View Poll Results: Should Opticians Refract

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

    138 37.70%
  • Yes (with no supervision, but with restrictions as to whom can be seen)

    76 20.77%
  • Yes (with supervision)

    69 18.85%
  • No (because there is no need for Opticians to refract)

    69 18.85%
  • No (Opticians are not capable of refracting)

    14 3.83%
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Thread: Should Opticians Refract - The Poll

  1. #126
    Pomposity! Spexvet's Avatar
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    Quote Originally Posted by Judy Canty
    What is so frightening about an educated and regulated Optician?
    They demand a higher salary, so big business, MDs, and ODs will keep less $$$ for themselves.
    ...Just ask me...

  2. #127
    What's up? drk's Avatar
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    No, no, and no!

    Nothing "scary" about educated, well-trained opticians! Scary would be a decrease in the level of vision care provided to the general public. Agreed, at least in principle?

    I agree that certification for technicians and opticians is a good thing (as for anyone). It already exists. Should it be mandatory? Possibly. Should any type of professional be allowed to work as an employee? Good arguments for and against.

    Any OD that would be busy enough to make a business arrangement with another professional would tend to make more money, not less, I'd think.

  3. #128
    Pomposity! Spexvet's Avatar
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    Quote Originally Posted by drk
    Any OD that would be busy enough to make a business arrangement with another professional would tend to make more money, not less, I'd think.
    But the immediate, short-sighted decision is: do I pay a Licensed Optician $20/hour to do the job that I can pay Natalie Knownothing or Wally Workingfortheweekend $6/hr to do? Sure, the job won't be done at the same level. But it's very tempting to save the $560 for a forty hour week - that goes a long way to offset all the remakes. You and I know that the long range effects will erode the business, but I worked for the Evil Empire, and saw it happen every day.
    ...Just ask me...

  4. #129
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Then why do the AOA and NAOO lobby so strongly against licensure for Opticians? If creating and maintaining quality professional services is good for everyone's bottom line, then I just don't understand the objections. These folks are, if nothing else, bottom-line oriented. It seems to me that if most OD's appreciate the value of an educated and regulated Optician then those same folks should be able to influence the policies of their national organizations. Or am I becoming delusional again?

  5. #130
    OptiBoard Professional Dannyboy's Avatar
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    Judy....

    Man I do not know what wrong here... OD DO NOT NEED OPTICIANS. We are in their way of domination of the eyecare industry. They only want "help" not licensed Opticians.

    ODs as collective group are only interested in their pockets!
    As a collective group they hate Opticians, they hate our organizations and they hate everything that insinuates that Opticianry provides a public service.

    Even when we tell them that we have our own colleges and our own state boards and our own organizations..still that is not good enough because we are NOT ODs. They only point the bad of opticianry...they only see that we are only licensed in 28 states...they will never contribute anything towards opticianry. So let me set you straight... They do not need us...They do not want us....They hate us.

    We survive because of our own initiatives.

    I am sorry that I had to remind you...and that possibly you are getting early dementia thinking that ODs want to help us...silly and funny girl....:)

    Dannyboy

  6. #131
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    I'm not going to engage in OD-bashing. It serves no useful purpose and further polarizes the debate. I would, however, like to hear from someone involved with policy decions at AOA answer my simple questions. At some point, we need to start communicating.

  7. #132
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    I must be an exception to the rule because I work for an O.d. as a Licensed Optician that doesn't hate me. Acutally, he respects what I know and what I'm capable of doing. Of course, I'm sure he doesn't want me taking "his job" either and I have no interest in doing so. I got into this business because I love it. I love what the job entails and I'm good at it. I have no desire to refract, if I did, then I would have went to school to be an OD. That doesn't mean I can't do it, but frankly, it's not my job and I'm ok with that. I think it's ok to have Opticians and techs refract, but I do not think it's ok to have them refract and write a rx that the doctor just signs without verifying.

