Supplementary Eye Examinations

This page provides information on supplementary eye examinations provided under General Ophthalmic Services (GOS) arrangements in Scotland, under the following headings:

All references to the "Statement" are to the determination made by Scottish Ministers in exercise of powers conferred by sections 28A and 28B of the National Health Service (Scotland) Act 1978 and regulation 17 of the National Health Services (General Ophthalmic Services) (Scotland) Regulations 2006 ("GOS Regulations"), after consultation with such organisations as appear to them to be representative of contractors providing GOS. The current version of the Statement can be found on the Legislation page of this website.

 

What Is A Supplementary Eye Examination

Under regulation 2 of the GOS Regulations, a supplementary eye examination means an eye health check which is either carried out:

  • after a primary eye examination for a particular reason which has arisen during the primary eye examination; or
  • in circumstances set out in regulation 22A(2) of the GOS Regulations, where the eye examination is carried out more frequently than permitted as a condition of remuneration by the Statement

and includes the tests and procedures appropriate to the clinical needs of the patient. Appendix D of the Statement provides further information on the tests and procedures relevant to a supplementary eye examination.

Table B of Appendix D of the Statement lists the reason codes to be used in accordance with the carrying out of a supplementary eye examination, and further supporting information on some of these reason codes can be found further below. 

 

Supplementary Eye Examination Fees

The fees payable to GOS contractors for undertaking supplementary eye examinations are set out in Appendix A of the Statement.

 

Specialist Supplementary Eye Examinations - Overview

Specialist Supplementary eye examinations under GOS support Independent Prescriber (IP) optometrists and ophthalmic medical practitioners (OMP) to manage patients with specified acute anterior eye conditions closer to home in the community, helping to free up capacity within the hospital eye service and reduce the burden on GPs.

Practitioners should follow Appendix D and Annex C of the Statement for further information on when a payment claim can be made under the GOS Specialist Supplementary service.

The GOS Specialist Supplementary service has been implemented in two phases:

  1. Interim Measure (which applies to GOS specialist supplementary eye examinations undertaken between 1 August 2025 and 18 January 2026 inclusive), as set out in PCA(O)2025(04)
  2. Full Implementation (which applies to GOS specialist supplementary eye examinations undertaken on and after 19 January 2026), as set out in PCA(O)2025(08) and PCA(O)2026(01)

 

Specialist Supplementary Eye Examinations - Patient Referrals

Patients who are deemed to require Stage 2 treatment for one of the anterior eye conditions covered under the GOS Specialist Supplementary service (as set out in Annex C of the Statement) can be referred to an optometry practice at or from which the service is being provided by a specialist IP optometrist/OMP. See paragraphs 22-30 of PCA(O)2025(08) for full information on the rules and and process regarding such referrals. 

When making such a referral, the referring optometrist/OMP must:

  • take into account the location where the patient normally resides
  • telephone the specialist IP optometrist/OMP to discuss the referral request
  • ensure the specialist IP optometrist/OMP has accepted the referral before directing the patient to them. 

Details of optometry practices at or from which the GOS Specialist Supplementary is provided can be found on the NHS Inform website by selecting 'GOS Specialist Supplementary service' from the 'Services Offered' search category.

Further to the completion of the episode of care for that patient (see Appendix D of the Statement for further information on what constitutes an episode of care), the specialist IP optometrist/specialist OMP who accepted the referral should provide feedback to the optometrist/OMP who initiated the referral. Where appropriate, the specialist IP optometrist/specialist OMP should also consider making the patient’s registered General Practice aware about the care provided to the patient.

Referrals and feedback to referrers must be made via one of the following two methods:

1) The GOS Specialist Supplementary 'Referral' and 'Back To Referrer' forms in SCI Gateway.

