# Optical Forums > Canadian Discussion Forum >  The theory of refraction...at Georgian

## renee1111

Hey guys! Just wanted to let all you Ontario Opticians out there know, that Georgian College is finally ready to offer this course. It starts May 13th, registration just started Aril 21st. As far as i know it's Monday and Tues 9-3 until June 24th (for the first module) 
So if anyone is interested in this course, please register ASAP. They need 12 students to go ahead with it, and so far I'm the only one. So come on and join me!!

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## Refractingoptician.com

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## renee1111

> How many modules are there and what can you do with it at the end ?


Yah know, I don't even know how many modules there are...it took me a month and half just to get the info I've posted, and to register. 
The new legislation that went through stipulates that we can now legally refract, under the supervision of an OD, (which by the way is a joke! Cause really, which OD in my town would help me, their competition anyway?) But I hope that Ontario can catch up to BC, and maybe someday soon I will be able to on my own. So when that day comes....I'll be ready, and fully educated! One can only hope!

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## optical maven

I just thought I needed to clarify.  Everybody in Ontario is allowed to operate an autorefractor, in the same way that anybody in Ontario is allowed to measure blood pressure, or body temperature, or body weight.  What is not allowed is the communication of a disease or disorder and to prescribe from that measurement.  Opticians were restricted from autorefracting because too many of them were using the results of their autorefraction to communicate a disorder of the eye and prescribe glasses without the direct supervision an OD or MD.  The COO has decided to run with this change and announce it like it is something new.  My staff is allowed to run my autorefractor, and if you worked in an OD or MD office, you would too.  The law in BC was proposed to change in 2004 and is still unchanged.

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## renee1111

> I just thought I needed to clarify. Everybody in Ontario is allowed to operate an autorefractor, in the same way that anybody in Ontario is allowed to measure blood pressure, or body temperature, or body weight. 
> 
> What is not allowed is the communication of a disease or disorder and to prescribe from that measurement. Opticians were restricted from autorefracting because too many of them were using the results of their autorefraction to communicate a disorder of the eye and prescribe glasses without the direct supervision an OD or MD. The COO has decided to run with this change and announce it like it is something new. My staff is allowed to run my autorefractor, and if you worked in an OD or MD office, you would too. 
> 
> The law in BC was proposed to change in 2004 and is still unchanged.


So everyone in Ontario is allowed to operate an autorefractor, but under the direct supervision of an OD or MD, right? Which is where the problem lies, not all of us have the pleasure of working side by side an OD.

I thought BC Opticians were allowed to perform independant refractions?? No?? Hey BC Opticians....HELP US OUT!!

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## Barry Santini

Q: Should "Dr.s" (ODs, MDs) "supervise" their patients/clients when they *select* their OTC reading eyewear...

...or any type of eyewear online?

Food for thought...

Barry

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## AdmiralKnight

> So everyone in Ontario is allowed to operate an autorefractor, but under the direct supervision of an OD or MD, right? Which is where the problem lies, not all of us have the pleasure of working side by side an OD.


An auto refractor is a simple thing to use, and definately doesn't need any type of school to learn. I'm fairly confident the Georgian course is to learn actual refraction, not autorefractors.

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## opti-refractonator

The Georgian Course is being done in vain.  But i guess that you have to start somewhere.  Already have taken the georgian course and am in my co-op phase.  The toughest thing is going to class every week knowing that you cannot do anything with your knowledge.  You get to learn lots of interesting things and you can begin to see the eye exam from the doctors perspective (more than just a visual refractive correction).  Unless the college allows us to refract independantly (within guidelines and following contraindications) so we can issue an rx, this course is just a waste of time.

I took the course because I am married and it was an excuse to leave every week.

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## HarryChiling

> Unless the college allows us to refract independantly (within guidelines and following contraindications) so we can issue an rx, *this course is just a waste of time*.


You gotta learn to crawl before you can walk.  It's only going to be the minority of opticians that step up their game to attain the levels you talk about, if you take the course you will be ready to take advantage of change when it happens.  Good luck with the course it sounds fun.

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## Refractingoptician.com

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## LandLord

I want to clarify something as well.  Any unlicensed, non-health personnel have always been allowed to manually refract a patient and then hand the results over to a supervising prescriber who could then use that information to write a prescription.  Opticians could not.  Until recently, that is.  Now we can officially do so in the course of our practice.

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## eyemanflying

If it's a 'simple eye exam' refraction only, compared to current spectacles and not diagnosing, I say go ahead with it as I would certainly do it.  It's a great, convenient service to offer and all you are doing is tweaking the Rx.  I know at least a dozen opticians already doing it and the College couldn't care less at this point since they put the cart before the horse on this issue.

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## optical maven

Communicating a diagnosis, diagnosing a disease or disorder, prescribing or dispensing are all controlled acts in Ontario because they are deemed to be harmful if not done correctly, by a trained person.  Fitting glasses on any 2D myope is fairly simple, which anyone probably can do.  However, we are all trained for the exception, and not the rule.  I just examined a 13 year old who had been autorefracted, er sight tested, at a retail store.  She was a simple myope, -2.75 OU,  and her myopia 14 months earlier was -1.00.  She complained of asthenopia at school with her new glasses.  Glasses were made correctly and her refraction was correct.  So, your the sight tester:  What are the reasons for her complaint and what further questions should you ask about this case?  I'll give you the answer in a few days.

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## Barry Santini

> Glasses were made correctly and her refraction was correct.


