View Poll Results: Should Opticians Refract

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  • Yes (unequivocally, with no supervision or restrictions)- with formal training

    106 36.30%
  • Yes (with no supervision, but with restrictions as to whom can be seen)

    60 20.55%
  • Yes (with supervision)

    55 18.84%
  • No (because there is no need for Opticians to refract)

    58 19.86%
  • No (Opticians are not capable of refracting)

    13 4.45%
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Thread: Should Opticians Refract - The Poll

  1. #76
    fortwo eye jediron's Avatar
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    Unhappy

    Paw said:
    If opticianry is the fabricating and dispensing of lenses, why is optician learning how to do a medical procedure like retinal angiography? Playing doctor? Scary...

    Believe it or not, a lot of Opticians want to expand there knowledge and expertise in different areas, where by becoming
    more proficient and more valuable to the MD they are working for.
    At least in Western N.Y. a lot of the MD groups have hired Opticians to fill a dual role. One as Optician and the other as a tech. Where they will adminster taking of history and a host of other questions regarding the patients heath.The office
    I used to be in, I was responsible for autoclaving all instruments,
    taking history ect.ect. Also instructing patients on contact lens procedures. Retinal photography, auto-refraction and adminstering field testing. This freed the OD or MD to continue on with the other patients and then coming back to go over the results from the previous patients. I also had the resonsibilty to order frames, lenses and cases. Problem was once my pay reach a certain level it didn't matter how much I had learned, it came down to how much was he paying me and he thought that was to much after 3 years of service. Live and learn.
    :bbg:

  2. #77
    OptiBoard Professional Dannyboy's Avatar
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    payscales talk

    Paw, ophthalmologists are delegating everything under the sun..that is why JCAHPO has been so sucessful. The average Mds malpractice insurance is more than 10 grands a year and have seen it go to 60-70K...so they are really covered even if a mistake happens..right or wrong it is happening.

    Ophthalmologists have discovered that they can safely delegate almost everything they do (obviously diagnosing not) but techs can do everything...


    And then we fight wether an optician can do a mere refraction?

    :( dannyboy

  3. #78
    fortwo eye jediron's Avatar
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    Unbelievable!

    Chip said:
    But now that the whole thing can be done by machine as well as many refractionists bother to do. Why not just get refraction de-regulated as a "medical practice" and buy a damn machine without bothering to take a lot of complicated courses and legislation.

    Paw and vitalogy44 you have to understand Chip perfers on the job training. What he has against education is beyond me.


  4. #79
    fortwo eye jediron's Avatar
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    Big Smile

    Dannyboy said:
    Paw, ophthalmologists are delegating everything under the sun..that is why JCAHPO has been so sucessful. The average Mds malpractice insurance is more than 10 grands a year and have seen it go to 60-70K...so they are really covered even if a mistake happens..right or wrong it is happening.

    Dannyboy is right Paw. But in some cases the malpractice is even
    higher than that. Most MD's don't care about malpractice insurance. The practice I used to work in, the two main Ophthalmologists were each bringing in well over 750.000 to one million per year for themselfs. And they were delegating everything to the techs. They even incorporated an incentive. If you were certified by JCAHPO in COA,COM and COMT you were given a very nice bonus for achieving that status.:D

  5. #80
    sub specie aeternitatis Pete Hanlin's Avatar
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    If opticianry is the fabricating and dispensing of lenses, why is optician learning how to do a medical procedure like retinal angiography? Playing doctor? Scary...
    Actually, if Opticians ever do manage to make the leap into refracting (which, IMO is never going to happen- at least not until all LDOs are graduating from formal education programs), it will represent the second time Opticianry has done so.

    After all, Optometry derived its existance from Opticianry around 100 years ago when a portion of the field began to seek higher education. At the time, MDs had the same "scary" objections. From what I've read, the Optometrist's defense was "A lens is not a pill."

    Now- whichever side of the refaction argument you happen to fall on- it is undeniably interesting that the same group that argued so vehemently that refraction isn't practicing medicine are now arguing just as adamantly that refracting is tantamount to the practice of health care.

    Oh what a difference a century or so makes! :D

  6. #81
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    Question I do refract...

    As to whether optician should do refraction, being a trained Optical Dispenser from Sydney and currently living in Singapore.
    Well when i was living and dispensing in Sydney, Opticians are not allowed to do any refraction. But when i moved to Singapore in 1995 it really amazed me to find out that Opticians here do actually do eye refraction as well. They only refer the patients to eye doctors if they detect something wrong with the patient's eyes. So as an Optician i had no choice but learn to do eye refraction as well to be on par with the other local Opticians here.
    I also understand that Opticians in some of the Asian nations do eye refraction as well. So i guess Opticians should be allowed to refract if they are properly trained and they know what they are doing.