  8. #133
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    Advancement

    ODs advanced; why not Opticians? If education and training allow for ODs to advance their scope of practice, Opticians should be able to as well. The MDs for years said that if ODs want to be "real doctors" they should go to medical school. That is simply not holding water any longer, and I am amazed to see posts like the last one. ODs advanced because they educated and legislated themselves into an increased scope of practice. Opticians today have available technology that will allow them to be more competitive and independent, but do not support each other. We need to educate ourselves at a higher level, and prove we can safely provide higher levels of service than measuring a PD and taking a seg height! If the previous poster does not want to refract, then he shouldn't, but do not hold back others from advancing if they choose to do so.

  9. #134
    Manuf. Lens Surface Treatments
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    Blue Jumper Why the bickering ??????????????????????

    Quote Originally Posted by wmcdonald

    ODs advanced; why not Opticians? If education and training allow for ODs to advance their scope of practice, Opticians should be able to as well.
    Very well said .............................

    The profession of optician has been around for the longest, long before the other 2 O's.

    However as I see it, the profession has not much advanced in the way of learning, over the last 40 years. Opticians lately are taking their learning from big corporation advertising, make their own opinions and practise them.

    Many states do not even have a licensing law and anybody can be a street cleaner one day, and an optician the next.

    The device rules and regulations of rhe FDA list the optical as the last resource to be controlled. Eveything that goes on glasses is subject to FDA regulations and most of the manufacturers and importers have found ways to go around these rules. I could go on with this subject for hours.

    Optometrist's have very much advanced in their professional education, but have never given much attention and details to the dispensing part of glasses in any optometric schooling I know of.

    So there is plenty of space for opticians and any bickering is for the birds.But all opticians should unite to have proper education in theory as well as in practical and material's knowdledge so they will know the difference between reality and martketing. Only then they can advice customers properly for and against what is good for them.

    This profession is not going to hell but it needs some sprucing up!!!!!!!!!



  10. #135
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    wmcdonald, you need to re-read part of my post because I believe I stated in there that I think they should be able to refract, I myself however, choose not to and I'm ok with that because that part of Optics isn't what I enjoy doing. But I also said I don't believe that Opticians should be able to write rx's and I'm sorry, but I'm a firm believer in that. If they want to be able to write rx's, go back to school and get the degree that will allow you to do so. Until then, enjoy what you do now.

  11. #136
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    Quote Originally Posted by shellrob
    wmcdonald, you need to re-read part of my post because I believe I stated in there that I think they should be able to refract, I myself however, choose not to and I'm ok with that because that part of Optics isn't what I enjoy doing. But I also said I don't believe that Opticians should be able to write rx's and I'm sorry, but I'm a firm believer in that. If they want to be able to write rx's, go back to school and get the degree that will allow you to do so. Until then, enjoy what you do now.
    I don't understand. What's the point of being allowed to refract if you can't write an Rx?

  12. #137
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    Quote Originally Posted by 1968
    I don't understand. What's the point of being allowed to refract if you can't write an Rx?
    as................he likes to bake the cake but does not like to eat it...................

  13. #138
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    Thanks for the clarification

    I re-read the post. I typically do not argue here....it is a waste of time and energy, but you did not indicate your support for refraction. Writing an Rx for spectacles is not the issue, and I indicate that we need to EDUCATE ourselves to be able to do refraction. Optometry has moved into a medical model for ther education and training. We need to move forward too. I appreciate your clarification, however and appreciate your support.

  14. #139
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    I'm going to respond again, and no one is going to listen to me, but what the heck.

    Please allow me to establish my credentials first. I'm obviously an OD, and I have over fifteen years of experience. What I don't know about vision care you could put in your eye.

    "Refract", "refract", "refract"! How many times am I going to have to tell you that it's not as simple as that! You DON'T KNOW WHAT YOU DON'T KNOW about this!

