Optician will refract in Canada?!

Yes.. Licenced Opticians may now use an autophorptor to check the prescription of anyone ages 19-65 (exceptions applied to those with eye disease etc).

There was a simliar post discussing about this issue earlier....
http://forums.studentdoctor.net/showthread.php?t=115446

I am very surprised to see how many of you are just taking this and accepting a bunch of technicians performing medical procedures. I have attached some recent information for those of you who are interested to see that this bill in BC can be the beginning of a much troubled future for our profession. I am deeply disgusted by how uninformed our politicians are to allow a bunch of technicians (i.e. Opticians) who only get two years of college education (not any university education) which is mosly focused on fitting glasses and bending frames to perform refraction. I have done years of research on design of autorefractors myself and know how notoriously inaccurate they inheretingly are. I have sent e-mails to the politicians in BC and urge all of you to do the same. I can guarantee you that if BC bill stays in effect, all 50 states and the rest of Canadian provinces will follow and allow Opticians refract. So, lets stop this before it gets out of hand. You can start by writing to the BC's minister of health, Colin Hansen: [email protected]

Some more background info:

Government to allow opticians to refract, here in North America! See the
> report's link at bottom
>
> Hello everyone:
>
> Please forward this to every OD you know!
>
> We need every OD to mobilize and leave a word or two to stop this from
> happening. Here's the email address to respond to, please help your
> colleagues in Canada by stopping this risky slippery slope in which we are
> about to embark: (Colin Hansen, Minister of Health)
> [email protected] As you may know, the government here in British
> Columbia has amended regulations governing the roles of it's opticians who
> now will be allowed to 'sight test' patients from 19 and 64 using
> computerized testing equipment after a simple consent form is signed. This
> of course, only further blurs the difference between a sight test and an eye
> health exam. This proposed change is expected to take effect following a
> three month consultation period. This proposal was generated by the
> Optician Association's reaction to proposed regulation amendments allowing
> OD's to diagnose and treat some eye diseases and disorders, and prescribe
> some therapeutic drugs. I moved here, like most of the other local OD's,
> from Oregon. We certainly have no shortage of qualified OD's. The mere
> proximity to P.U.C.O. entitles us to having the highest OD per person ratio
> in Canada, as well as most of the U.S. Therefore, any need in having
> Optician's refracting to assist in any backlog of patients is a preposterous
> notion. This is a very urgent call, we must pool every resource from OD's
> everywhere, this is a very serious precedent setting law. Once this is
> done, it will be impossible to reverse. So let me, or our association the
> British Columbia Association of Optometry, or BCAO, ' www.optometrists.bc.ca
> ' know if we can provide more details.
>
>
> I want to thank you for your support ahead of time, I can't begin to tell
> you how critical the situation is becoming. We've done everything possible
> at the local level, we now need all of our partners in Optometry to mobilize
> and email their thoughts of how disgusted they are, and what risk the public
> is in. If there is anything I can do to expedite this, just say the word,
> but I think at this point if everyone we know could simply say a few words
> to those in charge of health care here, (Colin Hansen, Minister of Health)
> [email protected]
> I'm sure he is not aware of the elicit corporate friendships between
> Opticianry and the government that are behind this irresponsible
> contemplation.
>
> Again the address is: [email protected]
> To read the report on optician's change of scope: http://www.gov.bc.ca/
>
http://www.opticians.ca/

That's one of the reasons that I want to become an OD actually.. I really want to compare whether is it that much difference between an OD doing refraction and an optician doing refraction. I've been to both, both gets around the same prescription ( just axis of cylinder a bit off since everytime the respond is a bit different). In terms of refraction, is there additional information on top of just the prescription of your eyes? If we are just talking about refraction only, is it such a huge difference between an OD doing refraction test and an optician doing refraction test?

please put up some simliarities and differences coz I do want to know whether I should go to an OD to check my eyes or just go to an optician.

nice post doinkOD....i received that email and was going to post it myself....ppl please email this to every OD you know.....North America, wherever.....we need this to stop

