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Thread: Has sight testing been harmful to optometrists in BC?

  1. #51
    What's up? drk's Avatar
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    Quote Originally Posted by fjpod View Post
    So, after all these vision tests, you are handing to the patient a copy of their Rx so they can go shopping elsewhere, right?
    Probably. But they're releasing someone else's "Rx".

  2. #52
    What's up? drk's Avatar
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    What, Dr. Mac, is the "protocol" that would prevent glaucoma from being undetected?

    I could go on.

  3. #53
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    Redhot Jumper very simple answer .........................................

    Quote Originally Posted by optical maven View Post

    Didn't the BC government also deregulate the dispensing of glasses? How has that affected opticians and optometrists?

    very simple answer .........................................

    ...............opticians and optometrists have not sold the over 4 million pairs of Rx glasses that have been sold through their BC based online opticals so far.

  4. #54
    What's up? drk's Avatar
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    And, while that's probably at least partially true, I ask the idiot de-regulators from the Great White North: when the field of professionals shrinks by 50% or more, are you going to be happy?

  5. #55
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    Dr. K the average patient does not receive a complete exam every year, as suggested, only approximately every 2.3 years as you are aware. If they come in for sight testing, and at least have that done we can encourage them to have a complete exam and refer to a competent practitioner. A yearly exam is a good thing and I do not debate that but is someone breaks their glasses and needs a new pair, at least an updated Rx is not a bad thing either, and we can remind the of the importance of a full medical exam at the same time. We would not be seeing peds patients, teen nor old folks like me, where most of the significant eye disease exists. I can also tell you we are open to working with anyone to help us make it better, so rather than just shooting us down, tell us what we can do to improve.

  6. #56
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    See Ted's post above again regarding more specific protocols.

  7. #57
    What's up? drk's Avatar
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    I'm here to tell it to you, straight.

    1. There's no such thing as a "disease predicting protocol". That's a fantasy or a lie.

    2. Even so, it would be unenforceable.

    3. Emergency spectacle replacement is a canard. The majority of this will be people diagnosing themselves as having refractive error change and self-directing their treatment (with the help of an optician). Can I have you come into my office and see how many times the chief complaint is "blur" and the diagnosis is NOT refractive error? To that end, it cracks me up (and makes me cry) when people come in--using some loser vision care plan--for "new glasses" (self diagnosis) when they have everything ELSE wrong with them. It's the lot in life of an optometrist. Ophthalmologists probably don't get that silliness.

    4. ODs don't know ANYTHING and I mean ANYTHING (did I tell you...ANYTHING) about optics, anymore. Nothing. And they don't want to and they don't care to. They wouldn't know an individualized PAL from a D-seg. They wouldn't know 1.67 from crown glass. It's PATHETIC. This is where the need is. This is where the opportunity lies. Design the dang lenses.

    5. There's a GLUT of ODs and more to come. You will never, ever, ever, never outcompete ODs for patient care. They will always out-vision-care opticianry. Forever. Move on. That ship never sailed. It sunk.

    6. If I were a kick-butt optician, I'd form a nice optical and recruit an OD as an indy contractor and make hay. Superb frame collection. Top notch service. Intensive optics knowledge. Cool environment. Maybe even skinny jeans. Take control of the optical field. No one knows it better than you guys, now. Optometry has sailed for the island of "Club Med". The door is open.
    Last edited by drk; 02-16-2018 at 08:31 AM.

  8. #58
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    Dr. K, calm down. You're gonna have a stroke. There are better ways to put it.

    Let's not kid ourselves, technician/computer/optician refracting is not being moved forward for the benefit of the patient. It is being done for the eyeglass sale. When the independent opticians wanted it, we cited reasons why they couldn't do it. Now the BIG BOYS, Ess, Lux, VSP, and the rest want the sale, and they will step over whatever dead bodys they have to to get it. They will con the OMDs to sign the Rx's, and they will walk over the ODs and LDOs licenses regardless of state law. Afterall..."it's on the internet". That makes it valid and true and accurate.

    There's almost no sense in complaining anymore.

    Yes, optometry moved into ophthalmology's turf, medical treatment, decades ago... but, Optometry is an 8 or 9 year deal of Baccalaureate, Masters and/or Doctorate degrees. Opticians, as of yet, do not have a standard two year program (yeah, I know wmMcdonald, it's Optometry's fault )... just like it's ophthalmology's fault that optometry is not doing surgery in every state by now. (BTW, I am not necessarily an advocate of optometrists doing invasive surgery).

