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

  1. #26
    What's up? drk's Avatar
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    Quote Originally Posted by mike.elmes View Post
    Sight testing is an evaluation of refractive error of the eye.
    AKA "optometry".

    It is accomplished as a refraction done with an autorefractor, autophoropter, and lensometer.
    In other words, you take the old glasses (probably determined by an OD), get a variably-accurate autorefractor reading, and you're done.

    It is done by a trained technician, using computer aided software.
    "Computer-aided software"? Is there another kind of software? "Technician", huh? Who trained the "technician"? Seriously. Who?

    The final results (subjective) are compared to the clients existing glasses prescription.
    Which tells you exactly....nothing. What's the point? Can you explain that to me?

    The whole procedure uses Snellen charts to determined visual acuity.
    Ooooh. Snellen charts.

    The final results are sent via fax to an eye doctor for final approval by an ophthalmologist.
    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.

    This system works nearly flawlessly. I have used mine for almost 10 years. Redo rate is maybe 1%.
    Bull-freaking-crap.

    It is explained to the potential client as being a non medical exam. No determination of eye health. The client must sign a waiver stating that the procedure is strictly used to determine a prescription for eyeglasses or contact lenses.
    "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.
    Last edited by drk; 02-09-2018 at 01:30 PM.

  2. #27
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    Quote Originally Posted by Lab Insight View Post
    Well said. It's a beautiful accurate system. And having an optician do the entire process is why it is 1% error vs. 10% coming from the OD offices.
    How do those with sight testing apparatus troubleshoot Rx failures?

  3. #28
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    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.
    What is the role of the opthalmologist in the determination of the Rx? Is there any input by him or is he a rubber stamp? Could the MD role be performed by an OD, and if not why not? And if so, why is an MD involved and not an OD, or is the choice entirely a political decision?

  4. #29
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    It is a personal ‘sight-test’, so try to get over the unfortunate use of the word “exam”.

    And nobody is being ripped off. When the BC government formally permitted licensed opticians to sight-test back in 2010, there were already tens of thousands of successful sight tests performed in BC and Alberta. And enough safeguards were put in place by government and the regulatory Colleges to adequately safeguard the public. Since 2010 there have been another ‘tens of thousands’ of successful sight-tests. The public is very good at complaining when vision through their new eyeglasses, produced by a sight-test and performed by a specialty BC-licensed optician, is not effective.

    Personally, I like the ‘Sight-Test’ model proposed by NY opticians many years ago when they lobbied government to permit sight-testing by NY opticians. They almost succeeded, but NY Optometry with better lawyers and deeper pockets prevailed.
    Every sight-test by a NY licensed optician was to be followed 2-years later by a formal optometric eye examination.
    Sure, there are medical issues that could arise in the interim, but that is what your family doctor is for.

    Still waiting for a BC Optometrist to chime in on the original issue raised.

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    I'm pretty sure the sight test described by M Elmes in Alberta is different to the one in B.C. Alberta apparently still requires a doctor to sign off on the prescription, whereas BC does not. (otherwise, why get an ophthalmologist involved, rubber stamp or not)

    So a clarification of what a sight test actually is, in BC, would be informative as well.

  6. #31
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    What would be informative is the subject matter of this thread:

    Has sight testing been harmful to optometrists in BC?


  7. #32
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    And enough safeguards were put in place by government and the regulatory Colleges to adequately safeguard the public.
    Such as?

  8. #33
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    Quote Originally Posted by drk View Post
    Such as?
    Only permitted between ages of 19-65; no history of certain chronic diseases permitted; mandatory refer to OD/OMD if certain acuity not met. These are just some of the mandatory sight-testing protocols. And let's not forget a 20-years history of no medical or legal complications due to sight-testing process. Check with either BC or Alberta regulatory Colleges' website if you want further details.

  9. #34
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    Age is verified, how? (And of course we know no disease happens from 19-65?)

