consumers. However, 62% of the retail price of spectacles was calculated to be profit (before promotional and related costs) by a Financial Times columnist.[9]
High fixed costs, economies of scale, and TV advertising make the establishing of an effective new competitor on the high street problematic, restricting competition. Specsavers was the UK's 46th largest purchaser of UK TV ads in 2006, spending £27 million.[10]
Laser eye surgery in the UK is provided by specialist clinics; not by high street opticians. Laser eye surgery has had a troubled history in the UK, with allegations of a poor safety record in the press in 2003 leading to a reduction in patient numbers, and National Institute for Health and Clinical Excellence (NICE) raising concerns about the long-term safety of the widely used Lasik method in 2004.[11]
However, the industry has staged a recovery and resumed growth, going from 95 clinics in the UK in 2006 [12] to 105 clinics in 2007.[13] In 2006, NICE stated that laser eye surgery was safe and effective when carried out on suitably selected patients. This was the first official endorsement of this form of treatment in the UK.[5]