Re: Welcome Back !! ......
Quote:
Homer said:
Maria and Sara. It's been a while.
Now on to the subject at hand:
As I see the original question, it was asking about refraction and not eye-examinations or eye-health evaluations or treatments.
Refraction is not a medical procedure!
With proper training (or NOT - note often refracting techs) anyone who has been dispensing and problem-solving eyewear for a few years probably has a pretty good chance of being a crackerjack refractionist.
Refraction 101 should be that ANY unusual or suspicious situations should be referred to the proper physicians; both OMD and optometric physicians(as they wish to be know these days). One not willing to recognize the limits of refraction sould be considered not only dangerous but also too stupid to either refract or dispense.
So, you are for crackerjack refractionists?? Well, maybe you should refract then?!? (That was in response to the sarcastic optometric physicians comment!!) Homer, j/k, listen, you have to know a lot more than just flipping lenses to refract. What happens when you have a 47 year old patient who sees 20/20 with -1.00 DS over his/her current refraction? That might not mean much, but to me it means possible diabetes. What happens if you refract someone with a high amount of cylinder? Possibly nothing, possibly keratoconus or a number of other corneal problems. And the most important question--say you do refract someone and he/she sees 20/20 -3 or 20/25--do you give them the script or refer them?? There will be a number of newly refracting opticians out there that say 20/25, that's ok, but there could be an underlying problem..........
WHY CAN'T OPTICIANS REFRACT?
Licensed opticians are well trained in subjects of visual optics (basis of refraction) and they should be encouraged to become Refractionist. I would prefer optician refract me rather than ophthalmic/optometric technicians who are lay people trained in doctor’s office. I agree with Pete Hanlin that optometry derived its existence from opticianry. Optometrists are still commonly known as optician in most parts of the world, please correct me if I am wrong. I disagree with Homer on refraction is not a medical procedure. It is 100% medical procedure but with proper training dispensing opticians can successfully undertake refractometry. Example of training program for dispensing opticians to become refractionist based on modular system: 2 yr dispensing course=you become licensed optician, add 1 yr contact lens course= you become licensed contact lens optician, add I-2 yr refractometry course(includes step by step diagnostic examination of the eye)=you become licensed refracting optician!
Yes,with right training opticians are capable of refracting independently.
That was my 2 shillings worth...:bbg:
Regards,
Optom
Chip,
Auto refractors are useless for refractionist,it can give you misleading results many times.It is an ophthalmic toy to impress patient.
Retinoscope in hands of experienced refractionist can be faster than auto refractor and accurate within 0.25D.
I hate to dissapoint you but..
The fact is that it is already happening in Canada. You may have heard of all those Eyelogic refractors north of the border. Also I can bet you that any ophthalmic tech after years of experience can and may do better refractions than many ODs. No pun intended there is just experience.
Maybe you will have a hard time accepting what the future has brought but the truth is that is happening now. Techs are overwhelmingly refracting for MDs. Also that is displacing us opticians because they have discovered (the Mds) that it is safe to delegate refractions thus allowing them to set opticals. if Ods would have been more fierceful and kept the refracting to themselfs this would not be happening. If it was such a harm it would not be happening specially if they have money to loose.
Also in many parts of the world (not third world countries) opticians with 2 or 3 years are already refracting. Lets no try to erase the line of what is currently happening and be blindfolded.
In one thing I agree with you and that is education. Refraction is almost taught in all schools of opticianry probably in more detail than in many Ods schools.
ODs dont want to refract..they want to be doctors...nothing wrong with that.Opticians dont want to be doctors, they just want to be able to serve the public just like any other healthcare practitioner... even if it means expanding the scope of practice. Again I am sure you will find a thousand reasons for not to happen. We are not s t u p i d you know.
I for one would love to be able to refract but what I would rather do is have the ability to hire Ods as employees. I hate those lease arrangements deals. I would like to have it like Chip said long time ago..each to its own plate.
In any case to respond about the media, it is fairly easy to use a slit lamp to rule out type of opacities. We do it all day when fitting cls. Now you will say what about blood or vitreous detachments...or other internals, well how about a good look with an indirect ophthalmoscope... maybe that will be the next step.
As far as prisms, ever heard of a profession called orthoptics..they are not doctors...or not even optometrists but guess what this people are in demand from Mds. Maybe the refraction courses taught to opticians do cover prisms.
Hate to disagree with you..
Maybe you being so far away have been missing what is going on here in US. For starters I agree that US optometrists initially were trained to be the best refractionists but that is changing as in all of the curriculums that is slowly being left out to give more space to important and relative medical subjects such as pathology and pharmacology. Optometry here in US is by no means the same optometry as in other parts of the world. Irvin Borish had to remind the ODS that refraction is their bread and butter and still some programs have shorten the ods training in refraction. Optics (glasses and contact lenses are below the new ods)
Also for starters European ODs are not Optometric physicians , they cannot prescribe drugs nor perform any sort of treatments other than optical. I guess in Africa is the same story, probably the closest to US ODs are the Australian programs and the New Zealand programs. Forget about the British programs as you would need to validate most of your schooling here.
The old definition does not apply to ODs here in US. That is why no Foreign trained optometrists is allowed to practice here in the United States, not even Canada allows Foreign trained ODs. If you are so proud of your optometric training, try come here to the United States to practice as an Optometrists. For them you are a refracting optician (funny that is what we want to become). Maybe Florida can take you, but as an optician.
Now if you trained here, then you are a real optometric physician. You would need to spend time validating your training here and also big bucks. Ods here are doctors because their scholastic credentials are 4 years of college in any subject (BS) and then 4 years of optometry schools.
So dont laugh to hard as the Americans ODs view foreign ODs as inferior. No Pun intended other than foreign OD programs cannot match what US ODs go through here. I am sure some ODs can expand into this subject about their turf.
American Ods go thru hell if they have to relocate to a diferent state after being licensed in one state. See, majority of states do not have reciprocity so the poor OD that has to relocate because their spouse is tranferred may actually have a hard time practicing in their new home state. Some even become techs or worse leave the professsion all together. I guess an eye maybe structurily different in Florida than in New York. Also the curriculum changes so much than in five years it may not be the same profession. That is why old ods are foggies according to VSP, eventually the old od will not be able to practice unless they get therapeutic credentials. Not a nice profession in the way they treat ther oldies.
As far as JCAHPO trained technicians , I have met many who are college educated and could actually do better than many newbie ODs as far as refraction. Go to the JCAHPO website and see for yourself. I have also met US Optometric Physicians who are MD program flunkies. Does that make them inferior? ATPO salary survey shows that salaries for these "high school drop outs" are starting to go up into the mid 40 and 50s. That is an envy for us licensed opticians. but our main advantage is that we can be our own boss and they cannot.
As for orthoptists you really have guts in assuming that they are uneducated as well. In order to be an orthoptists here in the US you need a Bachelor degree prior to entering training. If you do not believe me, web for the American Orthoptic council and see for yourself.
Hope this changes your opinion about things....yes I do now what is out there So are you really proud of the american ods now?
Dannyboy
:( :p :eek: