Hi folks
I believe back in May 2010, BC permitted sight testing by opticians. Was this change in any way a game changer for ODs? What is the work/job scenario for optometrists in the province these days? Is there less work now available for ODs compared to before the new law was implemented? Or are ODs basically "equally" busy now, as before the rule change? Would an OD moving to BC from another province find it difficult to find adequate work?
Thanks in advance.
“The main issue we have is that asymptomatic eye disease will go unchecked,” she says
Kirsten North, president of the Canadian Association of Optometrists, says that automated sight tests aren’t comprehensive. “The main issue we have is that asymptomatic eye disease will go unchecked,” she says.
For some eye diseases, such as glaucoma, early detection is the only way to prevent permanent damage. Symptoms occur late and lost vision cannot be recovered.Sight tests are also unable to detect problems such as retinal tears, corneal scars and eye tumours.
Automated Sight tests, alone, aren’t an adequate basis on which to generate prescriptions, says North. Factors other than refraction, such as age and health status, must be considered. “Even something as simple as how tall someone is can affect a prescription,” she says.
see all of it:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882486
Of course there are factors related to health, but much of that is scare tactics, Chris, and not really what the OP was asking. Has it affected ODs in BC? I have not seen any indication it has but would be interested to hear from those affected on both sides of the issue.
Last edited by wmcdonald; 12-28-2017 at 08:16 PM.
Originally Posted by wmcdonald
It for sure is affecting ODs as well as opticians because the sale of glasses is totally deregulated and opticians can test vision.
PROVINCE/TERRITORY, GLASSES, CONTACT LENSES, British Columbia.
A patient may obtain an eye glass prescription from an optometrist, physician or ophthalmologist. A patient may also obtain specifications for eye glasses from a sight testing optician. Both the optical prescription and sight test results must include a measurement of the interpupillary distance.
The patient can either use the eye glass prescription or the sight test specifications to purchase eyeglasses anywhere that eyeglasses are available. Dispensing is deregulated in British Columbia.
A patient must have an optical prescription or specifications from a sight test to initiate a CL fitting. A patient must have an initial CL fitting done by an optometrist, physician, ophthalmologist or optician.
Initial CLs may only be dispensed by the above regulated professionals. Replacement CLs can be dispensed indefinitely by anyone including internet CL sites.
source:
https://opto.ca/sites/default/files/..._version_2.pdf
I walked into a Vancouver Lenscrafters recently in a busy Cadillac Fairview mall and asked for the price of an eye exam. $125. I walked by 3 times on different days and not once did I see a single patient waiting in the waiting area. I don't think this qualifies as even an anecdote, much less data though.
Internet dispensing is everywhere, not just in BC. But BC regulations are almost devised to encourage people to buy online, so you'd imagine online dispensing would affect brick/mortar stores there "at least as much or even more" than in other provinces. So I wonder how brick/mortar opticals have been affected. I was last in BC about 14 years ago, and I recall seeing more optical stores in malls then, compared to now. I recall seeing the stores of a lot more optical chains that I had never encountered in Ontario, that I didn't really notice this visit. At the time, seeing Pearle and Iris was new to me as they hadn't entered the Ontario market yet. And there was at least another "smaller" chain or two that I recall too, that I didn't notice this visit. But my survey isn't scientific of course.
What would be informative is the subject matter of this thread:
Has sight testing been harmful to optometrists in BC?
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.
Thanks, Chris. I knew of those details, but I wonder if it has hurt the bottom line if the ODs. Are they seeing less patients? I have not been able to find detailed evidence of that anywhere in the literature. Are Opticians seeing an increase? Has there been an increase of significant ocular events due to this change. And I don't mean individual instances of something that should have been caught but was not.........that has always happened. I mean significant evidence of issues. Based upon the typical scare tactics, one would think half of BC was probably blind by now.
As always, I appreciate your insights.