    So, cloak these eye tests any way you want...."computer assisted...optician supervised...invisible eye doctor approved"... It is a reduction of care simply to get an eyeglass sale.

  9. #59
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    Blue Jumper It is a reduction of care simply to get an eyeglass sale...........................

    Quote Originally Posted by fjpod View Post

    So, cloak these eye tests any way you want...."computer assisted...optician supervised...invisible eye doctor approved"... It is a reduction of care simply to get an eyeglass sale.

    Interesting ........................however nobody so far has mentioned the retail pricing of these eyeglass sales, and the difference between the one side or the other.

  10. #60
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    Quote Originally Posted by fjpod View Post
    Dr. K, calm down. You're gonna have a stroke. There are better ways to put it.

    Let's not kid ourselves, technician/computer/optician refracting is not being moved forward for the benefit of the patient. It is being done for the eyeglass sale. When the independent opticians wanted it, we cited reasons why they couldn't do it. Now the BIG BOYS, Ess, Lux, VSP, and the rest want the sale, and they will step over whatever dead bodys they have to to get it. They will con the OMDs to sign the Rx's, and they will walk over the ODs and LDOs licenses regardless of state law. Afterall..."it's on the internet". That makes it valid and true and accurate.

    There's almost no sense in complaining anymore.

    Yes, optometry moved into ophthalmology's turf, medical treatment, decades ago... but, Optometry is an 8 or 9 year deal of Baccalaureate, Masters and/or Doctorate degrees. Opticians, as of yet, do not have a standard two year program (yeah, I know wmMcdonald, it's Optometry's fault )... just like it's ophthalmology's fault that optometry is not doing surgery in every state by now. (BTW, I am not necessarily an advocate of optometrists doing invasive surgery).

    So, cloak these eye tests any way you want...."computer assisted...optician supervised...invisible eye doctor approved"... It is a reduction of care simply to get an eyeglass sale.
    Works for me.

  11. #61
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    Quote Originally Posted by Chris Ryser View Post
    Interesting ........................however nobody so far has mentioned the retail pricing of these eyeglass sales, and the difference between the one side or the other.
    Of course, things on the internet are "cheaper". If you buy an $89 pair of cheapie eyeglasses online and it doesn't work out, you say, "Oh well, I'm not going to jump through hoops to try and get a refund... I'll just manage." But when you pay $229, you will be able to go back to the place of sale and talk it over with the professionals.

    So, I really don't have an objection to people looking for a bargain. You get what you pay for.

    What I object to is people examining and dispensing without a license at the location where the patient is. I'm OK with valid and true telemedicine, but what is going on now is not really lawful.

    When we got our licenses, the State (Province) promised us a "franchise" of sorts, and we had to jump through many hoops to get there, and jump through more hoops to stay here. Now big business feels they have the right to trample those laws using the internet as an excuse.

    ehhh, what's the sense of complaining.

  12. #62
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    Quote Originally Posted by drk View Post
    Probably. But they're releasing someone else's "Rx".
    I very much doubt they are releasing the Rx. My son, who is also an OD, called one of these online CL places doing an "exam" for free, and then you buy the CLs... So, at the end of the exam, he asked for the Rx, and the person on the other end could not comprehend what he meant. He then quoted the FTC regulations requiring the release of prescriptions. They had to scramble and get a supervisor. Bottom line, he got a CL Rx emailed to him in a day or so. They Rx'd toric CLs for him something like +0.50 -0.75 x 180, but he is young and doesn't wear glasses.

    So, you see, they will find anything they need during the "exam" to make the sale. It's all about making a sale.

  13. #63
    Master OptiBoarder mike.elmes's Avatar
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    With all the self diagnosing and online eyewear sales going on I hardly believe that a small percentage of refracting opticians are causing ANY lapses in eye health....and as for accuracy. I see way more redo's from the other O's than my Eyelogic system.

  14. #64
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    Quote Originally Posted by mike.elmes View Post
    With all the self diagnosing and online eyewear sales going on I hardly believe that a small percentage of refracting opticians are causing ANY lapses in eye health....and as for accuracy. I see way more redo's from the other O's than my Eyelogic system.
    +1. And as an optician you know how to dispense properly and accurately unlike most OD offices.

  15. #65
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    Quote Originally Posted by drk View Post
    AKA "optometry".

    In other words, you take the old glasses (probably determined by an OD), get a variably-accurate autorefractor reading, and you're done.

    "Computer-aided software"? Is there another kind of software? "Technician", huh? Who trained the "technician"? Seriously. Who?

    Which tells you exactly....nothing. What's the point? Can you explain that to me?

