The College of Optometrists

Examining patients who work with display screen equipment or computers

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Sub-sections

Key points

  • Employees have a right to have either vision screening or a full eye examination.
  • It is in the employee’s best interests to have a full eye examination.
  • The employer is not required to pay for any spectacles prescribed for purposes other than display screen equipment (DSE) use, even if they include DSE use.
A224
This guidance does not change what you must do under the law. 

Display screen definition

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Display screen equipment (DSE) is a device or piece of equipment that has an alphanumeric or graphic display screen. It includes conventional display screens and laptops, touch-screens and other similar devices. 

Principles of examining patients who work with display screen equipment

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You have a duty to carry out a full eye examination when examining patients as part of their entitlement under the Regulations from the Health and Safety Executive. The Regulations also give employers responsibilities to provide employees with ergonomically suitable workstations and working equipment.61 
A227
Using a screen or computer can be visually demanding and may cause asthenopic symptoms that are not apparent when the patient carries out other work. Use of the computer does not cause the eye problem. Visually related symptoms can also be due to ergonomic factors or poor maintenance of hardware.
A228
When a patient who is an employee takes up their entitlement under the Regulations, perhaps as a result of visual problems when using a screen or computer, you should: 
  1. carry out a full eye examination to determine the cause 
  2. ask the patient to describe their workstation and its environment
  3. give appropriate advice, including ergonomic information, if appropriate
  4. provide them with a prescription or written statement, as appropriate, and
  5. maintain confidentiality of clinical information at all times and only provide clinical information to an employer if it is relevant to the employee’s DSE work and only if you have obtained the patient’s consent. You must follow the guidance on obtaining consent. See section on Consent.
A229
You may also provide a report to the employee and employer (with the employee’s consent), which should: 
  1. state clearly whether or not the employee needs spectacles specifically for their DSE work 
  2. include any prescription for a corrective appliance for DSE work, and
  3. recommend when the employee should be re-examined, under the terms of the Regulations.

Prescribing

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In many situations a single vision pair of spectacles will be appropriate for DSE use. It is good practice to bring other items needed for the task into the same visual plane as the screen wherever possible, for example by using a document holder. 
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If the patient has to carry out a variety of tasks, it may be appropriate to prescribe bifocals, varifocals or degressive lenses. You should bear in mind, however, that the restricted field of view in a bifocal or varifocal lens may lead to postural problems. These could be more serious than those that would be created by the patient simply changing over spectacles. You should discuss the most suitable form of vision correction with the patient. 
A232
If you prescribe spectacles specifically to enable the patient to use DSE and do other associated tasks, their employer is required to meet the costs of providing a basic frame and the prescribed lenses. If the patient chooses more costly appliances (for example designer frames or lenses with optical treatments unnecessary for their work) their employer is not obliged to pay for these. In these circumstances the employer can either pay for a basic appliance or opt to contribute a portion of the total costs, equal to the cost of the basic appliance. 
A233
The employer is not required to pay for any spectacles prescribed for purposes other than DSE use, even if they include DSE use. The intention of the Regulations is not the free supply of spectacles to all DSE users, but to people who need spectacles only to use DSE as part of their employment. 
A234
Most DSE users will not require a specific prescription for DSE use. 

Vision screening

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It is in the employee’s best interests to have a full eye examination. Under the Regulations they have a right to a sight test, as defined in the Opticians Act, if they wish. However, the Health and Safety Executive has indicated that there is a role for vision screening and you may be approached by employers to carry this out. 
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If you provide a vision screening service you should: 
  1. make clear to both employer and employee that vision screening is not the same as a statutory sight test or a full eye examination and it cannot reliably be used to check for:
    • injury
    • disease, or
    • abnormality of the visual system
  2. make it clear that the employee has a right to a full eye examination
  3. refer any employee who has failed the screening check to their optometrist for an eye examination, and
  4. note that an employer may contract with you to carry out both vision screening and eye examinations, as well as provide any necessary appliances. However, you must hand the prescription and written statement to the employee.
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Eye tests for DSE users are to enhance comfort and efficiency by identifying and correcting vision defects, thus helping to prevent temporary eyestrain and fatigue.  
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There is no reliable evidence that work with DSE causes any permanent damage to eyes or eyesight, but it may make users with pre-existing vision defects more aware of them. 
A239
Some DSE work is specialised and requires people to see colour changes, do fine work or use DSE equipment over a long period. The regulations define ‘special’ corrective appliances as those that are provided to correct vision defects at the viewing distance or distances used specifically for the DSE work concerned. 
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