Q: How do/did you know refractions was "correct"??

Barry

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## optical maven

I examined her

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## opti-refractonator

hey Optical Maven, 
I agree with you that sight testing or a simple refraction won't cut it in every situation.  Part of the college guideline would be to only refract on patients over eighteen.  Secondly, any person coming back with any sort of incompatibility would be referred to the optometrist.
What we are trying to do is make the service of refraction available to the specific part of the public who only want to either confirm or tweak their RX to purchase a pair of eyeglasses.  
This WILL NOT work in all cases.  It was never intended to work in all cases.  Don't prejudge the context of what our goal is.  There are many situations where the optician is better to refer than to refract.  One other part of the framework for a refraction is that if a patient/customer has not seen an optometrist within three years, an Optician MUST refer to an OD for a full exam.   There is an entire list of reasons when /why we should refer.  

p.s.  The georgian course is a great start, but the course needs to be way more detailed and specific before we can start refracting.

peace brother,

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## eyemanflying

Non-registered persons under an Optometrist's direction shouldn't be able to perform registered Optician's duties, period.  This seems to remain unchanged in the near future, therefore it makes perfect sense for Opticians to be able to perform 'simple refractions' and gain back some of that market share.  Give, give, give, it's time to get some back.

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## LandLord

> What are the reasons for her complaint and what further questions should you ask about this case? I'll give you the answer in a few days.


I'll answer this trick question.  The answer is:

*Only a doctor knows the underlying cause of a medical problem.*

Sight testers don't pretend to be doctors.  Only sight testers.

Your example actually supports two points for sight testing:
a) sight testing works.  (you said the Rx was accurate)
b) sight testing should be reserved for those aged 18 - 64

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## Refractingoptician.com

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## opti-refractonator

OM
the answer is vergence insufficiency.  The eyes inability to fuse images caused by stress.  Check with maddox rod or von graffe.  Simple phoria or tropia.

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## renee1111

> I'll answer this trick question. The answer is:
> 
> *Only a doctor knows the underlying cause of a medical problem.*
> 
> Sight testers don't pretend to be doctors. Only sight testers.
> 
> Your example actually supports two points for sight testing:
> a) sight testing works. (you said the Rx was accurate)
> b) sight testing should be reserved for those aged 18 - 64


Great points!! Couldn't agree more!:D:D

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## optical maven

> Non-registered persons under an Optometrist's direction shouldn't be able to perform registered Optician's duties, period. This seems to remain unchanged in the near future, therefore it makes perfect sense for Opticians to be able to perform 'simple refractions' and gain back some of that market share. Give, give, give, it's time to get some back.


 
These are common practices in physician's offices.  Is your concern the same for physicians, and if yes has your association expressed similar outrage and concern to the OMA and government to stop delegation in a physician's office?  Are you also expressing similar outrage to your association to stop delegation within opticianry?  Or are these only issues when it involves optometrists?

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## Refractingoptician.com

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## optical maven

Sort of correct.  Examination revealed a high AC/A (about 6/1) which results in a convergence excess (not insufficiency) with new Rx.  Advice is to remove glasses when reading.  However she also complains that school is difficult because she shifts focus from distance to near, near to distance.  So removing glasses is inconvenient.  This one of those few instances where a bifocal would help to reduce accommodation and therefore reduce convergence.  How much convergence do you want to reduce and what is the correct add?

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## eyemanflying

> These are common practices in physician's offices. Is your concern the same for physicians, and if yes has your association expressed similar outrage and concern to the OMA and government to stop delegation in a physician's office? Are you also expressing similar outrage to your association to stop delegation within opticianry? Or are these only issues when it involves optometrists?


I'm referring to OD's only.  Opticians and OD's should not be able to delegate frame adjustments or the measuring of PD's or heights.  Delegation should be kept at a minimum and should not exceed choosing suitable frames, coatings or performing repairs.

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## Oedema

> I'll answer this trick question.  The answer is:
> 
> *Only a doctor knows the underlying cause of a medical problem.*
> 
> Sight testers don't pretend to be doctors.  Only sight testers.
> 
> Your example actually supports two points for sight testing:
> a) sight testing works.  (you said the Rx was accurate)
> b) sight testing should be reserved for those aged 18 - 64


But yet we have another example of a sight-tester disregarding college guidelines.  This sight-tester is probably not even authorized by the college to be doing this.

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## optical maven

My office uses an automated pupilometer.  Why is my technician not able to press the button and come up with the PD?

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## optical maven

> But yet we have another example of a sight-tester disregarding college guidelines. This sight-tester is probably not even authorized by the college to be doing this.


 
The point of the example is to say that autorefracting (sight testing) is often accurate.  That's why OD's and MD's have used them for 30+ years.  However there are other considerations when examining someone, beyond the physical measurement of the refractive error.  There are no simple examinations.  Every person I examine comes in with a complaint.  I assume every person I examine has a problem, whether it be refractive, binocular or pathology.  It is my job to find out the answer.  The end result might be -2.00, but the road to that conclusion is why I went to university.  The fact that the "sight tester" does not understand this, is the very reason why they are autorefractors by a fancier name.

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## opti-refractonator

Hey OM
Very well clarified. well spoken and very justified.  However, opticians are first to both giveaway their own roles through delegation and secondly try to acquire an academic skill (refraction) yet not want to increase their education.  

Opticians are still wrong when they believe that it is the optometrists who are stopping them from refracting.  Not True.

