Are their spectacles really necessary?

an experienced ophthalmic optician, I am also the Scottish representative of the British College of Ophthalmic Opticians and chairman of the National Optical Consultative Committee. The main defect in your editorial lies in the assumption that '80-90% of the prescriptions' for the 516 wearers of supposedly unnecessary spectacles out of 13 800 school children aged 10 years or less 'have been issued by nonmedically qualified persons.' You give no source for that figure of80-90% but it presumably applies to all age groups in the population. But the 'School Eye Service' is staffed almost entirely by medically qualified ophthalmic practitioners who very probably account for a much higher proportion than 20 to 10% of refractions in the age group 10 years or under. I have no access to figures in the Bristol area where Dr Stewart-Brown's survey was done,2 but I personally have ascertained information about all spectacle dispensing in the Lothian, Scotland, area in February 1985. That month was chosen because it was probably an average month and because after 1 April 1985 these figures will not be available. Of the 85 children under the age of 10 years who had spectacles dispensed 37 were seen by an ophthalmic optician and 48 by