The Health Professions Council of South Africa (HPCSA) and the South African Optometric Association (SAOA) have voiced concerns about the increasing trend of various retailers who market prescription spectacles and contact lenses without proper eye tests by authorised and registered practitioners. 

In a joint statement, the two associations say that eye tests are important for evaluating vision, detecting eye diseases and identifying other health issues. 

HPCSA’s spokesperson Priscilla Sekhonyana tells Health-e News that spectacles and contact lenses are medical devices. The manufacturing and sale of these medical devices are regulated by the South African Health Products Regulatory Authority (SAHPRA).

“When devices are sold online there is no assurance or checking that the lenses received are manufactured according to the prescription and measurements specified. There is also no way to verify the quality of the product,” she says. 

Sekhonyana says the Health Professions Act sets down conditions for online sales of optical medical devices in detail. 

While the law doesn’t directly address the sale of spectacles exclusively online, she says various regulations included in the Health Professions Act  apply to the overall sale and dispensing of eyewear including online sales.  It specifies that spectacles cannot be dispensed to any person without a written prescription that is signed by a medical practitioner or an optometrist. 

Speaking on behalf of the optometric association, Noko Thema tells Health-e News that when purchasing spectacles without a prescription from the optometrist or off the shelf, people need to consider several significant risks.

“A comprehensive eye exam is essential to diagnose any underlying visual issues or health concerns. Without a proper prescription individuals may end up with glasses that do not address their specific needs, potentially leading to eye strain, headaches, uncorrected squint and deterioration of vision,” Thema says. 

Risks of buying glasses without a proper eye exam

Sekhonyana says a comprehensive eye exam is important for detecting conditions that may result in vision impairment or vision loss. 

“Without a proper eye examination by a registered practitioner the conditions may only be detected when there has been significant or irreversible loss of vision,” she says.

She says vision-threatening conditions such as glaucoma, an eye disease that can blur central vision, and certain damage to the retina of the eye may result in irreversible vision loss if not detected earlier.

“Furthermore, purchasing cosmetic or colour lenses from untrained, unqualified persons not registered with the HPCSA poses significant risks which include eye infections and permanent loss of vision,” she says. 

Thema adds that 80% of blindness globally is avoidable. 

“It is imperative for all South Africans to undergo a comprehensive eye health and vision examination by a registered practitioner at least on an annual basis,” Thema adds.

Buying reading glasses from pharmacies

Thema says it is not illegal to buy reading glasses from retail stores or pharmacies as long as they are sold off the shelf and meet certain regulatory criteria.

“Over-the-counter reading glasses must be limited to single vision moulded lenses with equal power in both eyes. The lenses must be within the range of +1.00 to +3.00 diopters. These glasses are designed for individuals who are experiencing age-related difficulty seeing up close and need basic magnification. They are not intended to address more complex visual issues such as nearsightedness or blurry vision,” she says.

She says as per HPCSA regulations the reading glasses must be supplied with a warning label. The label should read: “Diseases causing blindness can be detected only by having a regular, professional examination”.

“The reading glasses are only for short-term use by persons over the age of 40 years and are not suitable for driving. While purchasing basic reading glasses is legal, prescription eyewear requires professional oversight. Prescription glasses must be dispensed based on an eye examination and individual measurements,” Thema says. 

Socioeconomic pressures 

Thema says in South Africa several socio-economic factors contribute to the prevalence of buying glasses on illegal or unregulated markets. 

She says the most significant of these factors are affordability, accessibility and lack of awareness. 

“Many people in lower-income communities may struggle to afford comprehensive eye exams and prescriptions. As a result, they turn to illegal markets where spectacles are often sold at lower prices. In certain areas, particularly in rural or underserved communities, access to qualified optometrists and optical clinics can be limited,” Thema says. 

She says that many people don’t consider vision correction an urgent critical health need.

“This perception coupled with economic pressures can drive individuals to seek cheaper alternatives on the black market where immediate solutions are more easily accessible. Unfortunately, this can lead to poor visual outcomes and over time can worsen eye health,” she says. 

What to look for when buying spectacles

Thema says there are several key factors to consider when looking for glasses.

“Before purchasing spectacles ensure you have an up-to-date prescription from a licensed optometrist. The prescription should include details such as the power of the lenses, the pupillary distance and any other specific requirements like segment height for bifocal or progressive lenses,” she says. 

She says people should ensure that the spectacles are sourced from a reputable optometry professional or licensed distributor. 

The lenses and frames should meet the required safety and quality standards such as those outlined by the International Organisation for Standardization and the HPCSA. – Health-e News