The SCI Gateway forms will only be available in NHS Greater Glasgow and Clyde when GOS Specialist Supplementary Full Implementation goes live on 19 January 2026. The implementation of these forms in other Health Boards is for those Boards to manage locally. Health Boards are individually responsible for informing their local optometry sector as and when these forms are available in SCI Gateway.

Where a patient is being referred to a practice in a different Health Board, the referring optometrist/OMP must ask the receiving specialist IP optometrist/specialist OMP whether they are in a Health Board that has locally implemented the SCI Gateway referral and feedback forms. Where this is not the case, the PDF form linked to further below must be used.

Guidance on using the SCI Gateway forms is available as follows:

2) The GOS Specialist Supplementary 'Referral and Back To Referrer' form (PDF).

This must be submitted via NHS email, and it is recommended that this is sent to both the individual clinician and practice NHS email accounts (practice NHS email accounts are available in the relevant practice's entry on NHS Inform). 

 

Specialist Supplementary Eye Examinations - Applications

IP optometrists and OMPs who wish to enter into arrangements with Health Boards to provide GOS Specialist Supplementary eye examinations on and after 19 January 2026 must submit an application and have been approved by the relevant Health Board.

Full information on the application process is set out in PCA(O)2025(08). Applicants are strongly advised to ensure they read the full content of this circular and the Statement prior to deciding whether or not to submit an application. If, after reading this, an IP optometrist/OMP wishes to proceed in submitting an application then one of the following forms should be submitted:

STREAM A Application Form - this is for IP optometrists whose GOS Specialist Supplementary application is consistent with the information currently held about them on the Ophthalmic List(s) of the Health Board(s) with which they wish to enter into arrangements to provide GOS Specialist Supplementary. Stream A applications must be submitted from the individual's NHS email account to NHS National Services Scotland at: NSS.psd-GOS-SS@nhs.scot. Guidance on how to complete this form is available here.

STREAM B Application Form - this is for IP optometrists whose GOS Specialist Supplementary application is not consistent with the information currently held about them on the Ophthalmic List(s) of the Health Board(s) with which they wish to enter into arrangements to provide GOS Specialist Supplementary. Stream B applications (which also apply to all OMPs) must be submitted from the individual's NHS email account to each relevant Health Board via the email address on this webpage.

If additional practices need to be added to either a GOS Specialist Supplementary application, then the Additional Practice Addendum form should be completed and submitted along with the relevant application form.

 

Specialist Supplementary Eye Examinations - Withdrawals

If you need to withdraw entirely from arrangements to provide the GOS Specialist Supplementary service in a Health Board, or withdraw from providing the service from one or more specific practices in that Health Board, you should complete and submit a GOS Specialist Supplementary Withdrawal Form to the relevant Health Board via the email address on the Health Boards area of this webpage.

If additional practices need to be added to the Withdrawal Form, then the Additional Practice Addendum Form should be completed and submitted along with the relevant Withdrawal Form.

In withdrawing from arrangements for the provision of the GOS Specialist Supplementary service, if you are a Part 1 listed specialist IP optometrist / specialist OMP you must ensure that you have made arrangements for patients attending the relevant practice(s) to continue to receive care where this is required.

 

3.9 Reason Code – Cataract Referral Advice and Counselling

This code is to be used when providing advice and counselling to a patient (in person or using remote facilities) following an eye examination which has resulted in the patient being considered for referral. This may include providing prognosis or counselling and preparation for consent for cataract surgery, including risk factors.

An Aide Memoire Form has been developed by NHS Scotland to support community optometrists when referring a patient to secondary care for cataract surgery, and can be used to structure the 3.9 Reason Code supplementary eye examination appointment (‘Cataract Referral Advice and Counselling’). Ideally, the patient will already have received an information leaflet about cataract surgery prior to this appointment.

Note: It is not mandatory to use this form, as practitioners may have alternative ways of recording their discussion with the patient and any advice given. However, the College of Optometrists Guidance for Professional Practice on keeping full and accurate records should be noted.