  7. #82
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    Thumbs up S.E. Asian Opticians...

    Most Opticians in countries within south east asia do refraction as well except for Phillipines the refraction is done by a trained Optomerist. Optician in Japan do refraction as well.

  8. #83
    since 1964 Homer's Avatar
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    Welcome Back !! ......

    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.

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    Re: Welcome Back !! ......

    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..........

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    Re: Unbelievable!

    jediron said:
    Why not just get refraction de-regulated as a "medical practice" and buy a damn machine without bothering to take a lot of complicated courses and legislation.

    Paw and vitalogy44 you have to understand Chip perfers on the job training. What he has against education is beyond me.

    The primary reason is that there are no "machines" out there that can refract. If you could see all of the auto-refractor measurements vs. the Rxs I write--I would say that the auto-refractor gets within -0.25-0.25x??? about 5-10% of the time. And I would estimate my Rx check rewrite % at about 1-2%. Did you really intend to write..."without bothering to take a lot of complicated courses and legislation"?? Are you serious??

  11. #86
    Bad address email on file Rick Strong's Avatar
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    Idea

    Well here`s my 2 cents worth.

    I voted no.
    I see Opticians refracting as a way for major chains to further
    dominate the industry. Opticians with private practices will have
    to try to charge the public for their new services while the chains
    will offer this service for free.
    One of the problems I see will be in advertising this service
    to the public, will it be advertised as:
    An Eye Exam
    Or
    A Refraction

    Will the general public be able to tell the difference ?


    Rick

  12. #87
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    Training and Education

    Opticians can and should be able to refract after appropriate education and training just as my OD friends have been able to prescribe pharmaceutical agents for the diagnosis and treatment of disease....but only after significant academic effort has been expended! Now some OD will now say "if you want to refract, go to Optometry school". That is the same old tired argument that MDs used on you 20 years ago...it will not float. On the other hand, Opticians have to understand that it can never be accomplished via some on-the-job training program and a simplistic 100 question exam. The argument vitalogy is presenting offers some good points, but a competent Optician CAN be TRAINED and EDUCATED to effectively refract and recognize appropriate referral protocals. No one is trying to make Opticians "junior eye docs", only to allow the playing field to be leveled a bit. Opticians deserve the opportunity to advance, just like other professions. As to the chains, I think that the argument that allowing Opticians to refract will give the chains more power is a stretch...it is more about the profession advancing. Reading Classe' (Legal Aspects of Optometry) there is a section that provides a history of the evolvement of Optometry from Opticianry. There were those who simply did not want to do independent refraction. They remained behind and continued to align with Ophthalmology. The more forward thinking among them went about educating and training themselves and look at where they are today versus Opticianry and our historical alignment with the MDs. I want Opticianry to advance. If you are an Optician and don't want to do more than you currently do, then so be it, but PLEASE let others advance if they have that desire. Why continue to hold us back?

  13. #88
    OptiBoard Professional Dannyboy's Avatar
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    get real

    Vitalogy, opticianry will expands its scope of practice wether optometrists are on their side or not. Refraction without an eye examination is possible if patient education is given importance. Refraction alone will not tell if someone is diabetic or if they have a tumor etc...

    Now opticians are not the evil empire per say and they want the best for the patients too. That is why I foresee more alliances among opticians and ophthalmologists. Face it, technology is on our side.


    Refraction is almost perfect with todays computerized equipment.
    Now you may say what about the health of the eye? That would be the next step and it will come sooner than you think to an optical close to you.

    Let me explain, medicine (real physicians), are just waiting to expand it radius of action. Once medicare approves the codes, the barriers will start coming down.

    If I was an ophthalmologists my next step would be to equipt independent opticals. The optician "rents" space to these cyber doctors. The magazine ads speak for themselfs.

    The epic system advertises refraction by technicians and can be program for the individual doctors testing sequence.... Slit lamp cameras that capture images of ocular adnexa and are "telemedicine ready", non contact tonometers that a person without experience can use and now we have "Optos" ophthalmoscopy machine that takes incredible pictures of the retina and without dilation and it is telemedicine ready....

    Now the real question would be not wether opticians can refract alone but wether optometry embraces the technology and allow opticians to perform refraction and them (ODs) read the results of these "eye exams".


    Dannyboy

    :hammer:
    Last edited by Dannyboy; 06-12-2003 at 07:19 PM.

