An auto Refractor without a corneal topographer is useless, IMHO.Originally Posted by kcount
B
An auto Refractor without a corneal topographer is useless, IMHO.
B
I'd like to see Auto Refractor/Topographer/Tonometer in one box.
- Optician
- Frame Maker/Designer
- Teacher of the art of crafting handmade eyewear.
I'm with Austin on this - having been that tech for years in two different ophthalmology practices. Yeah, they both offered "training" on refractions, which in each case, represented a single sheet 'handout' the techs got, and about an hour with one of the older docs showing us "all we needed to know". They also expected you to deliver perfect refractions, while at the same time collecting and documenting a complete med history, reading specs (often multiple pairs), charting everything in the system, and dilating the patient. Practice number one was uber lenient and gave us a massive time-slot of 10-12 minutes to accomplish everything. Practice nuber two was less so - you had a sore hind end if you took more than seven - ever.
Needless to say, spec remakes were crazy high much of the time - unless the OD was the doc in the room. They'd usually repeat the entire refraction again and make corrections as needed. Sometimes the MD's would do the same, but that was rare. I'm always highly skeptical now of outside MD's numbers in the area - with a few very rare exceptions, it's paid to be wary and to educate the patient as to the likelyhood of remake problems.
I can't see the auto glasses machine doing any better. Unless every pair is fitted with an opti-grab. Then it'd be ok.
Careful point of order:
The issue is whether a self-refraction or autorefraction is acceptable as a prescription. No, I don't believe so.
The issue is not whether opticians should be able to write prescriptions. No, I don't think we need it, but if it were to be done then the optician should do it right.
To KCount's point, there's no reason why an optician couldn't do it "right", but it would'nt be a stand-alone refraction or autorefraction. Heck, most of the good opticians on here are so conscientious that they take explicit care on something fundamental as measuring p.d.'s. Many of you would make excellent prescribers, given the circumstances, I do not doubt, but you would use the same procedures as the classical optometrist does (did?): history, lensometry, acuity, objective and subjective refraction, binocular/accommodative testing, etc. (Barry's greater point).
If an OD or OMD tech does just a "stand alone refraction" (myself included), I'm not going to generate good Rxs. (Uileann's and Austin's point.)
Last edited by drk; 02-21-2012 at 10:48 PM.
Just what constitues a "perfect" refraction?
My take would be a *very* satisfied client...regardless of the exact numbers.
Your take?
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I think you mean "a perfect experience". Again, "refraction" is only a part of the chain.
Yeah, it's subjective, and we're here to please the end user, so I agree with you.
100% Agree.
- Optician
- Frame Maker/Designer
- Teacher of the art of crafting handmade eyewear.
Group hug!
This is a fine illustration of the deterioration of the profession and the human condition at large--eliminating human interaction. I think that our compliance with and submission to large corp. retail optical has contributed hugely to the existing environment to allow this to take hold of the public. We used to be a profession made of, largely, small businesses--now we are, largely, employees of large corporations who are often managed by those who have never done our jobs, and they do not necessarily have the same agendas. Ultimately, we 'professional's let it happen. As we sought to advance our professions and our numbers, we lost our sense of ownership and let the powers-that-be dictate to us how we would practice. In turn, their lack of ethos became our apathy. If we want to take back our profession from the 'item' retailers we have to be of one mind and a common ethos, be better, be smarter, and beat them at their own game. We need to re-establish that the patients' welfare as the prime interest. This type of situtation, along with the potential for online refractions (i.e., 20/20 article posted by Santini below) that is also up and coming, will seperate the chafe from the wheat. I think it is the propensity for all professions to go through these reinventions at some point: I realized the kiosk potential back in the '90s, but my peers blew it off. It's time to see our profession as it is and start taking it back. See the opportunities in adversity. Turn these lemons into lemonade! For the record: although I have worked in private practice, today I too work in large corp. retail. I strive to make a difference in my profession every day, to educate consumers, and not to comply with those things that I think lessen my profession within the realm of retail optical.
60 minutes special this past sunday was about the various types of jobs being replaced by robotics, machines, computers etc. Seems germane to our conversation.
AA
http://www.cbsnews.com/video/watch/?id=50138922n
Ha ha ha, this thread is awesome. I can't wait for my overlord the box.
Every procedure can be automated, then simple psychology can improve the satisfaction rate. If an aberrometer were to weed out the more difficult to correct, and then a autorefractor were to determine a starting point, the rest is show. Place a few lenses in front of the patient and ask for a response (patient is now vested in the outcome because they are a participatory accomplice in their script). Next open an aperature allowing client to peer through the mall (trial frame and confirm patient satisfaction with the script). If the patient does not like the view restart with up to 3 loops through the routine before recommending the mall OD, then offer a significant discount for their time to come back and utilize the spec service.
This bill has been scuttled for 2012.
Nothing an OD can't fix with a trip to the mall and a can of spray paint.
How could you say that about the Peoples Republic of America ?
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