Optometry/Ophthalmology: the Future

• 1 The most serious problem for the future of optometry and ophthalmology is surplus manpower. It is imperative that the two groups immediately join in future eye-manpower studies before we face an insoluble problem.
• 2 It is important that moderate leadership of optometry and ophthalmology put more time and effort into reducing the conflict between our two professions. The present actions by optometry and ophthalmology in legislative hearings are producing nothing but harm and a lack of credibility for optometry and ophthalmology. In general we are looked upon as ‘money grabbers’.
• 3 It is important that greater efforts be made in the area of joint education between optometry and ophthalmology in order to obtain not only better patient care but also to develop a better understanding of our roles in the eye-healthcare field. To obtain this, ophthalmology should provide leadership in developing programmes for optometrists. However, it is equally important that optometry ask ophthalmology to assist in formulating joint programmes.
• 4 It is important that we expand MD-OD or OD-MD committees that meet on a regular basis in order to discuss inter professional problems and to present a joint front in areas of common interests where unified action will be of benefit to the public, optometrists and ophthalmologists.
• 5 It is desirable to form more group practices of optometrists and ophthalmologists in order to provide better services at lower costs. The increasing costs of instruments, salaries, rent, etc., are making solo practice in metropolitan areas too expensive to provide services at a reasonable cost.
• 6 If optometry and ophthalmology fail to form closer relationships, the future is not good for either group, because the third party who pays the bills and the public will take advantage of our inability to respond rapidly to social problems and health-care costs.
• 7 It is important that optometry and ophthalmology review their individual attempts to obtain consumer attention, because the present actions result in consumer confusion. Despite both optometry's and ophthalmology's efforts to ‘educate the public’, a majority of consumers think of eye doctors and not the difference between the skills and practices of optometrists and ophthalmologists. Many consumers interpret these educational efforts of the public by both optometry and ophthalmology as serving the self-interest of each group and increasing eye-health-care costs.

(The Carel C. Koch Award Lecture, 1977 reprinted by kind permission of the American Journal of Optometry and Physiological Optics 55, 1 .)     

Optometry research. Part 1: Funding sources.

Part 1 of this report presents an overview of U.S. ophthalmic research in general and of optometry research in particular and identifies the National Eye Institute (NEI) as the dominant funder of both types of research. Part 2 examines how NEI funding has been distributed among the U.S. schools and colleges of optometry in the past, whereas Part 3 examines the production of published research from the schools and colleges and the Department of Veterans Affairs Optometry Service. Information is presented to indicate that the schools of optometry account for about 3% of all NEI funding and produce about 3% of all published ophthalmic research. Published optometry research results mainly from the activities of four schools and the VA Optometry Service, which has rapidly become the leading source of articles published in The Journal of the American Optometric Association and presenter of continuing education at the Academy's annual Ellerbrock Lectures. This study suggests optometry needs to husband its relatively small research base and, in the author's opinion, concentrate on the support of clinical trials and research directly relevant to primary eye care rather than basic biologic or physiologic research.     

Artificial intelligence-aided diagnosis and treatment in the field of optometry

With the rapid development of computer technology, the application of artificial intelligence (AI) to ophthalmology has gained prominence in modern medicine. As modern optometry is closely related to ophthalmology, AI research on optometry has also increased. This review summarizes current AI research and technologies used for diagnosis in optometry, related to myopia, strabismus, amblyopia, optical glasses, contact lenses, and other aspects. The aim is to identify mature AI models that are suitable for research on optometry and potential algorithms that may be used in future clinical practice.     

充分应用视光学知识,努力提高我国人民的视觉质量

随着现代眼科学及视光学的迅速发展,人们对视觉质量提出了更高的要求。视光学知识和研究成果在眼科各领域的应用势必对提高人们的视觉质量产生影响,这也是我国广大眼科工作者今后主要的工作方向之一。本文从眼底病、白内障、眼表疾病及青光眼4个方面探讨视光学和眼科学的结合点,旨在为眼科工作者今后的研究方向提供依据。     

Health law in 1985--implications for the optometric profession.