Wake up you fu#*ing moron opticians, it is your college that controls it.  We have a group of vag's running the show.  They care more about themselves and blowing smoke up each others asses than to actually do anything.

True story.  The OMA asked all health professions to VOLUNTARILY submit a delegation policy for their profession.  Out of all professions, Opticianry was one of only two professions to submit a delegation policy.  Thanks COO.   The COO is run by that fat girl in your fifth grade class that new the answer to every question, was the teachers pet, wore braces and read books at lunch time in the library, and was a virgin until 30.

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## renee1111

> But yet we have another example of a sight-tester disregarding college guidelines. This sight-tester is probably not even authorized by the college to be doing this.


Huh??????????????????????????????????????? What exactly are you talking about here? Am I missing something?

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## renee1111

> The point of the example is to say that autorefracting (sight testing) is often accurate. That's why OD's and MD's have used them for 30+ years. However there are other considerations when examining someone, beyond the physical measurement of the refractive error. There are no simple examinations. Every person I examine comes in with a complaint. I assume every person I examine has a problem, whether it be refractive, binocular or pathology. It is my job to find out the answer. The end result might be -2.00, but the road to that conclusion is why I went to university. The fact that the "sight tester" does not understand this, is the very reason why they are autorefractors by a fancier name.


And where in this thread did we state that we wanted to be "doctors"? NOWHERE!!! No offence but you couldn't pay me enough to want to become an OD. Being stuck in a tiny office, asking "is this better or worse" over and over and over....not to mention the God complex that seems to come along with the title. No Thanks...not interested. I love what I do, and I wouldn't change it for the world....except for maybe adding sight testing to my normal routine.

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## tmorse

> The point of the example is to say that autorefracting (sight testing) is often accurate. That's why OD's and MD's have used them for 30+ years. However there are other considerations when examining someone, beyond the physical measurement of the refractive error. There are no simple examinations. Every person I examine comes in with a complaint. I assume every person I examine has a problem, whether it be refractive, binocular or pathology. It is my job to find out the answer. The end result might be -2.00, but the road to that conclusion is why I went to university. The fact that the "sight tester" does not understand this, is the very reason why they are autorefractors by a fancier name.


My, my, my...aren't we superior!!

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## Oedema

> Huh??????????????????????????????????????? What exactly are you talking about here? Am I missing something?


Optical Maven gave gave a case in which he/she examined a *13yo* with complaint of HA's after receiving a "sight-test" and  spectacles  made on the results of that "sight -test." 

The COO recently released standard of practice guidelines for optician performed refraction.  Some of the relevant guidelines are:
1. Patient must be between the ages of 19-64
2. Patient must have had an eye health exam within the last 365 days with clearance/referral from the physician/optometrist
3. Optician must hold a "refracting designation" from the COO
4. Optician must provide a copy of the patient consent form to the COO (for every patient).

Now this is partially speculation on my part... But I'm thinking that at least three of the above were violated in this case.

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## HarryChiling

> Communicating a diagnosis, diagnosing a disease or disorder, prescribing or dispensing are all controlled acts in Ontario because they are deemed to be harmful if not done correctly, by a trained person. Fitting glasses on any 2D myope is fairly simple, which anyone probably can do. However, we are all trained for the exception, and not the rule. *I just examined a 13 year old who had been autorefracted, er sight tested, at a retail store.* She was a simple myope, -2.75 OU, and her myopia 14 months earlier was -1.00. She complained of asthenopia at school with her new glasses. Glasses were made correctly and her refraction was correct. So, your the sight tester: What are the reasons for her complaint and what further questions should you ask about this case? I'll give you the answer in a few days.


Oedema,

It's speculation if this really happened or not, and it's speculation what optical maven is talking about here, I can't tell if it was an autorefractor reading, a sight tester, or a horrible OD pumping scripts out.  Maybe a bit more clarification is in order, optical maven can you give more definates as to what exactly happened?

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## tmorse

> Optical Maven gave gave a case in which he/she examined a *13yo* with complaint of HA's after receiving a "sight-test" and spectacles made on the results of that "sight -test." 
> 
> The COO recently released standard of practice guidelines for optician performed refraction. Some of the relevant guidelines are:
> 1. Patient must be between the ages of 19-64
> 2. Patient must have had an eye health exam within the last 365 days with clearance/referral from the physician/optometrist
> 3. Optician must hold a "refracting designation" from the COO
> 4. Optician must provide a copy of the patient consent form to the COO (for every patient).
> 
> Now this is partially speculation on my part... But I'm thinking that at least three of the above were violated in this case.


So Optical Maven simply needs to call the COO and register a formal complaint!!!

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## renee1111

> So let me get this straight, Renee1111, you don't want to be a doctor sitting in a room saying one or two. When you go to Georgian for your course, what did you think they are going to teach you. "here is the autorefractor, put the plug in the wall socket, turn on the power, press the big green button, take the rx and make some glasses". No sweetie, bring yourself into the real world. 
> 
> 
> I also don't want to be a doctor............ but i want the extra money
> I don't want to be an OBGYN........... but i want to look at pussy all day
> I don't want to be a porn star..........but i want to be hung like a horse


Oh, let me help clarify for you, I want to even the playing field when it comes down to being able to offer full services such as refraction. Because right now, it is nothing but a hassle trying to obtain my customers RX. Try giving someone a quote when it takes the OD's office three days to fax it to me. Or going through the trouble of finding the "perfect frame" semi-rimless no doubt, to later find out, their a +6.00D. It would save me the frustrations of depending on my direct competition.