    Ooooh. Snellen charts.

    Because ophthalmologists can turn crap into gold? So he can look at a lensometer print out, entering acuities, an autorefractor print out, and new acuities? Wow. Amazing powers of vision care! Some sleaze bag ophthalmologist is always available, it seems, to prostitute his license and his professional ethics. Maybe it was "Larry Nassar, M.D.?" What a farce.

    Bull-freaking-crap.



    "Non-medical exam". That, sir, is a contradiction in terms.

    a. It certainly is NOT a medical exam. It's not any kind of an exam. It's a "non" exam. Why bother calling it an exam?

    When some auto mechanic hooks up a computer to your engine, is that a "non-medical exam", too?

    b. The procedure is used to temporarily bridge the gap between glasses being Rx and non-Rx.

    c. I could author a Rx with my license with any information or no information, at all. Garbage in, garbage out. "Clients" are being ripped off by this. You can get a new grad OD to really examine your eye for about $40. Money well spent.

    d. Just rid yourself of the pretense. This is a "fake exam". Who are you trying to fool with all the lingo, and dog-and-pony shows? Buy a freaking autorefractor and let everyone belly up to it, and make glasses off the print out.
    DRK, we get that you're passionate and protective about your profession. However, call it what you want...the Eyelogic system is proven to have a 1% error rate regardless of where the prior Rx originated, which yes was most likely an OD.

    What angers the OD's is the fact it can eat your lunch, produce an amazing accurate Rx within a few minutes, even with a 'chimp' pressing the buttons. Surprisingly, Eyelogic also has no ego, feelings or emotions of anger, remorse, frustration or interest in industry politics.

    The same cannot be said with optometry (subjective Rx human intervention) and is much higher, most likely around 10%, but hey OD's always pass the redo cost along to the vendors so the other 9% doesn't really count right? God forbid they would ever admit there was a mistake and eat it themselves.

    The numbers don't lie. The entire eyecare system needs to be imploded and rebuilt into three categories:

    1. Visual acuity eye test (done by any of the three O's including Eyelogic) Believe it or not, a full ocular health exam is not required every time a customer/patient needs a new pair of glasses or CL's.

    2. Full exam - ocular health, IOP, retinal scan etc.....OD or Ophthalmologist

    3. Surgery or Pharma - Ophthalmologist only. Why the heck some of the OD's have ever been allowed to prescribe is beyond me. It's like a holistic approach to voodooism. Last time I checked, there's still no MD abbreviation upon graduation from optometry school.

  16. #66
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    Lots of professions prescribe meds without an MD abbreviation, and without as many years of graduate courses as an OD.

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    Edit. Nevermind. Don't want to wade into this useless OT argument that will lead nowhere.

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    Quote Originally Posted by optio View Post
    Edit. Nevermind. Don't want to wade into this useless OT argument that will lead nowhere.
    This is a forum after all where professionals are free to voice their opinions, which welcomes both support and debate. Nobody is right and nobody is wrong.

  19. #69
    Master OptiBoarder mike.elmes's Avatar
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    In the new age society, all professionals strive to increase their scope of practice....which is beneficial to the public. Pharmacists now routinely give injections, Optometrists prescribe medication and Opticians can do refractions. For example, I used to work for an Optometrist. I was trained to do the retinal photography, Tonometry and to do Field testing along side my dispensing and manufacturing of eyeglasses. These things I was trained to do increased my scope of practice. Surely we're all able to upgrade our training to do more
    Last edited by mike.elmes; 02-17-2018 at 03:39 PM.

  20. #70
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    Quote Originally Posted by mike.elmes View Post
    In the new age society, all professionals strive to increase their scope of practice....which is beneficial to the public. Pharmacists now routinely give injections, Optometrists prescribe medication and Opticians can do refractions. For example, I used to work for an Optometrist. I was trained to do the retinal photography, Tonometry and to do Field testing along side my dispensing and manufacturing of eyeglasses. These things I was trained to do increased my scope of practice. Surely we're all able to upgrade our training to do more
    That's a good point Mike. If the additional scopes of practice were shared equally with the appropriate training provided would be beneficial to consumers. But that's not the case in the regulated parts of Canada and the U.S. where OD's aren't willing to let refracting go to opticians.

  21. #71
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    DRK, we get that you're passionate and protective about your profession.
    Only to the degree that we serve the public's health.
    However, call it what you want...the Eyelogic system is proven to have a 1% error rate regardless of where the prior Rx originated,
    Maybe you can explain what "Eyelogic" is. What is "99%" accurate? Because I think the world needs to know.
    1. Visual acuity eye test (done by any of the three O's including Eyelogic) Believe it or not, a full ocular health exam is not required every time a customer/patient needs a new pair of glasses or CL's.