In conclusion, I believe that you should seek to expand the scope of optometry into areas now regarded as exclusively medical practice, and devote less time and effort to protecting your rear from the encroachment of the opticians. I suggest this because it follows a seemingly natural process of expanding upward that one finds in other professions and occupations in the health field. Second, I have suggested that, to achieve an expanded scope of optometry, there may have to be some sacrifice of the concept of the independent, entrepreneurial practitioner in optometry. Even the medical profession is recognizing that the individual entrepreneurial physician is becoming less of a factor than he was before, and the future is not particularly bright for him further down the road. Third, to the extent you can influence the forum where the struggle over the expanded practice of optometry takes place, you may increase the likelihood that the expanded role will be recognized by law sooner. I have already alluded to the idea that costs of health services and funding mechanisms are intimately tied to the law related to optometric practice in the future. As you know from the legislative struggles in many states over inclusion of optometric services within state Medicaid programs, and freedom of choice legislation that required an insurer to pay any legally recognized practitioner who could provide the service, rather than physicians exclusively, the optometric profession is well aware how closely the success of a profession is linked to access to third party payment.(ABSTRACT TRUNCATED AT 250 WORDS)     

OPTOMETRIC PROGRESS AND COMMUNITY RESPONSIBILITY

Since the first opticians acquired registration and specific educational qualifications there have been many changes in the field of eye care. It could be said that the techniques of refraction have not changed greatly or that the shop fronts and some newspaper advertising differ little from years ago. However, there are several aspects of optometry which have progressed significantly. In the field of education, there are minimium standards which have been set down and achieved. In research, international publications have resulted in recognition in several areas such as colour vision, human factors and lighting engineering, and ocular physiology and pathology in addition to the more obviously optometric areas like contact lenses, optics and strabismus. In all these areas the optometrist is uniquely qualified. However, what of the other facets of optometry? Have we as a clinical profession kept abreast with scientific advances which can benefit our patients and the public in general? There are numerous new instruments and techniques, but is our moral and social conscience sufficiently developed to ensure that all or even the majority of optometrists are making use of such advances? There must be a minimum comprehension gap between the practising optometrist and the academics and researchers in the fields of visual science and optometry. We must be equipped to cope with computer lens design, with electronic instrumentation, drug use, new diagnostic techniques and the numerous technical innovations of our age. Without this type of progress can we give the best possible service and should we call ourselves a profession? My intention today is to look at some of the aspects of the profession of optometry and to see which of these have shown progress and which have shown regression. of even greater importance is the problem of how can progress in the future be assisted.     

The History of Optometric Research in Australia The Newham Waterworth Memorial Lecture Jubilee ANZAAS Congress,Adelaide, May 12–19, 1980

ABSTRACT This paper presents an overview of research by optometrists in private practice, in schools of optometry and in research units or institutions. It briefly considers the position of the Australian Journal of Optometry, the influence of research training on political thinking, and the further support the profession might afford to optometric research.     

EUROPEAN OPTOMETRY: SOCIOLOGICAL ANALYSIS OF THE OPTICAL PROFESSION IN CONTINENTAL EUROPE*

We drew Australian optometrists' attention, in an editorial in the January issue of this year, to some of the problems British optometry faces with the entry of Britain into the European Economic Community. Now we publish two papers-slightly abridged-which give some insight into the problems from the viewpoint of the ‘continental optician’ who wishes to be a professional practitioner. Mr. Jean Thiriart is president of the European Optometry Society and a staunch supporter of optometry as opposed to opticianry in Europe. Both papers appeared in Photons, a European review of optometry, published in Brussels, in October and November of last year.-Editor.     

The role of research,evidence and education in optometry: a perspectivea

Eye and health care are and always will be both art and science. The science of discovery, its translation to clinical care and the education that necessarily follows for practitioners is witnessing remarkable change and increasing impact on patient care. An independent and vibrant profession commits to discovery as a basis of better patient care; optometry is no exception. Some recent discoveries in our field are breathtaking and the increasing awareness in health care, including in optometry, of the advantages of accepting the challenge of translating these discoveries to patient care is becoming more evident. Health‐care practice is increasingly evidence‐based on careful science. The implications of evidence‐based health care are surprisingly broad, with impact on clinical care guidelines, reimbursement, future scope of practice responsibilities and education both within our schools of optometry and for our practitioner.     

World optometry: the challenges of leadership for the new millennium.