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## renee1111

> You love what you do, wouldn't mind sight-testing, but hate the idea of "being stuck in a tiny offie asking 'is this better or worse'"?
> 
> Something seems inconsistent to me here...


See above statement also....

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## LandLord

*renee:* I'll let you in on a secret.  OD's also hate being stuck in a little room all day asking "better one, better two." 

But they do love being called "doctor" and they do love the money they make.

Optometry school might be a big challenge but the job is the easiest money you can make!!

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## LandLord

> There are no simple examinations.


True, but most refractions are very simple.

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## eyemanflying

> Hey OM
> Very well clarified. well spoken and very justified. However, opticians are first to both giveaway their own roles through delegation and secondly try to acquire an academic skill (refraction) yet not want to increase their education. 
> 
> Opticians are still wrong when they believe that it is the optometrists who are stopping them from refracting. Not True.
> 
> Wake up you fu#*ing moron opticians, it is your college that controls it. We have a group of vag's running the show. They care more about themselves and blowing smoke up each others asses than to actually do anything.
> 
> True story. The OMA asked all health professions to VOLUNTARILY submit a delegation policy for their profession. Out of all professions, Opticianry was one of only two professions to submit a delegation policy. Thanks COO. The COO is run by that fat girl in your fifth grade class that new the answer to every question, was the teachers pet, wore braces and read books at lunch time in the library, and was a virgin until 30.


And I had a sighting of her and her bum buddy in NY while at the VEE.  Funny thing is, it was 1PM on Saturday afternoon and they were in a toy store and not at the show??  And I'm sure the trip was expensed on our funds to the COO.:hammer:

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## Steve Machol

Crude and offiensive post by opt-refractioner removed as well as posts quoting his. That type of language and conduct is not acceptable on OptiBoard. :angry:

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## kws6000

> True, but most refractions are very simple.


\


And exactly what gives you the expertise to make this statement?

 How many  refractions have you performed?

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## kws6000

> *renee:* I'll let you in on a secret.  OD's also hate being stuck in a little room all day asking "better one, better two." 
> 
> But they do love being called "doctor" and they do love the money they make.
> 
> Optometry school might be a big challenge but the job is the easiest money you can make!!



If it is so easy and if you are so smart,why dont you go to  into optometry and join the gravy train?

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## HarryChiling

> If it is so easy and if you are so smart,why dont you go to into optometry and join the gravy train?


Correct me if I am wrong but refraction is:

Establish SphereCylinder Axis RefinementCylinder Power RefinementSphere Power RefinementRinse and Repeat (OS)BalanceI think he meant the process of refraction is simple, the art behind it is another matter.  I would agree here with both sides their is an art to it that requires skill and knowledge, but the process of refraction is simple.

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## kws6000

> Oh, let me help clarify for you, I want to even the playing field when it comes down to being able to offer full services such as refraction. Because right now, it is nothing but a hassle trying to obtain my customers RX. Try giving someone a quote when it takes the OD's office three days to fax it to me. Or going through the trouble of finding the "perfect frame" semi-rimless no doubt, to later find out, their a +6.00D. It would save me the frustrations of depending on my direct competition.


If is such a hassle why dont you send the customer back to the od office to pick up the rx in person? Im assuming you are in Sudbury or some other small center where its likely a 10 min drive at most.

Sorry to burst your bubble of self importance,but it isnt  up to the optometrist to drop everything to send you an rx because your customer either lost their rx or didnt bring it in.

As you put it why would they go out of their way to help the competition?   You are lucky they even fax you the rx.  If they wanted to ,they could require the customer to pick up their rx in person.

Looking at your customers current eyeglasses would give you a rough idea of what their rx would be and would likely lessen the time you waste.

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## kws6000

> Correct me if I am wrong but refraction is:
> Establish SphereCylinder Axis RefinementCylinder Power RefinementSphere Power RefinementRinse and Repeat (OS)BalanceI think he meant the process of refraction is simple, the art behind it is another matter.  I would agree here with both sides their is an art to it that requires skill and knowledge, but the process of refraction is simple.



Any procedure can be simplified into a number of steps which fail to take into account the skill required to get an accurate and useful result.

If refracting were that easy,there wouldnt be any redoes.

I get tired of the OD envy exhibited by a few of the posters on this forum.If they honestly feel that it is that easy a way to make a pile of money,then why dont they become one instead of sniping.

The reality of the optical business is that ODs supply the majority of accurate RXs that opticians need in order to earn a living .

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## renee1111

> If is such a hassle why dont you send the customer back to the od office to pick up the rx in person? Im assuming you are in Sudbury or some other small center where its likely a 10 min drive at most. 
> 
> I have 3 OD's down the street. And do yah want to know what they do when someone goes in to ask for ther RX? First they guilt trip them, and make them feel as if they are doing something wrong. Then if they still haven't managed to change there minds, they make them wait for countless HOURS, (and I'm not exagerating here)
> to give them their RX.
> 
> _Sorry to burst your bubble of self importance_,but it isnt up to the optometrist to drop everything to send you an rx because your customer either lost their rx or didnt bring it in.
> 
> DITTO!!!! 
> 
> ...


I'm starting to think that it's a _conflict of interest for OD's to be dispensing eyewear_, just by the views expressed in this post. Doesn't look good on you....your patients may be reading this. Pull up and start acting like an respected professional!

