An optometrist is required to do a minimum of 3 years in a bachelor of science program at university, followed by 4 years of professional school at a School of Optometry. Optometrists are licenced by the Board of Examiners in Optometry in British Columbia, the profession’s provincial regulatory body. Every BC optometrist is also a member of the British Columbia Association of Optometrists.

What is an Ophthalmologist?
Ophthalmologists are physicians who, after graduating from medical school, undertake several years of post-graduate training in the diagnosis and treatment of diseases of the eye. Eye surgery is preformed by ophthalmologists. Patients require a referral from their optometrist or family physician to visit an ophthalmologist.

What is an Optician?
Opticians supply, prepare and dispense optical appliances based on prescriptions prepared by optometrists and ophthalmologists. Opticians in BC complete a 6 month to one year training program after which they take a national examination that enables them to dispense eyeglasses. Additional training is required to dispense contact lenses.

What is a sight test?
A sight test, more accurately called a refraction, determines a lens prescription by relying on a combination of computerized tests using automated equipment.

The comprehensiveness and accuracy of these automated sight tests is limited. Eye muscle co-ordination is completely ignored, and the test results can be influenced by eye fixation and alignment, pupil size, corneal or lens irregularities, and something called instrument myopia. This last problem is caused by the eye’s tendency to have its focus altered by the device being looked through. This can lead to an inaccurate measurement of refraction.

These sight tests will completely overlook many serious problems and diseases that do not blur a person’s vision at all or until the disease is more advanced. Some of these include; glaucoma, Type 2 diabetes, brain tumours, cancer of the eye, high blood pressure and retinal detachements. Early detection of these conditions is important to be able to protect not only the health of the eyes and the clarity of vision, but also the patient’s overall health and maybe even their life. Having a refraction (a sight test) done without an eye health examination presents serious risk.

Only ophthalmologists and optometrists are allowed to perform refractions and issue prescriptions. The regulatory bodies of medicine and optometry will not allow their members to provide refractions without also doing a complete eye health examination. In other words, ophthalmologists and optometrists are not allowed to sight test as it is considered to be dangerous for the public.

Some opticians are currently conduction sight tests. Originally they started by faxing the computer results to a doctor who would sign a prescription and fax it back without ever having examined the patients’ eyes. The College of Physicians and Surgeons of British Columbia stopped that practice with the following declaration;

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  In signing a prescription based on a refraction, a physician is practicing medicine and acknowledging a physician-patient relationship with all of the ethical and legal encumbrances of that.
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  Ocular health can only be certified by a complete ocular examination.
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  The signing of a prescription for visual correction, based on autorefraction, without taking a history from the patient and without conducting an ocular examination of that patient to ensure that no concurrent ocular pathology exists, is unacceptable medical practice.

On March 30, 2004 the BC government issued a media release announcing its plan to allow opticians to perform sight testing without the supervision of an optometrist or an ophthalmologist. The government phrased the release as “More Choices for Eye Health Care”.

If this regulation proposed by Minister Colin Hansen is allowed, then BC will have the lowest standard of eye care in North America. No other jurisdiction in North American allows sight testing by anyone, ophthalmologist, optometrist or optician as it is considered not safe.

The Board of Examiners in Optometry, the BC Association of Optometrists, the College of Physician and Surgeon and the BC Medical Association have all criticized the proposed sight testing regulation as being a serious health risk. So far the government has been unwilling to listen to the advice of the medical community.

If you would like to help fight the proposed sight testing legislation, please call or write to your MLA to voice your opinion. All calls and letters from constituents are tallied and it does make a difference.