Guess what I saw today in the afternoon!!

[Hamtaro]

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I was walking around in Crystal Mall, located in Burnaby-suburb of Vancouver (British Columbia) (for those of you who are not familiar with the Vancouver area, Crystal Mall is one out of the hundreds of Asian malls in Vancouver), doing some anime shopping. I walked past this eye glass store that has this big sign saying: Free Eyesight Examination refer within (all in chinese characters, no english). It was a nice store so I just walked inside to see how much they sell the contacts that I use. While I was waiting, I saw this kid (who looked around 7 to 8 to me) who was getting what his parents called a full eye examination with a machine (I don't know if the guy doing the refraction test is an optician or a sales but definately not an optometrist) !! I didn't know what to do about it cause I wasn't sure if that was allowed or not, so I just walked away after I got what I needed. My uncle (who owns many eye glass stores) later in the day told me that almost all eye glass stores in Richmond (where all the rest of the asian malls are) do free "eye exams" with the machine (actually just refractions) to all of thier customers when requested despite whatever their age is. What are all of your opinions on situations like this?

 

[Eyegirl2k7]

Using solely auto refractors is negligent.

Eyegirl

 

[chemgirlie]

I guess you get what you pay for. 😳

 

[JennyW]

Using solely auto refractors is negligent.

Eyegirl

Do you really think so? How many times is this done in nursing homes, or on patients that are non verbal? I've done it myself many times. If you have a good autorefractor that you know is consistent and reliable, I don't have much of a problem with it.

Jenny

 

[maxwellfish]

Do you really think so? How many times is this done in nursing homes, or on patients that are non verbal? I've done it myself many times. If you have a good autorefractor that you know is consistent and reliable, I don't have much of a problem with it.

Jenny

I totaly agree (and good point)... but I think the idea is using one with only an optician running them is a nono, am I wrong?

 

[Katalio]

Hye Hamtaro, are you referring to the Eyelogic systems that are in the optical shops now? Actually..from what I know... they cannot do perform that task on anyone below 19 and over 65.. coz It's illegal.. and salesperson cannot do that as well unless they are Opticians (although personally, I dont' think all opticians are qualified to do such thing, however, I can't say NONE of of opticians can).
I think you can ask your uncle who owns many optical shops for more details I guess...since he would've probably been asked if he would like to buy one of those eyelogic thingys.. (assuming your uncle owns these optical shops in BC)...

As before, for those who aren't familiar with what's this "eyelogic" thing.. it's not only an autorefractor..it DOES include the autorefractor but they also have an autophorytor in which the computer pops up differet sizes of letters and ask whether the "customer" can see the letters or not.. then it shows several different power of lens and will ask (by the operating person) the customer which one is bettter etc etc.. then by each response and trials, a prescription is generated.

Personally, although it has nothing to do with the health of the eye whatsoever, in normal circumstances (healthy eye I assume), that machine can check the PRESCRIPTION (only) of a customer with accuracy no less than OD.

Maxwellfish: How come you think that opticians using an autorefractor is a nono while an OD using the autorefractor is reasonable? The use of an autorefractor is not that complicated that an optician cannot learn to use rite?
Anyways...that's what I think.. hehe.. any inputs would be great. 😀

 

[xmattODx]

Do you really think so? How many times is this done in nursing homes, or on patients that are non verbal? I've done it myself many times. If you have a good autorefractor that you know is consistent and reliable, I don't have much of a problem with it.

Jenny

Retinoscopy is far more accurate than auto-refraction in children. Any exam of a child that does not delve into the binocular system is to say the least disappointing. In the elderly if you're confident in your auto-refractor and you are sure there is a clear lens auto-refraction is going to be close but a true refraction will still be better.

 

[JennyW]

Retinoscopy is far more accurate than auto-refraction in children. Any exam of a child that does not delve into the binocular system is to say the least disappointing. In the elderly if you're confident in your auto-refractor and you are sure there is a clear lens auto-refraction is going to be close but a true refraction will still be better.