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## HarryChiling

> Any procedure can be simplified into a number of steps which fail to take into account the skill required to get an accurate and useful result.


That's what I said glad we can agree.




> If refracting were that easy,there wouldnt be any redoes.


Your right, that's where the art behind the refraction coems into play, you would probably refer to it as your clinical judgement, tomato tomatoe.




> I get tired of the OD envy exhibited by a few of the posters on this forum.If they honestly feel that it is that easy a way to make a pile of money,then why dont they become one instead of sniping.


I am sure it's not easy making money performing exams, I bet the public gives you more of a hard time for a $40.00 - $60.00 eye exam than they give me for a pair of glasses that I would sell for $600.00.  There is no quick buck left in our industry.




> The reality of the optical business is that ODs supply the majority of accurate RXs that opticians need in order to earn a living .


That's true, I would more likely trust an OD's script before I trust an OMD's script, but I still think that the natural progression for my profession is in refracting.  I think that opticians can do it and can do it well if taught the correct procedures and skills.  Opticiasn at least in the US haven't seen our scope of practice increase in decades, many have attained the knowledge necessary to advance their scope, many have not.

I don't really understand why optometry doesn't embrace opticianry, if our profession gets stronger your profession gets stronger, in the mean time lets just let the internet retailers nip at our heals and the insurance companies nip at yours, doesn't make any sense.:hammer:

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## Barry Santini

> I'm starting to think that it's a _conflict of interest for OD's to be dispensing eyewear_


I do NOT agree!

Barry

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## HarryChiling

I think it's a conflict of interest to have optometrists try to dictate what an optician can and cannot do, but sell eyewear should be WELL WITHIN THEIR SCOPE OF PRACTICE.

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## Oedema

> As you put it why would they go out of their way to help the competition? You are lucky they even fax you the rx. If they wanted to ,they could require the customer to pick up their rx in person.
> 			
> 		
> 
>  Because it's LAW!!!!! Plain and simple!!!!!!!!!!!!!!!!!!!!!


Actually, the LAW doesn't have anything to say about faxing the prescription to you.  In Ontario... it literally says; professional misconduct is...



> 14. Failing to make available to a _patient_ _who requests one_ a written, signed and dated prescription for a subnormal vision device, contact lenses or
> eyeglasses.


Frankly I would be providing written Rx's to all patients just to avoid this kind of efficiency sucking fax requests...

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## optical maven

I'm not sure where I mentioned "Doctor" in my blog.  In fact I know I did not mention that anywhere in my blog.  I really don't care if you call me doctor, just don't call me late for dinner.  The case was a real case, one of many I have seen from autorefractors that were incorrectly managed and diagnosed.   It does not matter that the person was 13.  The same outcome would happen if the person was 23.  If you are going to examine eyes, you should know that.  But you are correct in saying that optometrists only do this for the money, and opticians do this for humanity.  Why else would opticians pay $40,00 for an autorefractor, and do the work for free.  Even better they make one pair of glasses and give you two more for free!!  Oh, the humanity of it!!  But competition being what it is, I'm giving free beer with each pair of glasses I sell to my customers.  Business has been great!!
I have, for 25 years, always given out an Rx after an exam.  I encourage people to shop around, but compare apples to apples.  They always come back because: 1) free beer, 2) I do great work, 3) I'm always less expensive than any retail store for the same item.  It has never made any business sense to try to keep people by not giving out an Rx.  Like woman, tell 'em your not interested, and they really want even more.

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## Jacqui

> I'm not sure where I mentioned "Doctor" in my blog.  In fact I know I did not mention that anywhere in my blog.  I really don't care if you call me doctor, just don't call me late for dinner.  The case was a real case, one of many I have seen from autorefractors that were incorrectly managed and diagnosed.   It does not matter that the person was 13.  The same outcome would happen if the person was 23.  If you are going to examine eyes, you should know that.  But you are correct in saying that optometrists only do this for the money, and opticians do this for humanity.  Why else would opticians pay $40,00 for an autorefractor, and do the work for free.  Even better they make one pair of glasses and give you two more for free!!  Oh, the humanity of it!!  But competition being what it is, I'm giving free beer with each pair of glasses I sell to my customers.  Business has been great!!
> I have, for 25 years, always given out an Rx after an exam.  I encourage people to shop around, but compare apples to apples.  They always come back because: 1) free beer, 2) I do great work, 3) I'm always less expensive than any retail store for the same item.  It has never made any business sense to try to keep people by not giving out an Rx.  Like woman, tell 'em your not interested, and they really want even more.


*FREE BEER !! WOW !!!!!*

When do you have an opening?? I'll be there, early. :bbg::bbg::bbg:

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## kws6000

> I'm starting to think that it's a _conflict of interest for OD's to be dispensing eyewear_, just by the views expressed in this post. Doesn't look good on you....your patients may be reading this. Pull up and start acting like an respected professional!


Well,you can think whatever you want.  I dont care if any of my patients are reading this.

You seem to be the only optician posting about how hard the evil optometrists  are making it for you to obtain scripts.

Have you done anything to make them annoyed at you,so they go out of their way to torpedo you?

You seem to get very emotional in your posts.Perhaps your tone when you contact the ODs office is part of the problem.

If you are getting so worked up about the realities of the business,you might want to consider a less frustrating career.

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## LandLord

> And exactly what gives you the expertise to make this statement?
> 
> How many refractions have you performed?


