Optical Prescriptions : Detail and Clarification

(All you need to know - but were afraid to ask)

Term Abbreviation Relevance to Voucher Category

Spherical Lens Sph Power of Sph, then power of Cyl determines Voucher Category
(see transposition detail below)
Cylindrical Lens Cyl

Axis x Not relevant to determining category

Added to Sph power to determine reading prescription.

Addition Add
If over +4.00 it determines category of a bifocal lens

Power is measured in Dioptres and is often written as DS (Dioptric Sphere) or DC (Dioptric Cylinder).
Minus (-) Sphere would be used to correct Myopia (Short Sighted)
Positive (+) Sphere would be used to correct Hypermetropia (Long Sighted) and/or Presbyopia (Loss of
Focus)
Cylinder (+ or -) would be used to correct Astigmatism (Rugby-Ball Shaped Eye)

Voucher Category
Voucher category is determined by power of the Spherical and Cylindrical component of the highest
powered lens in the prescription.
Each category of power has a different value.
To determine the amount to be paid, reference is made to tables which set out the categories A – H, and
is published annually in “NHS Optical Charges and Payments”.
However the prescription may be within two forms, Positive(+) Cyl or Negative(-) Cyl

Example 1: (Transposition)

Sph Cyl Axis

Positive Cylinder +5.00 +2.00 90

Negative Cylinder +7.00 -2.00 180

This prescription, which looks different, would give exactly the same powered lens.
As the above demonstrates a prescription written in Plus Cyl may give a difference voucher category to a
prescription written in the Minus Cyl, and vice versa.
To establish the voucher value the prescription should be “transposed” to give the highest spherical
power. ( At present this does not apply to an HES vouchers)
Further details on prescriptions and their relevance can be obtained from the PCT’s or Payment Agency’s
Optometric Adviser.

© RTB/Western Cheshire PCT 08/10

To transpose the prescription from one form to the other:

If the Sph and Cyl have different power signs (+ and -) or ( - and +) and the Cyl power is less than twice
the Sph power. Do Nothing. This is the highest spherical power.
If the Sph and Cyl have the same power signs (both + or both -) or the Cyl power is more than twice the
Sph power, then: -
Mathematically add Sph and Cyl together to give new Sph power (this will be larger than the old Sph
power)
Change the power of the Cyl, from + to - , or vice versa
If the axis is 90 or under then add 90 to it. If the axis is between 91 and 180, then subtract 90 from it
Only steps 1 and 2 above are critical to determining the voucher category

Example 2:

Sph Cyl Axis

Prescription in Minus Cyl -3.50 -0.75 45

Transposed to Plus Cyl -4.25 +0.75 135

Example 3:

Sph Cyl Axis

Prescription in Plus Cyl -2.75 +4.25 75

Transposed to Minus Cyl +1.50 -4.25 165

Some patients require 2 different prescriptions i.e. distance and reading. Usually they will be over the
age of 40.
This can corrected with 2 pairs of single vision spectacles, or 1 pair of bifocal or multi-focal spectacles.
The reading prescription may be written as a separate prescription, or it may be written as an addition
(Add) to the distance prescription. The Add should be added mathematically to the spherical component
of the distance prescription to determine the reading prescription. It should then be transposed if
necessary.
A pair of bifocals should be costed on the distance prescription if the reading addition (i.e. difference
between respective distance and near prescription) is +4.00 DS or less.
Where it is over +4.00 DS, the costing should be based on the reading prescription.
The Cyl detail is nearly always the same for both the distance and near prescriptions.

Example 4:

Sph Cyl Axis Add

Prescription +4.25 -1.25 90 2.00

Distance Prescription +4.25 -1.25 90

Reading Prescription +6.50 -1.25 90

© RTB/Western Cheshire PCT 08/10
Supplementary Additions to a Prescription

Prisms are used to correct a deviation in the visual axis between the two eyes.
The deviation can be manifest i.e. a squint or turn in the eye, or latent i.e. a muscle
imbalance.
Prisms
There are two elements to a prism - the power, specified in prism dioptres (D) and the
direction of effect, specified as Base In, Out, Up or Down.
The supplement value is added to the voucher value.

A tint on a lens is used to reduce the amount of light reaching the eyes.
It is used to correct a condition called photophobia, or intolerance to light.
A Ultra-violet or Infra-red filter is not a tint.
Tints
An anti-reflection coating is not a tint.
The tint must be visible.
The supplement value is added to the voucher value.

Further details on prescriptions and their relevance can be obtained from the PCT’s or Payment Agency’s
Optometric Adviser.

© RTB/Western Cheshire PCT 08/10