The World Council of Optometry has developed a mission and organizational strategies to improve the delivery of eye and vision care around the world, as well as to advance the profession of optometry. Its growth over the past several years is a tribute to the early pioneers in international optometry who unselfishly volunteered their time and expertise to improving the profession and eye and vision care. It also underscores the continued spirit of global volunteerism that energizes the recent leaders who have sustained this growth. Over the past decades, optometry has seen the steady growth of its educational infrastructure, scope of practice, and professional image. It has faced adversity and seized opportunities. Throughout, the overarching raison d'être has been optometry's responsiveness to the public health needs of society. The future growth of optometry within the global health community will depend on expanding this professional growth at an international level, and forging durable strategic alliances that address the significant prevention of blindness imperatives of our generation.     

Citation patterns in the optometric and ophthalmologic clinical binocular vision literature.

PURPOSE: The purpose of this study is to compare citation patterns in the clinical binocular vision literature of optometry and ophthalmology. METHODS: The author conducted citation analysis of two current clinical binocular vision textbooks from optometry and two from ophthalmology and of articles published in the years 2000 to 2004 in optometry and ophthalmology journals. Topical parameters for inclusion of sources were diagnosis and management of nonstrabismic binocular vision disorders, diagnosis and management of nonpresbyopic ocular accommodation disorders, and procedures for examining such conditions. These topical parameters were chosen because they are areas in which the diagnostic procedures and treatment options available to members of the two professions are not delineated by their respective scopes of practice. RESULTS: The most frequently cited journals in the optometric publications were optometry journals (63% of citations in the optometry textbooks and 58% in the optometry journal articles). The most frequently cited journals in the ophthalmology publications were ophthalmology journals (79% of citations in the ophthalmology textbooks and 49% in the ophthalmology journal articles). Each discipline also cited a greater variety of journals from within its own field than was cited by the other discipline. The journal with the highest total number of citations was Optometry and Vision Science (280) followed by Ophthalmic and Physiological Optics (73), American Journal of Ophthalmology (68), Investigative Ophthalmology and Visual Science (62), and Optometry (61). CONCLUSIONS: Optometry and ophthalmology sources show more citations to materials from their own discipline than from their fellow discipline in the area of nonstrabismic binocular vision disorders and nonpresbyopic accommodative disorders. Reasons may include lack of awareness of the literature of the other discipline, bias toward the literature of one's own discipline, or bias against the literature of another discipline. It is also likely that the diagnostic and management strategies of the two professions are significantly different, although scope of practice would not constrain the range of strategies for the conditions chosen as the topical matter for consideration in this study. The journals found to be most frequently cited in this study should help to identify the core journals in this area of clinical binocular vision.     

DEFINING OPTOMETRY

In the light of the training and actual work performed by the Australian optometrist, the legal definition of optometry and the practice of optometry contained in the various State Registration Acts is insufficient and anachronistic. This paper compares these definitions with those given by some authorities in the United States and concludes that the American optometrist has the nature and scope of his practice more adequately covered than has his Australian counterpart.     

Should optometry evolve as a vertically integrated discipline that includes all components of ophthalmology?

Change in the optometric profession is inevitable. Persuasive economic factors will play a great role in shaping the future of optometry and ophthalmology. Optometry is in a position now and into the future to leverage its great strengths to benefit the public in a cost conscious manner.     

Military externships: recruitment friend or foe?

The purpose of the study was to determine if optometry students who completed an externship at a military facility were influenced for or against future enlistment considerations. The responses of 62 students were evaluated over a period of 3 years using an original self-completion questionnaire. The results suggest that while the majority of students left their externship with a positive attitude toward the military practice of optometry, factors such as low salaries and lagging promotional considerations influenced most to overlook the military as a practice option. The important ramifications of the study, as well as potential threats to its validity, are discussed.     

Kurrajong People and Crystal Balls*

ABSTRACT This paper reviews the legislative and educational origins of optometry in Victoria, and traces its development to the present day. The author concludes by discussing the problems and challenges facing all the health care professions in the future.     