Katalio, thanks for your enquiry. This is exactly the type of response I am hoping to get from the public. I trust that our patients are samrt enough to make the right decision for themselve, once they are presented with the facts. The unfortunate thing is that, Opticians present false information to the public and try to misinform patients, in an attempt to legitimize their greed for more money.
To answer your question, it is not the actual act of refraction by Opticians that is putting public in danger, but rather it is the fact that refraction is just one important part of a whole eye examination. The result of the refraction, along with the results of many other tests that are performed in a comprehensive eye examination by an Optometrist or an Ophthalmologist, gives much information about the ocular and general health of the patient. Many systemic diseases and a number of diseases of the oculo-visual system manifest themselves as a change in refraction. These diseases will be overlooked by an Optician who will simply give new glasses to the patient and the patient will see better with his/her new glasses, but the real underlying and potentially dangerous cause for the change in the refaction is not addressed. A new study by the University of Waterloo School of Optometry indicates almost one out of every seven people who visit an optometrist for a regular eye exam had eye disease with no apparent symptoms. The study also found two thirds of the patients who had eye disease had good vision. Many patients equate eye exams with getting new glasses and as a result if these new glasses are given to the patient by technicians (i.e. Opticians), the patient may not see his/her Optometrist or Ophthalmologist for regular eye exams and by the time the patient notices any loss of visual field or sever reduction in vision, even with correct glasses, it is often too late to do anything. So, it is very important for patients to get their regular eye exams with a doctor, either an Optometrist or and Ophthalmologist. Furthermore, eventhough autorefractors can be used to obtain an approxiamtely accurate measurement of the refractive error of the low myope(nearsighted patient) or a low hyperope(farsighted patient), the result of the refraction is NOT the final prescription. There are many more factors and test results that are considered by the doctor before writing the final prescription. The state of binocular vision (i.e. how the eyes work together) and the presence of any possible underlying pathology is considered to prescribe the correct amount of prism, correct colour of tint, correct center thickness of the lens, correct base cure of the lens, etc. just to name a few for you. To make a long story short, getting the measurment of the refractive error is just the first step in prescribing glasses and only a properly trained doctor of optometry or medicine can use his/her clinical knowledge of pathology and optics of the eye and the visual system to prescribe the best lenses for each individual pateint. No computer can ever replace the judgment of an Optometrist or a physician and all these new automated equipments are just tools to facilitate and assist the doctor in making the best decision for the patient and by not mean replacing the doctor. That's why it is so unfortunate that Opticians are abusing public's lack of total understanding of the issue and equating refraction with the prescription. I hope this helps.

good stuff

Thanx for the information DoinkOD... that surely clears something up in my head... I guess the problem arose from the government health care plan. I forgot what yr, but they stopped sponsoring adults for eye checkups therefore people had to put out around 70-80 per check I believe. It all came down to economics dont' you think?
But yeah.I do agree that not all opticians are qualified to use the autophorptor and autorefractor for refraction... however, I also wonder why the goverment allowed opticians to do refraction test in the first place.........

Aside from health problem..some misc. Q's I have and wonder if ppl can put some insight in.
Wouldn't it be much better if Opticians can't do refraction and Optometrist MAY not do dispensing? in terms of business.. it seems like now opticians are stepping into OD's niche, and optometrist stepped unto opticians' niche.
It is true that OD spend more time studying and knows MUCh more concepts about the eye than opticians (who spends 2 yrs learning about dispensing and about the eye) and they should be able to dispense as well. But why would most OD sell glasses/CL/accessories/sunglasses while they are doing refractions? is it because they can make more money or simply because they think opticians are not competent enough to dispense?

Enough said... many of you probably think why do I sound like I'm defending opticians.. well.. the truth is... I work in an optical shop and planning to become an optician during my undergrad and apply for OD after I grad. As we constantly keep in contact with OD's (regarding prescription confirmations etc).. I can totally see why some opticians are upset. This is going to be quite long but I'm just trying to give you guys some insight of what Opticians think sometimes. (since majority of ppl who read this are OD/future OD and less opticians)