    Chronic disease is verified, how? Self-report? That'll catch everything, right? "Sir, if you want to get glasses here today, please fill out this form carefully. BTW, if you have any diseases, you're getting back into your Subaru."

    Referral is enforced, how? "Hey, you're 20/30 today. You should see someone about that. It's the law."

    But they're still getting those glasses, right?


    In the better system, the doctor's butt is liable. That works wonders.

    Amazing how "third-world-style" Alberta, Canada decided to go with their health care.

  10. #35
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    1) The customer walks into any store (online or BM)
    2) The trained (highly)14 year old measures (computer assisted) PD and seg height
    3) Results are faxed to ophthalmologist who confirms and glasses are sold.

  11. #36
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    Quote Originally Posted by drk View Post
    In the better system, the doctor's butt is liable. That works wonders.
    I forget to mention... should any error or omission on the part of the sight-tester resulting in real loss, all specialty-licensed Optician are required by their regulatory Colleges to carry a minimum of $1,000,000.00 ($1M) Errors & Omissions liability insurance policy. In fact, every licensed Optician across Canada carries this same amount of E&O liability insurance.

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    Yes, we will cause cancer by doing these kind of refractions, and Opticians are too stupid to be able to know when to refer based on established protocols, right? ODs have been accused of over-stepping for many years, and if one really understands the issue, the incidence of significant eye diseases is minimal in the ages described above. This is no more than a turf battle, and used properly these new refraction devices can be effective, and increase access. All these health concerns are nothing more than scare tactics. The MDs have no real issue here, and they are the folks ODs refer to when needed, so again, just turf. You can do a simple refraction on a cell phone today, and if patients are informed of the need for an eye health exam then they made a choice.

  13. #38
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    Quote Originally Posted by tmorse View Post
    I forget to mention... should any error or omission on the part of the sight-tester resulting in real loss, all specialty-licensed Optician are required by their regulatory Colleges to carry a minimum of $1,000,000.00 ($1M) Errors & Omissions liability insurance policy. In fact, every licensed Optician across Canada carries this same amount of E&O liability insurance.
    I find that amazing, if true.

    You have an hourly employee professional-liability insured? That's crazy.

    In other words, you are getting screwed.

  14. #39
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    Quote Originally Posted by wmcdonald View Post
    Yes, we will cause cancer by doing these kind of refractions, and Opticians are too stupid to be able to know when to refer based on established protocols, right? ODs have been accused of over-stepping for many years, and if one really understands the issue, the incidence of significant eye diseases is minimal in the ages described above. This is no more than a turf battle, and used properly these new refraction devices can be effective, and increase access. All these health concerns are nothing more than scare tactics. The MDs have no real issue here, and they are the folks ODs refer to when needed, so again, just turf. You can do a simple refraction on a cell phone today, and if patients are informed of the need for an eye health exam then they made a choice.
    There aren't any "established protocols" Professor McDonald. And if they are, they're dog crap. Trust me on that one, OK? You're making yourself sound totally ignorant. Your post is 100% incorrect. 100%. You don't even begin to know what you don't know.

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    Quote Originally Posted by drk View Post
    I find that amazing, if true.
    ‘I am shocked Sir, shocked I say, that you should doubt the veracity of my claim.’

    As you well know, Insurance companies use ‘actuaries’ to determine level of risk and they have determined the possibility of real risk to the patient by Opticians fitting eyeglasses, contact lenses and performing sight-tests to be so low that the annual cost of E&O liability insurance for Opticians to be little more than insurance file-opening costs.
    In Canada, part of registration process for licensure requires that every optician registrant must obtain $1,000,000.00 ($1M) Errors and Omissions liability insurance. Our National organization ‘Opticians Association of Canada (OAC) offers this amount of E&O coverage as just one of the many benefit that form part of annual OAC membership dues. An official certificate of $1M E&O coverage for the member is sent by OAC to each respective regulatory College in Canada. And annual OAC membership is $125.00/yr (or about $100.00USD) + tax.

