View Poll Results: Should Opticians Refract

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

    109 36.09%
  • Yes (with no supervision, but with restrictions as to whom can be seen)

    62 20.53%
  • Yes (with supervision)

    60 19.87%
  • No (because there is no need for Opticians to refract)

    58 19.21%
  • No (Opticians are not capable of refracting)

    13 4.30%
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Thread: Should Opticians Refract - The Poll

  1. #251
    Underemployed Genius Jacqui's Avatar
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    I don't want to do this again.

  2. #252
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by fjpod View Post
    Harry, not trying to start an arguement, but so much of what you said is opinion, not fact. I will just leave it alone.
    Here is what I ask, I will not argue with you if you will read and discuss this paper by David A Goss, OD PhD on the History of Optometry a lecture given in Indiana University School of Optometry, since there program incorporates opticians and optometrists it is the most unbiased lecture I have seen to date on the subject. This is where I got my infromation from.

    Dr Goss makes a very brave statement to his peers that I find says it all:

    "Lesson for today: Every profession justifies its existence (in part) by being better at
    something than any other profession (a niche). We need to maintain our strength in
    the treatment of refractive problems and eyestrain."
    I have always said although an OD having the privledge of medical care is nice it is not the primary purpose of the patients visit. I judge the strengths of an OD first and foremost by his/her skill in the lane, my profession depends on it which is why I get heated sometimes.

    PS - It's a great read and even though you may feel burnt out by this discussion it is a great document that shows our professions roots.
    Attached Files Attached Files
    Last edited by HarryChiling; 09-26-2008 at 03:24 PM.

  3. #253
    ATO Member HarryChiling's Avatar
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    So within 18 minutes of posting I can be called a liar, in another 17 minutes I get blown off as just starting something, yet I try an post my facts and it has been a littel over 1 hour 20 minutes and no one has even downloaded and read the proof that was written by a professor of optometry. So then I just spew rederick is what the minds have decided. It's a shame, I can't argue with that kind of logic and I have been a fool for trying for so long, don't worry I don't hate optometry as much as I loath opticians lately.
    Last edited by HarryChiling; 09-26-2008 at 04:33 PM.

  4. #254
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    Refracting

    After working in ophthalmology for the last few years, and seeing the "techs" that they "train" off of the street with no medical or optical background, and the refractions that they are allowed to do and expected to do after only a few weeks on the job, I say that opticians would be a much better choice in ecp's doing refractions.:drop:

  5. #255
    Underemployed Genius Jacqui's Avatar
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    Quote Originally Posted by bmintzer7 View Post
    After working in ophthalmology for the last few years, and seeing the "techs" that they "train" off of the street with no medical or optical background, and the refractions that they are allowed to do and expected to do after only a few weeks on the job, I say that opticians would be a much better choice in ecp's doing refractions.:drop:
    That's one of the reasons that I think NP's should be allowed to refract.

  6. #256
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    Sure! As long as it is checked by O.D./M.D.

    That's what our office does :)

  7. #257
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    Harry, their should be more strong people like you, with confidence, strength and knowledge. We should concentrate our efforts on the people who support us and not the people who drain us. I would like to thank you for all the useful information, because I have passed it on to the appropriate personnel. And any Opticians out there who feel the same go to your legislatures. Optometrists fight everyday to take away what the Ophthamologists are doing everyday without the supervision of an Ophthamologist.

    Quote Originally Posted by HarryChiling View Post
    So within 18 minutes of posting I can be called a liar, in another 17 minutes I get blown off as just starting something, yet I try an post my facts and it has been a littel over 1 hour 20 minutes and no one has even downloaded and read the proof that was written by a professor of optometry. So then I just spew rederick is what the minds have decided. It's a shame, I can't argue with that kind of logic and I have been a fool for trying for so long, don't worry I don't hate optometry as much as I loath opticians lately.

  8. #258
    What's up? drk's Avatar
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    Quote Originally Posted by chip anderson View Post

    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.

    Chip
    It took fifteen years, but Chip proved to be a prophet.

    P.S. I did not resurrect this.
    Last edited by drk; 01-17-2020 at 03:13 PM.

  9. #259
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    No. Why would you want to? It's not a question of not being capable. Stay in your lane. Patients want the Doctor to do the Doctoring..... Think of all the bad rx's from techs at MD practices. Focus on helping your patient. If you have time to refract then your business needs help. Sell multiple pairs, get your AR percentage up.......... Focus on customer service. We are not Doctors.

  10. #260
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    Quote Originally Posted by HarryChiling View Post
    So within 18 minutes of posting I can be called a liar, in another 17 minutes I get blown off as just starting something, yet I try an post my facts and it has been a littel over 1 hour 20 minutes and no one has even downloaded and read the proof that was written by a professor of optometry. So then I just spew rederick is what the minds have decided. It's a shame, I can't argue with that kind of logic and I have been a fool for trying for so long, don't worry I don't hate optometry as much as I loath opticians lately.

    Well said Harry. This proves you were definitely on Optiboard. It’s why I seldom read it any more.

  11. #261
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    Btw Harry , I did download and read the paper.

  12. #262
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    Personally, I would love to be trained to refract. And then, of course, have the chance to use it.

    My dad recently had a refraction from an ophthalmology tech, and it didn't take me long to realize it was super off. When my dad brought this up to the doc even the doc was annoyed with the Rx results. And yet the doc hadn't even bothered to check it - the Rx was simply accepted and given to my dad to use for updated lenses. Since I caught the error I had my dad come in to see our OD for a "real" refraction.

    I agree - if these techs can do it (and be allowed to do it badly) why can't opticians refract? Not that opticians would do it badly, but my training allowed me to see there was a problem. We've got some know-how about what results could be expected.

  13. #263
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    Quote Originally Posted by charisw View Post
    Personally, I would love to be trained to refract. And then, of course, have the chance to use it.

    My dad recently had a refraction from an ophthalmology tech, and it didn't take me long to realize it was super off. When my dad brought this up to the doc even the doc was annoyed with the Rx results. And yet the doc hadn't even bothered to check it - the Rx was simply accepted and given to my dad to use for updated lenses. Since I caught the error I had my dad come in to see our OD for a "real" refraction.

    I agree - if these techs can do it (and be allowed to do it badly) why can't opticians refract? Not that opticians would do it badly, but my training allowed me to see there was a problem. We've got some know-how about what results could be expected.
    In my experience, opticians refract a lot better than ophthalmic techs. Techs are generally too afraid of making decisions in favor of the patient while operating in a world of no refunds if things go wrong. Refracting opticians not only understand optical needs better than techs, but they are also aware of the eyeglasses acceptance risks and are comfortable adjusting everything for the needs of the patient. Because of the risk of refunds, opticians are also better communicators and generally set up expectations better than techs. The fitting knowledge only helps the conversation.

    That being said, techs are generally better, faster and sharper on every other equipment they run (autorefraction, IOP, slit-lamps, retinal pictures, visual acuities, etc).
    Last edited by vfpamp; 01-24-2020 at 09:20 AM.
    Vitor Pamplona
    CEO, EyeNetra Inc

    Come check our autorefractor, lensometer and phoropter.

  14. #264
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    Thanks, Vitor. Opticians could play a much larger clinical role if they only would. Working in conjunction with other professionals, we could greatly expand our opportunities.

  15. #265
    OptiBoardaholic CNG's Avatar
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    Quote Originally Posted by vfpamp View Post
    In my experience, opticians refract a lot better than ophthalmic techs. Techs are generally too afraid of making decisions in favor of the patient while operating in a world of no refunds if things go wrong. Refracting opticians not only understand optical needs better than techs, but they are also aware of the eyeglasses acceptance risks and are comfortable adjusting everything for the needs of the patient. Because of the risk of refunds, opticians are also better communicators and generally set up expectations better than techs. The fitting knowledge only helps the conversation.

    That being said, techs are generally better, faster and sharper on every other equipment they run (autorefraction, IOP, slit-lamps, retinal pictures, visual acuities, etc).
    I think Opticians should know about refraction but performing a refraction is simply not worth the time of the optician. I would rather have a refracting service or an OD doing it so I can concentrate in what I do best. Stand alone refraction should be viewed the same way we view neutralization. Not optimal but a means to get a sale. Just make sure you simply refer the patient for a health afterwards. The customer can decide if they wants it or not. The OD/OMD will still be in the loop and most could care less about refraction as they want to do medical. I am sure in time autorefractors with the aid of AI do subjective refraction which would take refraction out of human hand. Just another tool.

    CNG

  16. #266
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Disagree with this. Opticians should be able to refract and also perform bV testing. But training and education should be made available.

    And the public must be taught the value of a periodic, complete medical eye exam.

    B

  17. #267
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    Quote Originally Posted by Barry Santini View Post
    Disagree with this. Opticians should be able to refract and also perform bV testing. But training and education should be made available.

    And the public must be taught the value of a periodic, complete medical eye exam.

    B
    So maybe we have refracting opticians and dispensing opticians? Maybe one day they would come up with different words for each skill set. There are a lot of skills there to be mastered Barry.

  18. #268
    Master OptiBoarder rbaker's Avatar
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    Nineteen years and still beating a dead horse. You want to refract, go to work for an MD or go to Optometry School. Otherwise, stick to your knitting.

  19. #269
    Master OptiBoarder CCGREEN's Avatar
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    Quote Originally Posted by rbaker View Post
    Nineteen years and still beating a dead horse. You want to refract, go to work for an MD or go to Optometry School. Otherwise, stick to your knitting.
    LOL You nailed it rbaker. You would think that after 19 years of this thread running that refracting opticians would be further along then just a dream on a thread out in cyber land by now. I guess the desire is not strong enough yet.

  20. #270
    Master OptiBoarder AngeHamm's Avatar
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    Quote Originally Posted by rbaker View Post
    Nineteen years and still beating a dead horse. You want to refract, go to work for an MD or go to Optometry School. Otherwise, stick to your knitting.
    No one had commented in this thread for three months.
    I'm Andrew Hamm and I approve this message.

  21. #271
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    There is no leadership or vision amongst opticians. The regulatory bodies I am familiar with once tried and made some in roads but even there, in my opinion they had no idea what they were up against and a leadership challenge, not to mention a poorly executed approach. After dealing with the leadership issue , then there is an incredible apathy level amongst opticians which was in in my humble opinion partially created by the lack of leadership and vision.

    On the optician side of the coin, they simply don’t have the guts to stand up, vote out the old guard and vote in leadership, let alone define and find leadership, in my opinion. They also don’t have the knowledge to know what goes on in the political arena and how to learn those ropes.
    Last edited by idispense; 06-24-2020 at 12:50 AM.

  22. #272
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    I post rarely any more. There are so many disparate views here that seek to destroy versus build, which has been a part of the problem. But this has been a long standing thread, so I felt compelled to comment this morning. I am not going to debate the same old folks, I am just offering my point of view, and I hope it offers food for thought.

    Leadership here has been the primary issue, along with lack of vision at the top, and even some jealousy that held Opticians back from many things, especially refraction. Opticians will never provide independent refractions without some baseline education, which means it won't ever happen, and with the ability to use a cell phone to provide that service, it is OK. A high school diploma and a certificate just will not be a base for us to stand alone as a profession any longer. We have fooled them longer than I thought we would, and the time has now past for the good old days many here remember. But there are still going to be folks called Opticians, and some will be in retail environments, and others in labs, etc. Those who want to work in a clinical environment with ODs and MDs can learn and do more than tell Ms. Jones she looks great in those blue frames, after measuring her PD if they wish, including doing subjective and objective refraction, and fit contact lenses.

    But I moved from the original topic. Look, folks, this thread is an example of why we don't do refraction. The old lab rats here certainly do not want it, because it is foreign to them. An Optician is someone who makes a pretty pair of glasses that are optically perfect (or as close as we can make them). That is their perspective. Another group is the old time "dispensers" trained under some knowledgeable folks who they truly worshipped, and they learned a lot. If it was good enough for them, why not now? They never saw the need for a real education, and they make up the majority still today. If someone did get a degree, did it make these older folks look "less than" (the jealousy factor I mention above)? Many felt it did, or either they had little respect for their own profession and its long term sustainability and self direction. And they were the leadership. That early leadership actually ran most of the larger organizations back in those days, and felt they would have to pay more for Opticians if they were licensed, so heavens, they did not want to do that. Later I watched in great dismay as some of those SOBs stood on stages across the nation and complained about the chains doing exactly what they had done a decade earlier! True servant leaders to the core. Another group are the post-corporate folks. We complain about the evil corporations, but they are here to make money, not to support our rather lax "profession." We feel the corporate folks have little respect for us. The truth is, they don't. We have no education and training to garner respect and support our value. Now some will shout loudly here their vast experience and all they bring to the table that can't be quantified, and that is fine, but corporations are there for profit not to provide the perfect adjustment to Ms. Jones. Will your perfect adjustment keep people coming back? Until someone down the street has a better sale maybe. That's just the cold hard truth for much of the customer base we now serve. The curtain has been pulled back on the wizard. The ODs have not helped and do not want us to be a separate profession. They do all they can to take down licensed states by testifying against licensure at every turn, and they even get help from Opticians from unlicensed states who see no value in it. I never understood why, but it may be because they do not have one, much like the reason some fight education.....but who knows. Some blame the ODs, and they are wrong. That is just turf, folks, and we are an easy target. I have seen the enemy and it is not on the outside.