How much "delving" do you think is needed?

Jenny

 

[Richard_Hom]

Using solely auto refractors is negligent.

Eyegirl

La mujare,

Por que, por favor.

Ricardo

 

[xmattODx]

How much "delving" do you think is needed?

Jenny

I think a complete 21 point exam in children is the least that should be done, however, I understand time constraints so an absolute minimum is:
Dx Ret and Subjective refraction (I really like the Humphriss technique)
Dx Ph and Vergence ranges
PRA/NRA
Near Ph
Some type of accom. posture testing (dynamic ret, 14 series)
Near Ph through near lens
Eye movements

This does not take a lot of time but really tells where the patient is and where they are going.

 

[Richard_Hom]

I think a complete 21 point exam in children is the least that should be done, however, I understand time constraints so an absolute minimum is:
Dx Ret and Subjective refraction (I really like the Humphriss technique)
Dx Ph and Vergence ranges
PRA/NRA
Near Ph
Some type of accom. posture testing (dynamic ret, 14 series)
Near Ph through near lens
Eye movements

This does not take a lot of time but really tells where the patient is and where they are going.

Shouldn't the baseline also include the following?
1. Would you include cycloplegic refraction?
2. Tonometry?
3. Dilated fundus exam with indirect?

Richard

 

[Hamtaro]

I asked my uncle, who has opened multi eye glass stores in the Richmond area, and he told me about the industry (he told me that he has chose not to purchse the autorefractor for now because it is way to costly, and this only refers to Vancouver, BC.. i don't know about other cities). Eye glass stores can only purchase the auto refractor if they have hired a certifed optician. In a mall in Richmond(suburb of Vancouver), Burnaby, and Vancouver City there are eye glass stores that give free "refractions" if you purchase glasses from them. In my own opinion, the people who get those free refractions done for them think that the refraction is equivalent to a full eye exam because the sign(s) that the store operators put up (advertising about the free refractions) are in Chinese and when translated literally means "Free Eye Check-up." The eye glass stores in those malls allow any one of their employees to use the autorefractor on their customers because their optician is not always free. All of those stores have hung up on their walls the certificate(s) of their opticians (which gives everyone int the store to operate the machine) and I guess that is all that is required in Vancouver for a Eye glass stores to give refractions (I am not sure about the law governing if only the optician can use that machine, but there seems like there is no such law implemented in British Columbia. Even if there is, no one would know that instead of the optician, the salesperson is using the autorefractor because the person getting their eye sight tested will not care or tell anyone else). Please feel free to share your opinion on the Eye Health care system in Vancouver. Thank you for taking your time with this post.

 

[Katalio]

Yeah..I totally agree with what you are saying Hamtaro, people tend to sneak their way thru with non-optician operating the Eyelogic system. I'm sure that only certified Optician can use the system. But people do tend to write " eye checkup"... I guess the people just dont' realize that it's just a refraction test instead of an Eye Exam. Moreoever, there are things that eyeglasses/Contacts only simply cannot suffice. A refraction test by Opticians simply cannot spot out any health problems related to the eye. They should clarify the differences I guess. =)

I believe the lawsuit/debate over opticians operating this machine is still going. Actually... there's always two sides to this issue...depends on how u look at it. If taken a poll (ofx not here becoz this is mainly an OD / futre OD forum) about this issue, I think that people will tend to favor the Opticians side. (which I never said is right/wrong)

Cheers,
Katalio

 

[xmattODx]

Shouldn't the baseline also include the following?
1. Would you include cycloplegic refraction?
2. Tonometry?
3. Dilated fundus exam with indirect?

Richard

Sorry I was speaking solely of refractive/binocular vision type stuff. I don't believe that cycloplegic is required for most children. There is a lot of interesting theory/study into what cycloplegic refraction is actually showing and it may not be true refractive error. Dilation at some point is probably a good idea but I must admit I don't do it on every kid.

 

[KaBlamO]

i guess some of you haven't been to hong kong. there's an eyeglass store at basically every corner. lol