SO..here it is....(I'm speaking behalf of what I"ve seen during my workplace).... (A few times, not always) Customer comes in with prescription from OD... we let the customer try on the prescription using "loose lens" (is it what u called them?) and check whether they can see clearly...they can't.. all they can see is perhaps 20/30? or 20/40? there wasn't any explaination or watsoever in the presciption regarding the distance the customer can see... so opticians add half a diopter and see if customer can see more clearly, customer see 20/20. THen optician ask whether customer would like to use the OD's prescription or the added one.. ofx.. customer would LIKE to see better but tend to choose the OD's prescription b/c one's a doctor and one's a technician. So optician goes and dispense the prescription the OD calls for, customer accepts. After 1 week, customer comes back and complain he/she can't see clearly... so optician check the frame adjustment etc etc. Still can't see clearly, so optician refer him/her back to the OD. So..the customer pays another time to see OD, THEN the OD changes the prescription by half a diopter or 0.25, then customer goes back to optician and demand a change. Opticians cannot charge the customer because it is stated in the prescription slip that changes in the power in prescription by the OD may be made and optician cannot charge the customer for the lens changes. So, what's the consequence? optician wasted 1 pair of lenses, wasted their time, and now had to change the lenses free of charge. That's not the worse,the worse is customer will think opticians did a crappy job in the dispensing leading to the blurry vision by the customer. I think during my workplace, the record was 3 times. Customer went back to OD 3 times and had their lenses changed 3 times and got fustrated and refunded the whole thing.
Anyways..from that being said... Opticians sometimes get upset.

I know this has nothing to do with opticains being able to refract or not and totally out of the topic.. but I"m just trying to tell u guys the views of some opticians and perhaps find a better solution in the future.

Note: I'm not trying to diss OD or question the ablity of OD's. I'm sure they had their reasons and that I won't understand most of the concepts until i become an OD myself.

Pretty soon the opticians will want to start checking IOPs or giving formal VF exams...or maybe even asking to write scripts or perform LASIK surgery, two things they are clearly not trained to do.

This conversation sounds very much like the threads when we disscuss how we (ODs) want to do lasik. I've often brought this up to freinds when we talked about this, we don't want opticians stepping on our toes...so it is easy to see why ophthalmologist don't want us stepping on theres.

I'm not bring this up to start and OD/MD thing, just to make all of us look at the picture by taking a step or two back.

I don't think that is it at all. As optometrist we a highly trained in refraction. As someone who has taught in the optician technician program at my school I will say that they don't learn anything about refraction at all. The procedures that they are taught are mostly prelims, some slit lamp and some tonometry. That is if they go to school at all. In some state, like Indiana, you don't even have to be licensed to work as an optician and in states like Ohio where you do have to be ABO licensed to work as an optician you still don't have to go to school but have the option of being an apprentice for two years and then taking the test. I was a licensed apprentice while in undergrad and there is no more to it and getting your ABO than learning to dispense, adjust and do a little math. There is no training thus far in refraction.

Does optometrist in US dispense eyeglasses after they finish an eye exam on a patients? or do they leave it to the opticians? Coz in where I live, quite a bit of optometrists love grabbing the eyeglasses/sunglasses business along with the refraction business. Why need opticians if optometrist are stepping into what opticians should do? I think that opticians are more like technicians and salesman while OD are health care personels (doctor). Opticians shouldn't step into "refracting" coz it's out of their field of duties as they don't have enough knowledge in optometry to point out any eye diseases etc. But I too think that optometrist shouldn't step into dispensing glasses, selling sunglasses, and other situations where it's clearly an optician's job. (Some exception such as special hard contact lenses etc).

You don't see MD's fill drugs prescription to patients, those are usually what Pharmacist do. So it's like an analogy... you get OD/MD and Opticians/Pharmacist. Ofx, Pharmacist are normally university graduates, but I think the same analogy applies.

Sorry about this issue once again, but I do want to know how other OD's in other areas think about this.



BTW: I feel sorry for the ppl in Hong Kong, I think an autorefraction is all they have... I don't remember seeing a phoryptor..

I wouldn't necessarily say that optometrist are stepping on the opticians territory by dispensing; optometrist recieve all the necessary training and licensing to dispense too (at least at the University of Waterloo). Part of the curriculum at UW involves grinding lenses, setting them in frames and even working with patients/customers in the clinics optical.

Also, I believe many optometrist that dispense don't actually do this on their own, they employ technicians - opticians to handle these duties for them.

PS. Hong Kong is an interesting case... I think optometrists there have only been formally recognized as more than refracting techncians for <10 years. So before HK Polytechnic established their optometry program people either visited foreign trained (USA, Canada, UK, Australia) optometrists (who had a limited scope) or they went with the autorefraction route. And of course the autorefractors have persisted...