In better times the Irish government had the financial resources to issue more and more people with medical cards.
As the government finances have deteriorated they are now trying to revers this process.
Means testing of peoples income now determines if people are re-issued with new cards once their old card expires.
Once a person has been issued a card and registered with a General Practitioner (GP), he or she is entitled to a range of free services from contracted professionals, e.
free eye test from registered opticians/optometrists.
Card holders do not have an automatic right to have an eye examination and dispensing of spectacles.
There is an entitlement but not a right.
In other words the Health Service Executive (HSE) want to control the situation by forcing everyone to apply prior to going for an eye examination under this medical card plan.
Certain restrictions apply.
Principally, because this is a budget-led scheme, the number of people sanctioned is determined by the resources of the individual health boards.
At present, there are very tight controls on these budgets.
Unfortunately, the budget for optical care is not determined by the demographic profile of an area or the number of card holders in that area.
No really knows how the budget for each area is determined, when these 2 pertinent factors are not taken into consideration.
For this reason, it is necessary to apply in advance to determine if a card holder is eligible for a free eye examination and glasses, if deemed necessary by their optician.
Opticians throughout the country have authority to provide eye examination and glasses to adults, (which implies those 16 years and over) with a valid card.
Dispensing of glasses, on the other hand, applies to all ages of children who usually get issued with a prescription for their glasses from the health board's community ophthalmologist or the hospital based ophthalmologist.
Children in Ireland are generally examined twice while in National School.
These examinations are part of an overall medical by the community district nurse.
This is a free service to all children within the National School system, irrespective of the medical card scheme.
On these routine screenings if a child is deemed to have a visual defect, he or she is then referred to the community ophthalmic physician for further examination and glasses prescribed where necessary.
There are many considerations other than just glasses alone.
Children with recurring headaches can often have eye co-ordination issues and eye exercises are more necessary than glasses.
Children with a "turn" in an eye may need referral for surgical intervention.
Occasionally eye lid droop may be interfering with a child's vision, and again referral for surgical treatment may be be necessary.
Children that have left National School, and fall outside of this scheme, between the ages of 12 and 16 years have theoretically no optical cover.
The sanctioning of an eye test for these children with their own medical card is at the discretion of the local health board to which one applies.
Commonly children over the age of 12 and outside of the school scheme will be sanctioned if they have a card.
Adults with current, valid cards are restricted to an eye examination on this scheme to every 2 years.
There are certain clinical reasons why patients can be seen more frequently than this.
Your GP or optometrist can decide if this is the case for you.
Applications for these exemptions have to be accompanied by a letter from the optometrist or the patient's GP explaining the condition and reason for an earlier eye examination.
The unfortunate financial restraints currently on the HSE allow very little room for good will gestures.