Ontario opticianry programs were teaching 'sight-testing' since 2005, until stopped by the Ontario government in 2009. BC was following Alberta's lead, and both produced tens of thousands of successful sight-testings until BC formally deregulated Dispensing in 2010, and permitted formally trained Opticians to sight-test. Optometrists were permitted to dispense certain TPA and BC Opticians were permitted to sight-test under certain conditions. Both were considered expansions of each professions' scope of practice. In BC, the fitting of Contact Lenses remains a regulated act, but not the sale of CL lenses.
Optometrists are still found in abundant numbers in BC and Alberta, over ten years after sight-testing by Opticians was first introduced. So I too would like to hear some views from some BC Optometrists.
the BC health minister was a principle in clearly.com before Lux bought them. Talk about a conflict of interest.
Dig deeper, to see the bigger picture, not just the provincial picture. Look at all the stakeholders, as well as all the shareholders.
I wonder if someone can define "sight testing" for me. I'm confused. Is it a refraction, a screening or eye exam or is it some sort of new procedure?
I wonder if someone can define "sight testing" for me................................
Sight testing is a new definition on the new optical world market, and part of the revolution just about making its official start in 2 month by the Essilor/Luxottica merger.
The USA is more than halfway deregulated and in Canada, BC and Quebec are done and they are working to do the same in Ontario.
see the latest trend:
https://health.economictimes.indiati...erjee/58744572
This is actually a good question. I imagine it is legally defined in the jurisdictions where it exists (i.e. BC). I'm assuming the BC optician governing body has outlined what constitutes a sight test. What I don't believe it is, is simply the results of an autorefraction used as the basis for an eyeglass prescription. Although speaking to pro-refracting opticians in the past (these folks took the optician refracting course offered in Barrie back in the day, like in 2005), my understanding is that that an auto-refraction --> eyeglass prescription was all they wanted from their lobbying efforts.
This is actually a good question..............................
The BC opticians website at http://www.opticians.bc.ca does not exist and is automatically diverted to the Canadian Dispensing Opticians Association.
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. The final results (subjective) are compared to the clients existing glasses prescription.
The whole procedure uses Snellen charts to determined visual acuity. The final results are sent via fax to an eye doctor for final approval by an ophthalmologist. This system works nearly flawlessly. I have used mine for almost 10 years. Redo rate is maybe 1%. 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.
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.
Well said. It's a beautiful accurate system.........................................
........................just like to add one more thing on the subject.
This system is and has been used all over the world, just about forever, and is nothing new, and has worked fine just about forever.
The North American Continent is lagging behind the world in this field.
Correct, and the lag is caused by the same group of innovators that are currently trying to take on the largest lens manufacturer in the world.
The legislation and policies need to change to better serve the public.
How do those with sight testing apparatus troubleshoot Rx failures?
I understand that this is how "you" have sight tested these last 10 years, but is this how "sight testing" is defined in BC? What is permitted in BC as sight test? Or does it require all the apparatus you describe? Or can it simply be an optican who uses a mechanical phoroptor (or even just an autorefractor?) to refract?
Edit: I ask these questions because my understanding of the intent of sight testing has always been to simply "eliminate" the optometrist from the sale of a pair of glasses. It wasn't intended to replace the him/her.
Last edited by optio; 02-09-2018 at 10:16 AM.
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.It is accomplished as a refraction done with an autorefractor, autophoropter, and lensometer.
"Computer-aided software"? Is there another kind of software? "Technician", huh? Who trained the "technician"? Seriously. Who?It is done by a trained technician, using computer aided software.
Which tells you exactly....nothing. What's the point? Can you explain that to me?The final results (subjective) are compared to the clients existing glasses prescription.
Ooooh. Snellen charts.The whole procedure uses Snellen charts to determined visual acuity.
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.The final results are sent via fax to an eye doctor for final approval by an ophthalmologist.
Bull-freaking-crap.This system works nearly flawlessly. I have used mine for almost 10 years. Redo rate is maybe 1%.
"Non-medical exam". That, sir, is a contradiction in terms.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.
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.
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.
Edit. Nevermind. Don't want to wade into this useless OT argument that will lead nowhere.
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?
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