Come on, you know refraction is easy.  It's all numbers for crying out loud.  If you asked the patient to use words to describe the two images, then it might get tricky.  I've performed over 5000 refractions myself.  My results were then used to either prescribe lenses or as the basis for lasik and PRK treatments.  Don't get your backs up, OD's.  Just admit that getting your license was much harder than the work you perform.

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## kws6000

> Come on, you know refraction is easy.  It's all numbers for crying out loud.  If you asked the patient to use words to describe the two images, then it might get tricky.  I've performed over 5000 refractions myself.  My results were then used to either prescribe lenses or as the basis for lasik and PRK treatments.  Don't get your backs up, OD's.  Just admit that getting your license was much harder than the work you perform.


Getting "a refraction" is easy.Getting an accurate and usable result is harder and where the skill enters into the picture,especially with poor responders.

Driving a manual transmission car is easy-driving a manual transmission car skillfully isnt so easy.

Your 5000 refractions would be about the equivalent of 5-6 mos for me-hardly enough for you to be an expert.Ive been doing this for 23 years and have a pretty good track record,about 2 redoes/year.

If it was so easy to master,then why are there so many redoes? There seems to be a disconnect between your comments and reality.

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## HarryChiling

> If you are getting so worked up about the realities of the business,you might want to consider a less frustrating career.


You know personally for me I have been contemplateing it more and more lately.  I am not saying that OD's are the bane of our industry but as an optician, often times:
The doctor won't release the script (OD and OMD)The scripts that do get released are riddled with errors (some offices in our area we just refuse to fill now due to the high number of clerical errors)Insurance companies won't allow opticians as providers (don't really know if that falls in the bad category)Eyewear is treated as a retail itemInternet retailers not only sell their wares online but then inform their patients that their opticiasn owe the measurements (counts as a minus for OD's and OMD's too)Licensing in most the US states is a pipe dream and unenforced in the states do have themNone of the O's respect the other O's in the industryIt's getting to be too much, everyone is looking to find a solution to our problems.  To me my lively hood depends on a script written and controlled by another which I don't mind and could really care less about, I don't find refraction as being interesting, to me it's the physics involved that fascinates me you throw physiology in the mix and you lose my interest, but if I can't get a script and the major reason is that the person writing the script benefits from me not recieveing the script then I have to look at this objectively as a problem and with this as a problem I start to look for solutions.  In the US some decades back a law was passed to make sure that patients were given their scripts after an exam.  I think the issue has beoem very polarized from years of abuse, I advocate refraction for opticians because I would like to see my profession thrive and I don't see that happening in the current symbiotic system that we operate in.

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## kws6000

> You know personally for me I have been contemplateing it more and more lately.  I am not saying that OD's are the bane of our industry but as an optician, often times:The doctor won't release the script (OD and OMD)The scripts that do get released are riddled with errors (some offices in our area we just refuse to fill now due to the high number of clerical errors)Insurance companies won't allow opticians as providers (don't really know if that falls in the bad category)Eyewear is treated as a retail itemInternet retailers not only sell their wares online but then inform their patients that their opticiasn owe the measurements (counts as a minus for OD's and OMD's too)Licensing in most the US states is a pipe dream and unenforced in the states do have themNone of the O's respect the other O's in the industryIt's getting to be too much, everyone is looking to find a solution to our problems.  To me my lively hood depends on a script written and controlled by another which I don't mind and could really care less about, I don't find refraction as being interesting, to me it's the physics involved that fascinates me you throw physiology in the mix and you lose my interest, but if I can't get a script and the major reason is that the person writing the script benefits from me not recieveing the script then I have to look at this objectively as a problem and with this as a problem I start to look for solutions.  In the US some decades back a law was passed to make sure that patients were given their scripts after an exam.  I think the issue has beoem very polarized from years of abuse, I advocate refraction for opticians because I would like to see my profession thrive and I don't see that happening in the current symbiotic system that we operate in.



From the posts that I have read,I cant imagine why anyone would want to go into optical ,especially in the us.In canada,online eyeglass places havent caught on yet,but its only a matter of time.

The whole industry has been *******ized by corporate optical with the result that the public looks at eyewear/cls as being commodities like a pair of socks.

Im hoping to retire before it really gets ugly.

No wonder Chip is cranky!

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## HarryChiling

> From the posts that I have read,I cant imagine why anyone would want to go into optical ,especially in the us.In canada,online eyeglass places havent caught on yet,but its only a matter of time.
> 
> The whole industry has been *******ized by corporate optical with the result that the public looks at eyewear/cls as being commodities like a pair of socks.
> 
> *Im hoping to retire before it really gets ugly.*
> 
> *No wonder Chip is cranky*!


Good luck on that, and can you blame him?  Yeah ******** along with a few @#$%^&**'s just about sums it up.

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## renee1111

> You know personally for me I have been contemplateing it more and more lately. I am not saying that OD's are the bane of our industry but as an optician, often times:
> The doctor won't release the script (OD and OMD)The scripts that do get released are riddled with errors (some offices in our area we just refuse to fill now due to the high number of clerical errors)Insurance companies won't allow opticians as providers (don't really know if that falls in the bad category)Eyewear is treated as a retail itemInternet retailers not only sell their wares online but then inform their patients that their opticiasn owe the measurements (counts as a minus for OD's and OMD's too)Licensing in most the US states is a pipe dream and unenforced in the states do have themNone of the O's respect the other O's in the industryIt's getting to be too much, everyone is looking to find a solution to our problems. To me my lively hood depends on a script written and controlled by another which I don't mind and could really care less about, I don't find refraction as being interesting, to me it's the physics involved that fascinates me you throw physiology in the mix and you lose my interest, but if I can't get a script and the major reason is that the person writing the script benefits from me not recieveing the script then I have to look at this objectively as a problem and with this as a problem I start to look for solutions. In the US some decades back a law was passed to make sure that patients were given their scripts after an exam. I think the issue has beoem very polarized from years of abuse, I advocate refraction for opticians because I would like to see my profession thrive and I don't see that happening in the current symbiotic system that we operate in.