  14. #89
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    I figure that within 10 years we'll just stick our credit card into a machine in the mall and get our eyes corrected laserly while we stare at a picture. 5 minutes later we're shopping with our new eyes. What do you think?

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    That kind of brings to mind an Arnold movie from long ago, the one with Sharon Stone. Also reminds me of Minority Report, which kind of grossed me out.

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    I wouldn't be the least bit surprised if that was routine in about 50 years.

    Maybe sooner.

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    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.
    Last edited by Optom; 08-16-2003 at 06:58 PM.

  18. #93
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    Re: get real

    Dannyboy said:
    Refraction is almost perfect with todays computerized equipment.
    Now you may say what about the health of the eye? That would be the next step and it will come sooner than you think to an optical close to you.

    Let me explain, medicine (real physicians), are just waiting to expand it radius of action. Once medicare approves the codes, the barriers will start coming down.

    If I was an ophthalmologists my next step would be to equipt independent opticals. The optician "rents" space to these cyber doctors. The magazine ads speak for themselfs.

    The epic system advertises refraction by technicians and can be program for the individual doctors testing sequence.... Slit lamp cameras that capture images of ocular adnexa and are "telemedicine ready", non contact tonometers that a person without experience can use and now we have "Optos" ophthalmoscopy machine that takes incredible pictures of the retina and without dilation and it is telemedicine ready....

    Now the real question would be not wether opticians can refract alone but wether optometry embraces the technology and allow opticians to perform refraction and them (ODs) read the results of these "eye exams".
    Danny, I have to disagree with the statement that refraction is almost perfect with today's computerized machinery. It is far from it--especially when the ocular media is not clear. As far as refracting goes--I feel that I am one of the best because I take my time. I know refraction well enough to fly through it and see that many more patients a day, but I feel in the long run--this will come back to haunt you.

    You better sit down for this and I have in my previous posts been playing devil's advocate, but I voted yes on the poll (with supervision, initially). This person would have to refract as I do--so that I know it is right. That is one good thing about having opticians refract--certain ODs could show them how to do it right. It is not simple--it is an art. I can't count the number of MD patients I have seen 3-6 months after the exam and they come to an OD. I don't know if it was the tech, MD, or auto-refractor that wrote the Rx, but it is way to common for it to be right.

    I can tell you this--there is no way that an autorefractor could out refract most ODs. Based on quantity, the Auto-Rx would probably win out, but qualitatively the OD would kill the Auto-Rx. I think this boils down to the subjective portion of the refraction. It has to be included--especially important in patients with ocular media anomalies, latent hyperopia, etc. Basically, the machine has to become much better before I would trust it with checking the Rx it spits out. How much prism can an Autorefractor put into an Rx?? There are so many variables.

    Also, I must disagree with Homer's post--I don't know why anyone think the way he does?!? I mean you have to respect the amount of information that a refraction can give you. He obviously doesn't know all the important information that you receive from refracting someone. I feel that it is a medical procedure. Refracting techs as a whole perform pitiful refractions. And I won't even touch this statement of his--
    "One not willing to recognize the limits of refraction sould be considered not only dangerous but also too stupid to either refract or dispense." Refracting does have limits, but to use all of the possible information is important. I mean it is this attitude that could be dangerous. If he was to refract--he could only schedule patients every other day, because he would have to see Rx checks on the other days.

    In Optometry school-I started refracting my first year and refracted more every year after that. Like I said -- it is an art. I'm not against opticians refracting--I'm against ignorant (not in a demeaning sense) opticians refracting.

    Look at wmcdonalds post--that's the way to get it done!!

  19. #94
    OptiBoard Professional Dannyboy's Avatar
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    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.

  20. #95
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    Big Smile

    vitalogy44 said that Jediron said:
    jediron said:
    Why not just get refraction de-regulated as a "medical practice" and buy a damn machine without bothering to take a lot of complicated courses and legislation.

    Paw and vitalogy44 you have to understand Chip perfers on the job training. What he has against education is beyond me.

    Problem Vitalogy44 is that you are attributing a quote to me, when in actuality I was quoting Chip, I never said that. Please get your facts straight.

    The second part of your post is correct.




    :bbg: :D

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    I like the idea of going back to the old "Drs apprentice" idea. You learn the trade working one on one and getting hands-on experience (and getting paid for it). After a prescribed period of time you become a Dr. yourself. Maybe a final exam or something like that. Bypass the whole college thing :p


    shutterbug

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    Wink take it easy..