    2. Full exam - ocular health, IOP, retinal scan etc.....OD or Ophthalmologist

    3. Surgery or Pharma - Ophthalmologist only. Why the heck some of the OD's have ever been allowed to prescribe is beyond me. It's like a holistic approach to voodooism. Last time I checked, there's still no MD abbreviation upon graduation from optometry school.
    Here you go, again. Knowing all this stuff that you don't know, and not knowing all this stuff that you do know.

    I should probably quit trying to get it through your noggin'.

    Suffice it to say, anyone who practices optometry or ophthalmology is embarrassed for you.

  22. #72
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    OD's aren't willing to let refracting go to opticians
    What on God's green earth are you jabbering about?

    You mean, I, I am holding back refracting opticians?

    What...are...you...smoking?

  23. #73
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    Quote Originally Posted by drk View Post
    Only to the degree that we serve the public's health.

    Maybe you can explain what "Eyelogic" is. What is "99%" accurate? Because I think the world needs to know.


    Here you go, again. Knowing all this stuff that you don't know, and not knowing all this stuff that you do know.

    I should probably quit trying to get it through your noggin'.

    Suffice it to say, anyone who practices optometry or ophthalmology is embarrassed for you.
    Exactly my point. Have you ever managed to listen to yourself with those big ears and tiny noggin' Bugsy???

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    I'm going to be specific and address the personal long-time experiences brought forth by Mr. Elmes. Despite their appearances, the "evidence" he shares is (1) basically irrelevant and (2) completely contradictory to his central position that opticians should be allowed to refract.

    Quote Originally Posted by mike.elmes View Post
    Listen here, I am a licensed Refracting Optician. I am licensed for 35 years
    Quote Originally Posted by mike.elmes View Post
    Sight testing is an evaluation of refractive error of the eye. It is accomplished as a refraction done with an autorefractor, autophoropter, and lensometer. It is done by a trained technician, using computer aided software.
    I'll first say I don't know much about the Eyelogic system, and I asked a few pertinent questions earlier that has so far have been ignored. That may be a sign that the significance of the questions aren't understood by those here. I'll get back to them at some point.

    (1) Your 35 years working as a refracting optician is no evidence at all that optician refraction is "safe", or "effective", or "justified" or whatever. You aren't even refracting. Refraction is a procedure used (using your own words) to "evaluat(e the) refractive error of the eye". You aren't "evaluating" anything. You are just moving buttons and levers as told to you by a computer. By your own words, you are simply a "technician". There is no analysis being done. So though you are licensed as a refracting optician, you aren't actually refracting. You are just autorefracting. Your evidence doesn't support optician refraction. It supports "anyone at or above a technician" refracting. You can also use your experience to argue that computer refraction is sound. But specifically optician refraction? No. The fact you are an optician is irrelevant in your argument.

    Quote Originally Posted by mike.elmes View Post
    The final results are sent via fax to an eye doctor for final approval by an ophthalmologist.
    (2) Does the "final approval" mean a signature? If so, then if you were really "refracting", then why are you sending your work to an OMD to be signed? It's not your refraction if it's not your prescription. It's his (or hers). It's his signature on that piece of paper. So again, you haven't been refracting. You've been the messenger. That's it. Unless your goal is to define optician refraction as being simply teching under a doctor. But if that's the case, then you're arguing refracting opticians shouldn't be independent service providers. Just like you haven't been all these 35 years. You've just been a cog under the thumb of an OMD. Why is that an argument for opticians to refract (independently)? I don't think it is. Who knows, maybe between you using an autorefractor, and all "your" RXs actually being the OMD's RXs, you don't actually know HOW to refract. Nothing you've said here indicates that you do. Everything you've said suggests you could've gone all these 35 years just following instructions turning dials and getting prescriptions signed.

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    Put another way. You're a licensed refracting optician. I'm a (refracting) optometrist. Why is it nothing you do resembles what I do? I don't need an Eyelogic system. I just need a phoroptor. To me, Eyelogic systems are for people who don't know how to refract. Does this make sense to you? So if that's the case, then you aren't a refracting optician. And this isn't about expanding one's scope. This is simply you wanting to remove the OD from a sale of glasses.

    Now don't get me wrong. If you can get the laws to agree with you. Then that's great. But call it or what it is. I am not falling for this lipstick on a pig.

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