    Follow me, here. A 6-year-old comes in because they failed the vision screening at school, and they're in your chair. You try to get an Rx on this wiggly kid with ADD. He's a malingerer, too, and you're not sure of his best-corrected acuity. You have to deal with it, so you do your best, and hope you don't screw this kid up, or get sued, or both.

    A 75-year-old comes in complaining that her near vision is blurrier over the past 6 months. She swears that it's these new glasses that the previous guy had given her. You get a different Rx, but she's still only 20/30, and you make her new glasses. Two weeks later, she's back complaining that it's not much better.

    A 39-year-old guy comes in to get a new glasses Rx. He asks you to fit him in contacts, too, which you do, and you tell him he needs to see an OD or MD for followup. Unknown to everone, he has glaucoma, too. He gets superb glasses and RGP contacts and promptly says to himself "I don't need to see anyone else at this point".

    The first case illustrates that YOU, "REFRACTING OPTICIAN", were unable to rule out any eye disease because you provided a very limited scope of service. That kid may have underlying pathology and you wouldn't know it. Heck, a kid who was super-cooperative and refracted easily to 20/20 could have pathology too. What exactly would you like kids to do, have "half" eye exams with you, and then see an optometrist or ophthalmologist? Where's the benefit TO ANYONE with that model of healthcare?

    The second case demonstrates that you had two choices in dealing with this lady. One, you could have stopped at the point where she couldn't get to 20/20, and referred her. Waste of her time and money. Or, you could do your best, and she's still not happy with her new glasses and wasted yet MORE time and money. How the heck is she supposed to know whether to self refer to an optician for "refraction" or an optometrist for a full level of service?

    The third case demonstrates that offering the public a watered-down eye exam is downright dangerous.

    MY POINT IS THIS: "REFRACTION" AS A STAND-ALONE SERVICE IS USELESS AND DANGEROUS. IF YOU WANT TO DO FULL-FLEDGED, MODERN-INDUSTRIALIZED-CIVILIZATION EYE EXAMS, THEN GO FOR IT. EDUCATE YOURSELVES AND BECOME A PROFESSION COMPETING WITH OPTOMETRISTS AND OPHTHALMOLOGISTS.

    Why, why, why, why would your profession feel the need to do that? Is it an ego thing? Is there a point to prove that opticians are smart as the next guy? Is it to "get even with those dirty ******* optometrists" who have been keeping you down?

    I CHALLENGE ANYONE HERE TO PRESENT A PUBLIC-HEALTH- BASED RATIONALE AS TO WHY THE REGULATING AUTHORITIES SHOULD CHANGE THE STATUS QUO IN ORDER TO OFFER PEOPLE AN ALA CARTE MENU OF HEALTH CARE PROCEDURES AND ALLOW OPTICIANS TO PROVIDE SEMI-EYE EXAMS.

    Think in terms of what good your "refracting" would do for the people, not your professional status.

    Implicit in this is some notion that your profession is somehow inferior, because it has a limited scope. Heck, so does mine, so does everyones!

    Shellrob has a healthy outlook on this, and I do, too. If I wanted to take out a cataract or laser a cornea, I'd go back to med school. I happen to enjoy my profession the way it is. You should too. The grass is always greener, believe me.

  15. #140
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    Inferior?

    You also do not know my credentials, and I will not bore you. Do you feel that somehow you can learn in your schools but we cannot. I said that we need to EDUCATE then attempt to do. I certainly do not feel inferior to anyone; it is a control issue. ODs continually want to expand (laser surgery is the latest), but in the name of good patient care attempt to de-license Opticians at every turn. If patient care, not money were the real issue, ODs would strongly support Opticians and licensure. ODs want to hire cheap assistants and train them in-office to maximize profit. They often have several locations with young folks dispensing that was at the local McDonals last week. ODs seem to think that only they can do refraction, which is far from the truth. If ODs would keep their noses in their business and not continually impede others progress, then we could have a great relationship. I have had ODs in my area return a patient with an Rx with a suppossed dispensing error, saying how poor a job that stupid Optician had done, only to find a major change in the Rx. That is not to say that all ODs are that unethical. I have many great friends who I see regularly that are ODs who indicate strong support for Opticians; others I know who think Opticians are just not worth anything. It is typically a function of where they are from. In many states Opticians have little or no training. I don't blame the ODs and/or MDs for thinking little of us. But in other states, there are some well-educated and trained professional Opticians.