Great post!! This about sums it up and I couldn't have said it better (without getting "emotional", lol!)

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## renee1111

[quote=kws6000;240916]


> Well,you can think whatever you want. I dont care if any of my patients are reading this.
> 
> You seem to be the only optician posting about how hard the evil optometrists are making it for you to obtain scripts.
> 
> Have you done anything to make them annoyed at you,so they go out of their way to torpedo you?


If you would have read my last posts, you would know that my family owned and operated a wholesale lab, for 37 years...producing 150 jobs a day. (with over a million dollars worth of state of the art equipment) We only sent out quality work and the best pricing...which still wasn't enough for our local OPtoms. Essilor tryed to buy my lab, and we refused, which is when they (Essilor) went to all our accounts and offered them a 60% disc. (way, way below our cost, by the way) Our accounts basically switched labs overnight , leaving us with their rush jobs (about 10 jobs a day) We tryed our best to survive on the few jobs left...but just couldn't. So we called it quits with wholesale and opened the largest, most beautiful retail store you've ever seen...and offer pricing that's out of this world! Now the locals are pi**ed, but they are too dumb to realize that they forced us into it. So when I call for scripts now, I'm always nice as pie, mostly because I know all the dispensers very, very well. The staff knows what we went through, and we're still friends. The problem starts when they have to ask the OD to release the script. This is why I am "emotional " when it comes to this business. But I've really never been happier, running my store. 



> You seem to get very emotional in your posts.Perhaps your tone when you contact the ODs office is part of the problem.
> 
> If you are getting so worked up about the realities of the business,you might want to consider a less frustrating career.

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## kws6000

Ok.

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## Stonegoat

These posts are depressing....with internet eyeglass and contact lens sales, I really wonder what the future holds for opticianry??  ODs can still get by doing exams and treating eye conditions, but even for us, the belt will have to tighten.... :Confused: 

I wonder in 20 years the whole of humanity will be employed by either Walmart or Costco..?  Seems to be the direction of things...more so in the USA, but it's starting in Canada.

Hope I can retire soon!  lol

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## LandLord

> Getting "a refraction" is easy.Getting an accurate and usable result is harder and where the skill enters into the picture,especially with poor responders.
> 
> Driving a manual transmission car is easy-driving a manual transmission car skillfully isnt so easy.
> 
> Your 5000 refractions would be about the equivalent of 5-6 mos for me-hardly enough for you to be an expert.Ive been doing this for 23 years and have a pretty good track record,about 2 redoes/year.
> 
> If it was so easy to master,then why are there so many redoes? There seems to be a disconnect between your comments and reality.


Please don't take it the wrong way.  I respect you and what you do.  I'm not saying refraction is unskilled labour, I'm just saying that if you consider the mental and physical effort it takes to refract and the corresponding financial reward, it's a pretty darn good ratio.  No?

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## Refractingoptician.com

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## Refractingoptician.com

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## Refractingoptician.com

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## Oedema

> COO"S rules for refraction are totally unworkable . They amount to a "foot in the door"  but that is all . Those guidelines are prohibitive and restrictive .


The guidelines are not intended to enable independent sight-testers, as the ministry already put the COO in it's place on that matter, rather their intended purpose is to establish a frame-work for _delegation_ of refraction in Ontario.

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## Refractingoptician.com

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## AdmiralKnight

> Frankly I would be providing written Rx's to all patients just to avoid this kind of efficiency sucking fax requests...





> I have, for 25 years, always given out an Rx after an exam. I encourage people to shop around, but compare





> You seem to be the only optician posting about how hard the evil optometrists are making it for you to obtain scripts.


I'd like to make a comment about this. It's great to hear that you all have made it part of your routine to make sure all of your patients have rx in hand when they leave your office. But please.. PLEASE don't think that all, or even a lot of offices are like this. I've experianced it from both sides of the coin. Customers coming in to see me when I worked retail, saying that they either had to ask for their rx, or was never given to them. Sure some of them could be full of it, not wanting to admit they've lost it, but I've also worked in two seperate OD offices, on different sides of the country. Neither office gave out the Rx unless it was specificly asked for. I'm sorry, but I'm more inclined to believe that more offices work like this than how your offices do.

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## kws6000

> These posts are depressing....with internet eyeglass and contact lens sales, I really wonder what the future holds for opticianry??  ODs can still get by doing exams and treating eye conditions, but even for us, the belt will have to tighten....
> 
> I wonder in 20 years the whole of humanity will be employed by either Walmart or Costco..?  Seems to be the direction of things...more so in the USA, but it's starting in Canada.
> 
> Hope I can retire soon!  lol


I think we are all getting frustrated with the optical business and that is showing up with the sniping and pissing matches in some of these threads.

I dont think optometry is going to get off easy with the *******...tion of the industry.

If I were young and looking at career choices,the optical industry,including optometry would be off the list.

Im frustrated with the  increased demands,lack of compliance with recommendations,and nickel and dimeing from patients .

