Hundreds of thousands of Kiwis who require screening for a range of vision conditions are being warned to ensure their prescription glasses are being dispensed by a registered dispensing optician.
The call comes after complaints from patients who have received incorrect glasses to manage their conditions, in some cases with the potential to endanger their health and mobility.
A lack of awareness means most patients are uninformed of the difference between a dispensing optician, who is a registered healthcare professional, and a retail ‘optical assistant’ working at an optometrist’s practice.
A registered dispensing optician, under The Health Practitioners Competence Assurance Act 2003 (HPCA Act), is trained to interpret an optometrist’s prescription and provide the patient with the correct eyeglasses or contact lenses, and advice for their condition.
Dispensing opticians are also qualified in the operation of diagnostic equipment including; digital imaging devices, colour vision tests, standardised visual perceptual tests, and the administration of certain medicines.
Kristine Hammond, professional teaching fellow at the University of Auckland, School of Optometry and Vision Science (SOVS), ODOB chair and qualified dispensing optician says many Kiwis are unaware of the role that the dispensing opticians play in eye health.
The Optometrists and Dispensing Opticians Board (ODOB) is NZ’s regulatory body for optometrists and dispensing opticians. Along with their prescribed qualification, the ODOB requires all registrants to hold an annual practising certificate and complete their bi-annual recertification requirements. This includes meeting the ODOB’s clinical, ethical conduct and cultural safety standards – including demonstrating the ability to apply the principles of Te Tiriti o Waitangi, holding a valid first aid certificate, and completing a cyclic random self-audit to review practitioners’ competence.
Hammond says currently not all staff performing the work of a dispensing optician are required to be registered with the board, which limits the protections offered to patients.
“As this is a voluntary registration, we have no control over staff ability in individual premises and we understand other terms are being used such as ‘optical assistant’ for unqualified workers who are dispensing glasses and contact lenses.
“A number of patients have called us to complain that while the initial appointment with an optometrist has gone well, at the time of dispensing they find they are unhappy with their frames or lenses. It often transpires that they have been assisted by unregistered retail staff.
“If the staff member had been ODOB registered, that could have warranted an enquiry to see whether the practitioner was in breach of our standards.
“Unfortunately, when we get a complaint in these situations, we cannot take action if the staff member is not a health practitioner registered with us. We instead have to direct these patients to the Ministry of Health’s Enforcement team, as well as the Health and Disability Commissioner (HDC).
“This leaves very limited avenues for people who are often vulnerable, and these avenues are already inundated with significantly higher risk complaints. Even though the government does have mechanisms to investigate, lay charges, issue infringement orders etc., due to capacity constraints not much is done about these complaints,” she says.
Hammond says that as part of a regular eye exam, optometrists check for a plethora of vision-related medical conditions including glaucoma, macular degeneration, cancer, and even diabetic screening.
“The role of the dispensing optician, working alongside an optometrist, is to ensure that the glasses, contact lenses and low vision aids they dispense address the vision conditions previously diagnosed or identified by the optometrist or ophthalmologist.
“It is a crucial role given that so many Kiwis live with varying degrees of eyesight, and we are operating in a digital age. While it may not be noticed daily, wearing the wrong glasses or contact lenses can have long-lasting adverse effects, for example, preventable falls or accidents and in some cases permanent vision loss, particularly in children.
“We know that a great many New Zealanders rely on glasses or contact lenses for driving. If they are having trouble reading road signs or seeing what is on the road, then they are putting themselves and others in danger.
“As well as dangers to their physical health, incorrect glasses can lead to headaches and a deterioration in eyesight over a longer period.
“For some, this may be immediate, while others may be at risk due to wearing the wrong or wrongly fitted glasses or contact lenses over the medium to short period. It is important to get the correct advice and lenses not only for a patient’s individual prescription but for their lifestyle,” she says.
Hammond says it’s important children with eye issues are identified early and points to a recent University of Auckland study which showed that one in 10 children aged between 8-9 needed glasses but didn’t have them. Any vision issues can negatively impact not only a child’s behaviour or academic achievement but also their sporting success.
“The research shows that those children with vision problems fall behind academically and believe they are not smart enough to keep up when the issue is they simply can’t see properly. These students need to be seen by an optometrist and then a qualified dispensing optician to fit them with the correct glasses or lenses,” she says.
Hammond says the relationship between a dispensing optician and a patient is not simply a commercial transaction.
“There is a therapeutic relationship as well, and these practitioners need to provide their patients with the security that comes with being registered.
“Every patient has the right to ask their optometrist for a copy of their glasses or contact lens prescriptions. This belongs to the patient who is entitled to take it to any registered dispensing optician to issue their prescription.
“A registered dispensing optician can also assist with sunglasses and tinted lenses ensuring a patient’s eyes are protected from UV and potential ocular cancers. We only get one set of eyes, so it’s important Kiwis understand how best to take care of them,” she says.