    I suggest that all parties need to support an increasing dialogue to allow for objective discussions. As to your examples; glaucoma is a serious disease. You can scare a few of those uneducated among us, but it will not work here. Using specific guidelines, the risk of something like that is not great. If you take a look at the number of OD lawsuits in the last few years you see a slight increase, but the percentage compared to number of exams is extremely small. The old patient with decreased VA is a referral situation, and should be sent on to another provider. I can and will debate with anyone this issue, but here is what I ahve always suggested.
    1. Let Opticians who desire to do more receive appropriate education and training.
    2. Let them work as mid-level practitioners under the supervision of ODs and/or MDs.
    3. Provide the criteria for safe and effective use of their new education to increase access, particularly for the poor.

    I remember vividly MDs indicating that if ODs wanted to practice medicine let them go to med school. ODs did not utilize therapeutic or diagnostic agents at the time. ODs strengthened their programs. I suggest that Opticians should as well. I have even suggested to some of my friends in Optometry that the OD schools would be a great place to offer advanced degrees and/or certificates for Opticians. that was not well-received.

    I appreciate your post and the ability to hold an objective debate. I look forward to further dialogue.

  16. #141
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    Redhot Jumper

    Quote Originally Posted by drk

    Think in terms of what good your "refracting" would do for the people, not your professional status
    drk is right......................

    Let's get to down basics .........in many European countries Master Opticians do refracting, but they are trained for it. Standard is not a good as US Optometrists.

    However in a country like the USA which does not even have country wide regulations for the optical retail trade you would end up in pure disaster if untrained un-professional opticians would refract without proper education, training and regulations.

    Maybe we might even have some cyber refractionists on the internet.

  17. #142
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    Education

    I repeat.......we need to educate. I agree with Drk on that point. I still think there is a role for Opticians to advance!

  18. #143
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    I believe that there are ways for advancement for an Optician. But it's up to the optician to get out there and receive the education. it's not going to fall in their lap and many think it should.


    I believe it's ok to refract if you're doing pretesting but then being followed up by the doctor. I agree with DRK that refractions are not an easy thing to do, especially if you work with a lot of seniors.( which our practice does). Patients come in all the time thinking they need a change in a prescription and although we may be able to get them to see better with a new rx, alot of the time, it has nothing to do with the refraction but an unrelated problem, such as dry eye, macular degeneration, cataracts, and so on and so on. That happens all the time here. And maybe some Opticians(I'm not saying all) wouldn't know what to do if they came upon this problem or wouldn't know what to look for. I know before I came to a private practice after being at a retail optical, I didn't know squat about any of that stuff, because at the place I worked, they didn't train you on that. It wasn't as important to them. My job was to sell glasses, we left the health side of the eye to the doctor. At the office I work now of course that is different as I work very closley with my Optometrist and the adjoining Opthalmologist in the office so I have learned a tremendous amount of stuff. I still wouldn't want to responsibility of doing refractions, plus the liability of doing them. man, I know how much these doctors pay in insurance. No thank you.

    Like I said before, the education is out there for Opticians looking to educate themselves. In the meantime, be happy at what you do and what we stand for. If you're not, then maybe you're in the wrong field.