    Why don't we refract? In my opinion we don't refract and do many other things like manage corporate locations for the reasons above and more because it takes next to nothing to get into the field. In 28 states the very strenuous requirement to become an Optician is a pulse, and that is reflected in many of the questions I see asked and debated here regularly. And it is only my opinion, but based on a great deal of observation and experience, and a desire to try to help for may years. If you go see an Optometrist, an Ophthalmologist or any MD, you see an RN, Dentist or Hygienist in Wyoming or Texas, California or the Carolinas, they have similar training and education and all are licensed. Opticians across the country look different from state to state, and even within states in some instances. As to education and training, we have none, and in fact most of the people we attract come for a job, and do not see it as a life-long profession like many of us who are more seasoned did in the past. The world has changed. Soon licensure will change, and there is great concern about that. I hate to see it, but does anyone here who reads some of the questions people ask from some of these "professionals" really feel good about the lowest common denominator in the field, which is how we are all judged.

    Opticianry was once a great field. but we could not produce any consistency. Licensing boards get appointed and feel all powerful, and would not cooperate across state lines because they knew theirs was better. Its still that way. Some complain that states are now moving to online testing through the ABO/NCLE, an organization that spends hundreds of thousands of dollars through outstanding testing organizations validating their exams to be sure they are up-to-date and objective. These same services also work for medicine and nursing and optometry, and others. Those folks do something wrong they can kill someone and its good enough for them, and all of them have significant levels of education. Who complains about it? Our folks, whose board filled largely with high school graduates that get together and write questions every 10 years or so and that is the test. Folks the old exams were generally written by folks who are not trained in testing at all, and just not up to standards today. But it is a change and it scares us. We are moving in a good direction there, although I know several here who who will disagree. State Associations struggle, and only survive if they have sufficient CE revenue. An example is Ohio, where those wonderful folks in their very successful association for many years had to deal with the state board allowing online education credits being accepted for CE credit. In reality, I believe if it were tested, all states would be required to do the same thing, and associations would falter. It is a shame the field sees no value in professional associations and the networking opportunities they offer. But hey, it takes little to get here. What more do they need to know?

    I have rambled enough, but I hope you can see that we don't refract, and do many other things because we are just not well prepared, and need a lot of improvement. I know I am speaking to the choir here to a large degree because we have some very bright folks in this space, some with degrees and some apprentice trained, that will make it no matter what happens. They know that, and I want them to understand I know it as well. I want them to know I have great respect for their knowledge and background, but my goal was always for improve Opticianry as a profession. As I move closer every day to retirement, I also realize that my voice has diminished. When I maintained an active presence on the lecture circuit, I was able to talk to many across the country. Most initially thought I was nuts seeking to mandate education and licensure. Trying to expand Opticians scope, and this refraction thing.......pure heresy! But now, that is not the case. and others come with the same, albeit gentler message.

    We are not done yet. This thread keep on coming back after all these years. So that means there is interest. Opticians have work to do but are not dead. If we just will find the right common voice and do it.

    Best wishes to you all,
    Warren
    Last edited by wmcdonald; 06-24-2020 at 07:55 PM.

  23. #273
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Thank you again, Warren, for posting your thoughts.

    Opticians love their ignorance.

    B

  24. #274
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    Speaking , only of Canada, one question begs answering , is there even a need remaining for provincial regulatory colleges ? I’m very doubtful they serve a useful purpose.

    In my opinion they hide behind a shield of “protecting the public” but I see no evidence of the public being protected.The public in each province is free to buy glasses and contacts anywhere without restrictions, on line vendors from out of province can legally sell into the provinces. The online vendors are not regulated, the public is not regulated. It’s only member opticians that are regulated and disciplined so I ask:

    1) Why should opticians bear the brunt of expenses to be regulated and forever taxed yearly on the knowledge they learned in school and not from a regulatory body ?

    2) Why should opticians be considered to have committed Professional Misconduct If they were to speak out against fellow opticians quality of work when on line vendors paint opticians as greedy and money hungry with unreasonable profits ?

    3) When did anyone last see a regulatory body spending your yearly license fees to advertise to the public the value of the opticians they license ?

  25. #275
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    I do not believe opticians should refract. They are not ready. They do not have the infrastructure in place.

    Opticians primary objective should be to clean up their regulatory bodies first and foremost. Refraction would give those bodies more rules to make so they can further hide behind a false shield of “we are protecting the public” .

    It’s old , but look at the video on YouTube “Optician Gone Mad ”. There is no regulatory body protecting the public in that video. There is instead a reporter protecting the public. Send your license fees to the man who is getting the job done. Send your license fees to that reporter. That reporter is a leader, not only does he get the job done , he’s not afraid to advertise to the public to both show and tell the public, how he’s protecting them. There’s no false pretence with this reporter. He leads.

    Although the jurisdiction for “Optician Gone Mad” was Ontario , why didn’t the other Canadian regulators or the Health Minister speak out ?

    Why didn’t Canadian opticians speak out ?

    Opticians are not ready to refract when they can’t even govern themselves or find leadership.
    Last edited by idispense; 06-25-2020 at 12:15 PM.

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