The perceived cost of visiting optician services has deterred some people from getting eye tests, according to a report from Healthwatch England.
The report, which surveyed 2,568 people about their eye care experiences between July and September 2024, found that one in seven (14%) had avoided eye care due to the cost.
Over a third (39%) of people who said they were ‘not at all comfortable financially’ were likely to say they had avoided getting eye care in the past two years due to the cost.
Respondents who said opticians had encouraged them to take up additional paid-for services were also twice as likely to say they had avoided getting eye care in the past two years, compared to those who had not experienced this (17% and 8% respectively).
Of those who had attended an eye test in the past two years, 72% had been offered additional services at a cost, the survey found.
The report recommended that the Department of Health and Social Care (DHSC) review the support for the cost of NHS eye care for those on the lowest income. It also called for the NHS to consider a targeted communications campaign to low-income eye care patients to explain what help is available.
Louise Ansari, chief executive of Healthwatch England, said: ‘Regular visits to the optician are essential to help keep your eyes healthy and identify any issues. However, there are clear signs that the extra costs people face could discourage those struggling financially from visiting opticians.
‘NHS funding to help meet eye care costs has not kept pace with inflation, which, in turn, is causing high-street opticians to rely more on selling additional services to make their businesses viable.
‘It is essential that this situation does not impact on the those most disadvantaged in society. This is why the Government needs to review the help available for those on the lowest incomes and ensure that more people are aware of how the NHS can help meet the costs of eye care.’
From the same survey of people, Healthwatch England also compiled a report into patient experiences of specialist eye care, where they suggested high street opticians should be used to cut waiting lists.
Recommendations in full:
Review support available for NHS eye care costs
- As part of a wider review of the NHS Low Income Scheme, NHS and DHSC should review the optical voucher scheme to ensure that patients can be
- This should include establishing that both the eligibility and the voucher values are at the correct levels. Consideration should be given also to whether any additional services beyond eye wear could be included in the voucher scheme, where they are considered clinically necessary.
- Many of our survey respondents, particularly those who had been offered additional services, were avoiding further eye care due to cost. The real-terms value of NHS optical vouchers has dropped severely in recent years, by over 30% on average (unpublished Healthwatch analysis, 2025) and the NHS sight test fee by even more. This, alongside significant changes to eligibility for some qualifying benefits since the scheme was introduced, further raises pressure on both patients and opticians.
Improve public confidence in seeking eye care
- The primary eye care sector must be mindful of their patients’ potential financial sensitivities and should have clear internal guidelines for how staff should assist low-income patients without affecting their confidence in seeking care. This should include how to make patients aware of financial support available to them, and how to sensitively discuss additional services not covered by the NHS voucher scheme.
- The Government and the NHS should also consider a targeted communications campaign utilising primary care settings, patient communication, and the NHS App to explain what help is available from opticians to help people meet the costs involved. Action to improve support for those with limited funds may enhance awareness and confidence in seeking eye care.
Increase the role of optometrists in diagnosing and treating eye conditions.
- Our previous eye care report called for greater use of optometrists and primary eyecare teams in diagnosing and managing eye care conditions. We believe that increasing the responsibilities and resourcing of these teams can also improve the quality of primary eyecare and lessen the reliance on additional services to deliver care.
