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Aipedia: Optometrists and opticians

Online sight tests and AI vision apps: where they stop

Remote vision checks and AI refraction apps can estimate visual acuity or a prescription, but they cannot assess eye health the way an in-person examination can. Practices that offer or recommend them must tell patients those limits clearly.

In short

Apps and online services can now measure acuity, estimate refractive error or screen for changes using a phone or computer, sometimes with AI. They do not examine the health of the eye in the way an in-person examination does, so problems such as glaucoma, macular disease or a retinal detachment can be missed. Where optical businesses or registrants offer or endorse these tools, the GOC Standards of Practice on communication (2), consent (3), scope (6.1) and judgement on digital data (7.8) apply. Indemnity for remote or app-based services depends on the policy and on whether the activity was declared.

What remote and app-based tools do

The range is wide. Some apps test visual acuity or contrast at home. Some estimate refractive error using the phone camera or on-screen tests. Some monitor patients with known conditions between visits. Others are marketed as a way to renew a prescription without attending a practice. AI is used to interpret responses, adjust test steps and produce a result.

Optical businesses use these tools in different ways: as a triage step before booking, as a monitoring service for existing patients, as part of an online spectacle or contact lens offer, or simply by recommending a third-party app. Each use carries different responsibilities.

Where they stop and an examination is needed

An app can only assess what it measures. It does not look at the optic disc, the macula or the peripheral retina, measure eye pressure or assess the anterior eye. A patient whose app result looks fine may still have a condition that only an examination would reveal. Symptoms such as new flashes and floaters, a shadow in the vision, sudden loss of vision or a painful red eye need prompt in-person assessment, not an app.

Under Standard 6.1 of the GOC Standards of Practice, registrants must recognise and work within the limits of their scope. A remote result should not be presented as equivalent to a full eye examination, and a registrant who reviews remote data must apply professional judgement to it under Standard 7.8.

The duty to tell patients the limits

Standards 2 and 3 require effective communication and valid consent. In practice, that means telling patients what the app does and does not check, when they should still book an examination and which symptoms need urgent attention. The College of Optometrists' interim AI position emphasises patient safety, and its draft guidance adds transparency with patients as an expectation. Remote services also involve health data on personal devices and cloud services, so Standard 14 on confidentiality and secure records applies.

What can go wrong

Illustrative scenario: a practice promotes a home vision app for existing patients between appointments. A patient's acuity result is stable, so they postpone their eye examination. In the meantime they develop gradual field loss from glaucoma that the app was never designed to detect. They complain that the practice implied the app was enough. The marketing material did not state its limits and the patient record has no note of advice given.

How cover treats remote and app-based services

GOC Standard 12.2 requires adequate indemnity. Whether a policy covers remote services commonly depends on how the business activities were described to the insurer, the territorial and jurisdiction limits and any exclusions for technology or software failure. A practice that builds or sells its own app may face product or technology claims that sit outside a standard optical PI policy. Where a registrant interprets remote data, a claim is usually treated as one about their judgement, subject to the wording. See does optical indemnity cover AI errors? and our optometrist PI guide.

Practical controls

You can reduce the risk with these steps:

Related: AI chatbots and recalls, AI referral triage, myopia management and the optical AI hub.

How Apex helps

Apex arranges PI for optometrists and optical businesses. A broker can check how your cover treats remote, online and app-based services before you launch them.

Sources

Frequently asked

Can an AI vision app replace an eye examination?

No. Apps can estimate acuity or refractive error, but they do not assess eye health in the way an in-person examination does. Patients should be told this clearly and advised when to book an examination.

What should I tell patients who use a home vision app?

Explain what the app measures and what it cannot detect, how often they still need an examination and which symptoms need urgent attention, such as new flashes, floaters or a shadow in the vision. Record the advice.

Is my practice liable for a third-party app it recommends?

Possibly, if a patient relied on your recommendation and the limits were not explained. The supplier may also be responsible depending on the facts. Clear communication and records reduce the risk.

Will my PI cover an app-based service?

It depends on the policy and on whether you declared the activity. Some policies treat remote services like any other clinical work; others have technology exclusions or territorial limits. Check before launch and tell your insurer.

Check your PI covers how you use AI

Tell us about your firm and the work you do. A broker will review how your current PI treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.