  19. #144
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    As Usual

    this is becoming tedious, so I will comment no further. I will suggest, however, that if you are not trained in the process and have never done a refraction, how do you know? Is it because your OD told you? Pre-tests can be done by anyone with very minimal training. It should not take a licensed health care professional to "sell glasses"; that is our downfall to begin with. THINK......we must move ahead or die. Opticians are on their last leg. The time to act is quickly evaporating. If we are to remain independent providers of any sort we need to move forward, not continue down the same old tired path. Education is the only answer. Refraction is only something that may come from it. You should not have to depend on the place you work for training, you should have received an education. We must strike some common ground on what Opticians are across the country to succeed as a profession in today's environment. Education needs to be mandatory; not something we may or may not seek.

  20. #145
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    Once again, you must only read what you want because I did say that I can refract, I choose not to because that is not why I became an Optician to begin with. If I wanted to refract(which I also already said) then I would've went to school and got my degree as an OD or an MD. I'm sorry, but we ARE NOT DOCTORS, therefore we shouldnot be allowed to write rx's. There's more to refracting than just numbers and no, it's not something the doctor I work for told me. It's a fact that here in this office speaks for itself everyday. I don't want the responsibility and certainly the liability of that. I love what I do as an Optician. I don't believe our profession is fizzling in anyway, if anything it's only getting better.

  21. #146
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Warren, I absolutely agree. Education is the key to expanding the scope of practice for Opticians. The Optometric community figured this out years ago. I will always fail to understand the vast majority of Opticians who decry their lack of standing as a professional while steadfastly avoiding post-secondary education in favor of out-dated apprenticeship programs.
    BTW, I am currently mentoring an Opticianry student utilizing the distance education program at J. Sargent Reynolds CC in Richmond. We are happily discovering that the combination of distance ed and practical experience provides a near perfect experiential education.

  22. #147
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    I still haven't gotten my point across.

    If the most skilled (place professional here) were to provide a refraction-only service, he/she would be doing that patient a great disservice.

    Think about it.

    It has to do with the level of service, not WHO'S DOING IT!

  23. #148
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    Quote Originally Posted by wmcdonald
    It should not take a licensed health care professional to "sell glasses"; that is our downfall to begin with.
    I disagree. No wonder you're looking for a way to change opticianry. You think it's irrelevant!

  24. #149
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    Education is correct..............................

    Quote Originally Posted by wmcdonald

    Education needs to be mandatory; not something we may or may not seek.
    You are on a good path now. Education......but first the basics and then the proof of ot..............and then the regulation contry wise. Only then you should even think of further advancement.

  25. #150
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    wmcdonald said:this is becoming tedious, so I will comment no further. I will suggest, however, that if you are not trained in the process and have never done a refraction, how do you know? Is it because your OD told you? Pre-tests can be done by anyone with very minimal training. It should not take a licensed health care professional to "sell glasses"; that is our downfall to begin with. THINK......we must move ahead or die. Opticians are on their last leg. The time to act is quickly evaporating. If we are to remain independent providers of any sort we need to move forward, not continue down the same old tired path. Education is the only answer. Refraction is only something that may come from it. You should not have to depend on the place you work for training, you should have received an education. We must strike some common ground on what Opticians are across the country to succeed as a profession in today's environment. Education needs to be mandatory; not something we may or may not seek.


    The premise of your rebuttal seems a BIT failed. On one hand you say education is the end all and on the other hand you say " It should not take a licensed health care professional to "sell glasses"; Where do you think you get the knowledge to sell glasses (If I can use so board a stroke)? What you just walk into an Optical shop and say " I think I will start selling glasses. I don't know what they are, how they work, or what any of the other things are " but as my mentor WCDONALD said: "you don't need a license" just go out and sell. What makes them any different then the sales clerk at McDonalds even though he or she might be college educated. For two or more years you have been ranting and raving that opticians need to be recognized and you get recognization with education and then license. Without a license you can't do a thing. If we work on your premise every nurse and doctor would say the h-ll
    with this WCD said we don't need a license we know all there is, I'm just going to hang my shingle out and start seeing patients. Without education and a license in N.Y. especially, see how far you get before they throw you in jail.
    I can't believe what I just read from WCD, unbelievable!:hammer:

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