    Dannyboy,
    In response to your last post, please take my advise, check out course syllabuses of all four O’s (fourth being orthoptist) you will come to know who is who and who is the best educated in our eye care profession. Those using eye logic refracting system in BC are not really refracting! I believe they don’t have right to write an optical prescription. What is the use of celebration for? Even an office cleaner can operate eye logic refractors with few instructions and can relay results to an optometrist or ophthalmologist for writing optical prescription. Another thing, though I detest to tell you this, but I think I must let you that some ophthalmic technician candidates I came across in north America who were appearing for JCAHPO skill evaluation at our MD offices where drop-outs from high school. Now how can you allow somebody in eye care field who has not even satisfactorily completed high school.
    Listen, optometrists are highly educated vision specialist and no other O’s are capable to challenge us when it comes to the art of refracting & prescribing. There are qualifying levels in optometry depending on country where you took your course e.g. diploma in optometry, B.Sc Optometry, Doctor of Optometry the same way we find in other professions e.g. diploma in pharmacy, B.Sc Pharmacy, doctor of pharmacy, BA law,doctor of law etc, this does not mean one is interested to be called doctor. I suggest you do some research before you comment on professions.
    Regards,
    Optom

  23. #98
    OptiBoard Professional Dannyboy's Avatar
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    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

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    Dan,

    FYI:
    1) European optometrists can prescribe simple topical antibiotics like chloramphenicol in urgent situation while in UK with diploma in ocular therapeutics it has expanded optometrists scope to broader prescribing spectrum.
    2) Some African countries already have OD degree programs. These African ODs can prescribe and treat some ocular conditions.
    Because of shortage of ophthalmologist in Africa, OA, nurses, opticians and optometrists have been trained to perform cataract surgery and in other important surgical intervention procedures to prevent blindness.
    3) Foreign trained optometrists are allowed to practice in US provided they have graduated from accredited college or university and are prepared to upgrade to US OD level, usually it is 2 more yr of studies. Look around you and I am sure you will find an OD originating from India, Africa or UK practicing in US.
    Likewise, US OD’s going overseas to work are required to meet registration regulations of foreign country including passing examinations and internship if necessary. So there is no question of American OD’s viewing down on foreign OD’s as you say, but it is of quality control i.e. making sure highly trained morally motivated people are getting into optometric profession. Is that not good for your and my country?
    I believe there is reciprocity arrangement in place for US-Canadian optometrists. So once a foreign trained optometrist has obtained his OD degree in US, he can locate himself in any provinces of Canada without hassle.
    4) I never said orthoptist are uneducated, I told you to compare course syllabuses of all four O’s so you know who is who in their field. What I actually meant is only optometrists are capable of performing professional tasks of other three O’s. Does that make you feel bit jealous.
    Remember, as primary eye care providers, optometrists are very important part of the health care team.
    I hope this will clear your misconception.

    I look forward to seeing opticians becoming refracting opticians and joining hands in “Vision 2020”, a worldwide concerted effort designed to eliminate avoidable blindness by the year 2020. The program will enable all parties and organizations involving in combating blindness to work in a focused and coordinated way to achieve the common goal of eliminating preventable and treatable blindness.
    Regards,
    Optom

    BTW, Do you know if American opticianry qualifications like ABOM, NCLE are recognized outside of North America? I know of British optical qualification FBDO (CL) is immediately granted recognition world-wide.

    cheers
    :cheers:

  25. #100
    OptiBoard Professional Dannyboy's Avatar
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    not so

    The NBEO has not recognize any foreign OD school in Europe or anywhere else (Canada is like Home).

    Optometry in Europe is not the same all over Europe. Optometrsits from Spain or Italy are not the same as Optometrists from UK or Autralia. Optometrists from South Africa still have to go back to school here in the US.

    Have you ever tried to come here to the US to practice, it is not easy. Get your facts straight. None of the State boards of Optometry accept foreign trained applicants. They have all to be upgraded to US standards by completing more than two years some almost do the entire career over. Yes I have seen and had many ODs working for me (sort of speak) from India, all good but all had to do an Undergraduate degree and revisit the OD program. In any case if you decide to come here, have fun because you will be stepping into OD school again. AND thats is a lot$$$.

    As far as Opticianry qualifications they are acepted in many states, Florida recently accepted the education part (Schooling) but they still had to take "THE TEST". The Also I heard that some OPhtalmologists from CUBA actually were accepted recently to sit for the little opticianry test. THey still need the ABO and the NCLE by law. The FBDO (CL) credentilal is not. But hey any one can take those. The tricky part is the State board exam which $800.00. And then there is the risk of failing.

    Dannyboy


    :bbg:

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