    Free Professional Errors & Omissions Liability Insurance
    Together with Western Financial Group, the OAC is proud to provide a FREE* $1,000,000.00 personal Professional Liability Insurance policy that protects its members from lawsuits for damages claimed by a third party, resulting from a professional error or omission or negligent act, committed during the course of their activities as an "Optician".
    Many provincial regulatory colleges require that Opticians carry their own personal Professional Liability Insurance policy to obtain and maintain their license.
    Opticians who wish to obtain more coverage can upgrade to a $3,000,000.00 or $5,000,000.00 PLI policy by contacting the OAC office at 1-800-847-3155 or email memberservices@opticians.ca

    See www.opticians.ca and check under MEMBERSHIP (Benefits of membership)

  16. #41
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    Well, that is very cheap.

    Carry on, my wayward son.

  17. #42
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    Quote Originally Posted by drk View Post
    Well, that is very cheap.

    Carry on, my wayward son.
    Thanks, Dads!

  18. #43
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    Listen here, I am a licensed Refracting Optician. I am licensed for 35 years. I am in my own business for more than 20 years. You sir are an Optometrist from another country, if Ohio is where you do business. We do indeed have protocols that we adhere to for the best interest of the patient/client. We refer often. This is really a turf war issue. Optometrists and Opticians can be compared to dentists and denturists.... this gets old. Lets agree to disagree.

  19. #44
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    Sure. Whatever.

    This is an international forum. I am the international OD of the webs. Whatever. I've been in the presence of Candian optometric smarties like Dumbledon and Jones. They're awesome but they seem to put their lab coats on one leg at a time.

    Unless you have different human beings with different physiology...

    I am a refracting optometrist and therapeutic optometrist since 1989 (how long is that?), and a business owner, as if that affects the truth of what I'm saying, which it does not.

    No protocols are sufficient. They merely put lipstick on the pig that is sub-standard health care (by American standards, at least).

    I fear that our standards will slip as low as yours. They probably will.

    It's not a "turf war" and this is not 1975. I don't need dentures yet, but you "old guys" seem to view the world through that prism. It's about another subject altogether.
    Last edited by drk; 02-14-2018 at 05:09 PM.

  20. #45
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    As for the accuracy and subsequent acuity of my clients, I would say that in all cases where we do a refraction with the eyelogic system the client picks the RX we come up with and receives the subjective results they ask for.
    I have seen so many doctors that wont give the patient what they say they see the best with. I'm just saying.

  21. #46
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    So, after all these vision tests, you are handing to the patient a copy of their Rx so they can go shopping elsewhere, right?

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    Redhot Jumper The MDs have no real issue here, and they are the folks ODs refer to when needed,

    Quote Originally Posted by wmcdonald View Post

    The MDs have no real issue here, and they are the folks ODs refer to when needed, so again, just turf. You can do a simple refraction on a cell phone today, and if patients are informed of the need for an eye health exam then they made a choice.

    Reading this thread that now has exploded into the old argument as all others when the refraction becomes the heated argument, I would suggest that you read up on Warren McDonalds professional activities right here on the web.

    See at:
    http://www.methodist.edu/about-metho...arren-mcdonald
    Chris Ryser
    ________________________________________
    DLO. NA.IC.I.T.PO

    http://optochemicals.com............................. http://arcoatings.com

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    Quote Originally Posted by drk View Post
    There aren't any "established protocols" Professor McDonald. And if they are, they're dog crap. Trust me on that one, OK? You're making yourself sound totally ignorant. Your post is 100% incorrect. 100%. You don't even begin to know what you don't know.
    Ignorant? Hardly, and certainly not incorrect. I will not stoop to personal insults, and just agree to disagree. Have wonderful day.

  24. #49
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    Didn't the BC government also deregulate the dispensing of glasses? How has that affected opticians and optometrists?

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    Not sure, but a good question!

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