The Eye Test That Also Wants to Sell You Sunnies

I got my eyes tested a couple of years back at one of the big chains, the kind with a name you’d recognise from a shopping strip anywhere in the country. Decent enough experience, except the bit at the end where the optometrist pivoted, almost mid-sentence, into asking if I’d considered a second pair for “screen use.” I hadn’t. I still don’t own one. But I remember thinking, at the time, that it felt a bit like buying a car. Nice chat about the engine, then straight into the finance options.

Turns out that wasn’t a one-off. There’s been reporting this week on internal documents from Specsavers, OPSM and Bailey Nelson, and it is grim reading if you care about the difference between a health appointment and a sales funnel. Optometrists told to hit conversion targets. Pay threatened if glasses didn’t sell. Staff instructed not to book clinical tests during “black-out periods” when the sales numbers mattered more. One optometrist ignored the memo, ran extra tests anyway, and found an unruptured brain aneurysm in a patient who had surgery the following week. That’s not a hypothetical about what corporatisation could do. That’s what it’s already doing, averted by one person deciding to do their job properly against instructions.

I want to be careful here, because “corporate bad, small business good” is the kind of tidy story that falls apart the second you look for exceptions, and there are plenty of exceptions in the comments under this story. People who’ve had lovely experiences at Specsavers. People who’ve found the “independent” down the road is really just a former chain optometrist running the same upsell playbook with better margins. Word of mouth still counts for something. So does luck.

But the structural point holds regardless of individual good eggs: when a health professional’s pay is tied to how many frames they sell, you’ve built a conflict of interest into the job description. One commenter put it plainly, that Medicare doesn’t pay optometrists enough for their time, so the business has to make its money on eyewear, and the optometrist becomes the delivery mechanism for that. It’s not really a story about greedy individuals. It’s a story about a funding model that quietly turned a health check into a retail transaction, then got surprised when it started behaving like one.

I think about this in IT terms sometimes, which is probably a professional deformation. We talk a lot about “incentive alignment,” and it’s usually said with a straight face by someone about to misalign incentives spectacularly. KPIs work. That’s the problem. They work exactly as designed, which is why an optometrist gets a call from head office because they scheduled too many time-consuming clinical tests in one day. The system isn’t broken. It’s doing precisely what it was built to do, and the thing it was built to do isn’t “catch the aneurysm.”

My daughter needs glasses, has for a couple of years now, and I’ve noticed myself steering us toward the same small independent place near home without fully articulating why until I read this. Partly habit. Partly a vague, half-formed sense that the bloke there seems to actually enjoy the job, isn’t checking a screen for conversion metrics between patients. I don’t know if that’s evidence of anything, really, one data point dressed up as an instinct. But I trust the instinct more after this week.

The optometrists trying to unionise, over a third of the workforce now apparently, aren’t asking for anything wild. They want to be classified as health professionals rather than general retail staff, which is currently not the case for a job requiring five to seven years of study. It’s a small, unglamorous kind of fix. Reclassify an award. Adjust a Medicare rebate. Not a revolution. But it’s the sort of unglamorous fix that tends to matter more than the ones that make headlines, and it’s the kind of thing that only happens if enough people sign the petition and enough patients start asking, out loud, whether the person testing their eyes is being paid to hurry.

I don’t have a neat ending for this one. The chains aren’t going anywhere, they’re too convenient and too cheap for a lot of people who genuinely can’t afford the alternative, and that tension doesn’t resolve just because I’d prefer it to. But I know where I’m taking my kid’s next eye test, and it isn’t the shopfront with the sale sign in the window.