I sympathize with the opticians posting on this board,especially in the us ,who have more of a problem with internet sales or discounters (5 pairs for $29) or who have  to work for some of the big outfits.

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## HarryChiling

> *I think we are all getting frustrated with the optical business and that is showing up with the sniping and pissing matches in some of these threads.*
> 
> _I dont think optometry is going to get off easy with the *******...tion of the industry._
> 
> If I were young and looking at career choices,the optical industry,including optometry would be off the list.
> 
> *Im frustrated with the increased demands,lack of compliance with recommendations,and nickel and dimeing from patients .*
> 
> *I sympathize with the opticians posting on this board,especially in the us ,who have more of a problem with internet sales or discounters (5 pairs for $29) or who have to work for some of the big outfits*.


You know the funny thing is that the doctors that are beign unscrupulous won't oftne visit this site, why would they you can make a fortune in any industry by being underhanded with business practices, just the fact that your here seems to indicate you are lookign for ways to better your profession or office or to learn more and I can't continue to fault your whole profession for the few bad apples.  I just wish again there was a way of differentiateing the good optometrists from the bad optometrists in practice, the same goes for opticianry.  I know the AOA is looking to implement a Board Certification thing which sounds liek a crock of poo to me.  

So the way I see it is if the general public respected the eye exam more, then the doctors would be reimbursed more for the time and effort spent with each patient then the doctors wouldn't have such a problem with sellign glasses or protectign their turf like rabid dogs, the real issue is the fact that their are too many outside hands in the cookie jar, insurance, retailers, now internet merchants.

Here is my suggestion or solution:

Put all our differences aside and work on ways to stop the ********tion.

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## fjpod

Question...

If opticians had the right to prescribe glasses or perform sight testing, would they have to hand the patient a written copy of the Rx so they could shop around?  Not doing so would be dishonest?  No?

Circular reasoning, isn't it?...  Counter productive, IMO.  Not everyone who sells what they prescribe is dishonest.  Is the dentist who detects and fills your cavity dishonest?  Is the OMD who detects and removes your cataract dishonest?  What about the mechanic who says you need a new timing belt and does it for you?  Should he be required by law to say to you, "Here's a list of what's wrong with your car.  Here's a list of the parts you need to fix it.  Now go take this information somewhere else."

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## LandLord

> If opticians had the right to prescribe glasses or perform sight testing, would they have to hand the patient a written copy of the Rx so they could shop around?


It would be a moot point because if all eyeglass sellers were refracting, there would be no need to visit 2 of them.  You could be refracted by everyone.  It wouldn't matter. 




> Not everyone who sells what they prescribe is dishonest. Is the dentist who detects and fills your cavity dishonest?


I agree.  It's only the ones who create a double standard about false conflicts of interest who are dishonest.  


> What about the mechanic who says you need a new timing belt and does it for you? Should he be required by law to say to you, "Here's a list of what's wrong with your car. Here's a list of the parts you need to fix it. Now go take this information somewhere else."


Your example is flawed because a) he is not a doctor, and b) you don't have to pay a mechanic to tell you your transmission is shot.

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## fjpod

> It would be a moot point because if all eyeglass sellers were refracting, there would be no need to visit 2 of them. You could be refracted by everyone. It wouldn't matter. 
> 
> I agree. It's only the ones who create a double standard about false conflicts of interest who are dishonest. Your example is flawed because a) he is not a doctor, and b) you don't have to pay a mechanic to tell you your transmission is shot.


Not all opticians would refract..just like not all ODs or MDs sell glasses.  The consumer would still expect the right to shop around, and the FTC rules on handing out an Rx would not go away.  In fact the likelihood is they would have to be expanded to include the prescribing optician.

Whether he has a college degree or not, the mechanic is the doctor of your car.  You have to depend on his honesty, and if in your past experience he is dishonest, you simply don't go back.  Sometimes they do  charge to figure out what is wrong with your car, and frankly I don't blame them.  I know it varies from state to state, but how about when the mechanic charges you $35 (as in NY) to do a safety inspection?  He tells you what is wrong and how much it will cost. He is absolutely expecting you to get your car fixed at his shop.  Do you expect him to give you all the details of the cars condition, a list of the parts needed, where to get them, and guarantee that if the repairs are made somewhere else, that the car will pass inspection after?  It's very similar to medical/optical situations.  Business is business.  Doctors are not above the rest of us, and mechanics are not below us.

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## Oedema

> The consumer would still expect the right to shop around, and the FTC rules on handing out an Rx would not go away.  In fact the likelihood is they would have to be expanded to include the prescribing optician.


Notice that this is the Canadian forum... being a US gov't agency the FTC has no power in Canada!  In fact Canadian OD's are not required to hand over an Rx to patients unless specifically asked for one.

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## fjpod

> Notice that this is the Canadian forum... being a US gov't agency the FTC has no power in Canada! In fact Canadian OD's are not required to hand over an Rx to patients unless specifically asked for one.


I did realize that.  I was speaking more globally.  I hear constantly on this forum that prescribers should have to hand out the Rx, and I am OK with that, although I can't think of too many professions or occupations that are forced to do this.  I'm not so sure all of us have thought this Rx release thing through(in the US, anyway).  

Whatever the rule, though, it should be equally applied and enforced.

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## LandLord

> I can't think of too many professions or occupations that are forced to do this.


There is no other profession or industry that has such power over its competition and customers the way optometry has.

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