不同年龄及不同进展程度的近视患者3种验光方法的选择时机

目的　探讨不同进展程度及不同年龄的近视患者选择小瞳验光、复方托吡卡胺散瞳后验光及阿托品散瞳后验光的时机。方法　将年龄7～18岁的304例近视患者按复诊的戴镜视力或初诊的裸眼视力分为3组:0.1～0.3组、0.4～0.6组、0.7～0.9组。所有患者根据不同年龄段（7～9岁、10～12岁、13～15岁、16～18岁）分别进行小瞳验光、复方托吡卡胺散瞳后验光及阿托品散瞳后验光,记录各组患者屈光度。结果　视力下降至0.1～0.3时,不同年龄段患者三种验光方式所得屈光度比较,差异无统计学意义（P>0.05）。结果显示各年龄段近视患者采用小瞳验光、复方托吡卡胺散瞳后验光、阿托品散瞳后验光的屈光度变化不明显。视力下降至0.4～0.6时,7～12岁近视患者复方托吡卡胺散瞳后验光、阿托品散瞳后验光都比小瞳验光所得屈光度低,而阿托品散瞳后验光所得屈光度降低更显著;13～18岁近视患者复方托吡卡胺散瞳后验光、阿托品散瞳后验光所得屈光度均低于小瞳验光所得屈光度,但其降低的差异随着年龄增长更加不明显。视力下降至0.7～0.9时,各年龄段近视患者小瞳验光、复方托吡卡胺散瞳后验光、阿托品散瞳后验光所得屈光度差异均有统计学意义（均为P＜0.05）。各年龄段近视患者小瞳验光、复方托吡卡胺散瞳后验光、阿托品散瞳后验光所得屈光度之间两两比较,差异均有统计学意义 （均为P＜0.05）。结果显示与小瞳验光所得结果相比,复方托吡卡胺散瞳后验光和阿托品散瞳后验光所得屈光度均降低,而阿托品散瞳后验光结果降低更显著。结论　视力下降至0.1～0.3的不同年龄患者可采用小瞳验光。视力下降至0.4～0.6的12岁以上近视患者可采用复方托吡卡胺散瞳后验光。视力下降至0.4～0.6的12岁以下近视患者和视力下降至0.7～0.9的各年龄段患者均需采用阿托品散瞳后验光。     

The unification of European optometry: how the profession will change after 1992.

The economic integration of the European Community (EC) targeted for 1992 has the potential to change the course of the development of the optometric profession in Europe. One of the goals of this integration is to create within Europe an environment free of professional barriers, such that European professionals will be able to practice their skill anywhere within the Community. Because optometry is practiced so differently among the 12 EC countries, the development of a system of reciprocity for optometric credentials in Europe will be a difficult task. Currently, there exists a strong movement, headed by the Association of European Schools and Colleges of Optometry (AESCO), to unify the profession by creating a European-wide examination for optometry. The implications of such an examination are tremendous in that it will establish a standard for the delivery of optometric care not only for the 320 million people within the EC, but also world-wide. The purpose of this paper is to examine the current status of optometry in Europe, to review efforts by both the EC and AESCO to unify the profession, and to discuss the impact of recent developments on the future of optometry not only in Europe, but throughout the world.     

PRACTISING OPTOMETRY IN THE UNITED KINGDOM

This paper is written for the Australian optometrist who may hope to practise optometry in the United Kingdom. It describes the statutory bodies which regulate and control the practice of optometry, the modes of general practice, orthoptic practice and contact lens fitting, and discusses in some detail the steps an Australian optometrist must take to be qualified legally to practise in the United Kingdom.     

睫状肌麻痹前后综合验光仪与常规验光比较分析

目的 对比分析睫状肌麻痹前后综合验光仪主觉验光和常规主觉插片屈光度的差异变化,探讨科学规范的验光方法.方法 选取2009年8月行屈光检查的近视患者108例,年龄17～28岁,睫状肌麻痹前后用电脑验光仪或检影镜进行客观验光,然后在此基础上进行综合验光仪主觉验光和常规主觉插片.将检测结果用统计软件SPSS11.0进行统计学分析.结果 综合验光仪主觉验光球镜和柱镜度数在睫状肌麻痹前后变化不大,差异无统计学意义(P＞0.05).而常规验光球镜度数睫状肌麻痹前后差异有统计学意义(P＜0.01).柱镜度数散瞳前后差异无统计学意义(P＞0.05).结论 对于成人屈光不正患者,规范科学的综合验光仪主觉验光无需散瞳松弛睫状肌即可获得准确的屈光不正度数,是一种简便准确可靠的验光方法.     

Optometric manpower development and utilization: a look toward the future.

This paper attempts to discuss in detail the rise in demand for optometric services and the manpower problems of the future. A proposal for the rational future development of optometric manpower has been made. Hopefully optometry will be able to consider its future development and scope of practice, and the types of changes to be made as the profession prepares for its increasing role in providing quality vision care to all Americans.