My Journey as an Optometrist

When I first graduated with my Optometry degree, there was a wave of optimism in my mind that I would be helping a lot of people with their eyes. However, this was stunted to a certain extent when I started working in UK with an optical chain outlet. It dawned on me that working as an Optometrist in a commercial setting is way different to working in a hospital setting. While you still more or less provide most of the optometric services that you have learnt in University, you are also obligated to work on the economics of the field and consider monetary needs of your employer. As a result, some sort of clinical cannibalism had to be done. An eye test that would normally take 30 - 40 minutes to complete had to be done in less then 15 minutes. I then learnt that I need to be more cohesive in my routine and be more picky on the routine that I should do and not do for the benefit of my patients and even if I do pick up an abnormality, I won't have the luxury of further diagnosis but to refer the patient on to the Hospital for further investigation. Working in the hospital however was absolutely more satisfying for the Optometrist in me, since you are exposed to more clinical practices (albeit at lower remuneration). I was thankful for that short stint that I had at the hospital as I managed to sample the experience of working in both a commercial and clinical setting in the UK.

With high hopes, I returned to Malaysia to start my private practice in Optometry. My first few month totally shattered me. I knew that by returning to Malaysia, I would have to take things slow as setting up a full optometric service opticians would cost a lot of money and would have to be done in phases. However, what I could not take was the total lacking of public awareness of what an Optometrist does. The general public had no idea what an Optometrist was and what we could offer to them as compared to the grandfather optician or qualified opticians in the field. Most treat an optical outlet like buying a pair of shoes, they only come in expecting a pair of glasses and nothing else. Even the big chains do not offer much primary eye care services but are totally retail orientated (even till now). Some of my patient didn't even know that there is a need to take up a degree course to become an Optometrist. While some even thought that you do not need a qualification to test eyes.

For the first few years of practice I had been scolded many times by my patients when I informed them of probable eye disease that they may have. The reaction that was given to me was always the same that is I am not a doctor and have no right telling them they have any eye condition and that they only wanted me to provide them with a pair of glasses and nothing else. Of course on every case I bit the bullet and insisted that further examination should be done before any glasses could be dispensed. Most times I would be reprimanded severely and with the patient walking out of my practice in fume.

8 years on, I persevered, adding more diagnostic equipment along the way. I would say that I am a machine or two away from my ideal optometric setting. Of course, the perception of the general public towards Optometrist are starting to catch up as well. One of the major challenges that I constantly face is a psychological war that I have with myself, one part of me tells me it is economically not sound to invest in diagnostic machinery that you could hardly charge since the public are still much ignorant about what we can do and of course the only way to convince them would be to give them full service at nominal or no charge, the optometrist side of me tells me to push for it since its what an  optometrist should do. Of course the optometrist side of me wins at most times but of course the economics side of me dictates the pace of upgrading.

Did I regret coming back to Malaysia to practice? No, because I believe that what i do here means more to the patients that I see now (even if they may not realise it) then back in UK in which the patients already expect such services in the first place.

Although full Optometric facilities in a private practice setting is hardly to be seen in abundance in Malaysia, I am hopeful that one day it would be THE norm.

I for one is almost getting there....

Carl Zeiss PhotoFusion : The new self-tinting lens by Zeiss

Carl Zeiss will be launching the new self-tinting lens dubbed PhotoFusion soon in Malaysia.

It is claimed that the lens react 20% faster and fade up to 2x faster then current photochromic lenses currently under its belt.

According to documentation, PhotoFusion lenses are very clear (92%), while outside in the sunshine the lenses turn very dark (11%).

Here's a video on the product by Carl Zeiss



PhotoFusion is available in all Carl Zeiss Single Vision and also Progressive lens range.

Although not launched yet, it is currently being sold at all Carl Zeiss Specialist outlet throughout Malaysia.

Check them out now~!

Pasar Malam Contact Lenses : Geo Lens and the likes of it

Recently I am sure many of you have observed the sudden mushrooming of colour and big eye contact lens stalls as we have our nightly stroll along our local pasar malam spots. You will see brands ranging from Geo lens, kinky eyes and much more fancy names associated with it.

This products are mainly bought by secondary school kids that for reason only known to puberty, grab them at the cheap. From my last visit, they are sold at a meager price of RM15 a pair. A big bottle of contact lens solution is more expensive then that!

Then there was this situation I bumped into while I was doing some shopping at Watson's. There is this group of about half a dozen secondary school girls, all clad in skimpy and tight fitting jeans or miniskirts browsing the contact lens solution area. Out of the group, I heard this girl teaching her friend on what product to buy and what not. To my amazement she told them to buy saline to wash their contact lens and not the standard multi purpose solution! The tone of her authority towards those kids could only be described as pure mistress like. I was telling myself, this is really a time bomb waiting to happen. On the way home, I regretted not voicing out towards the young kids on their misgivings.

This is but a small example of a malignant problem in society. Deep inside, I do not feel that authorities will do anything on the illegal sales of contact lens by non professionals in our country so I won't even try to shout about it. Probably the only thing that would turn this around would be a couple dozen of poor kids blinded by such contact lens sales and with the media blazing the news in force.

To those that understand Cantonese, I will leave this YouTube link regarding problems arising from cheap colored contact lens sales in hong kong for you to ponder upon.




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Anual Practicing Certificate for Optometrist and Optician

Have you had the insecurity when you go into an optical outlet and wonder if the person that is serving you could not be a professional that he claims to be?

This is a common feeling nowadays by many patients of mine especially contact lens wearer that has been spooked with various negative press regarding the complications that may arise from improper contact lens care. Many of them would ask me if there is any way to identify if the person that is looking after you at the optical outlet is really licensed to do refraction on you.

If you are unsure of the difference between Optometrist and Optician, read here

Generally, there is 2 ways that you can identify if the outlet has a licensed practitioner either for eye refraction for glasses or for the dispense of contact lens or both.

Here i will be explaining on one of the ways (you need both to be absolutely sure).

The first method is via the Annual Practicing Certificate (APC) for Optometrist and Optician.

This is a certificate given out by the Malaysian Optic Council to all licensed practitioner and need to be renewed yearly. According to the Optical Act 1991, every practicing Optometrist and Optician needs to be registered with the Malaysian Optic Council to practice legally in Malaysia. This certificate needs to be displayed prominently at the practicing outlet as proof to the general public of the availability of a licensed practitioner in the outlet.

APC comes in two colour certification (blue colour APC for Optician and green colour APC for Optometrist). In the APC you will find the name of the practitioner along with his/her Mykad number, the date in which the certification is given and its expiration and the name and address of the premise in which he/she is practicing.

APC for Optometrist


APC for Optician (Juruoptik)

What can you as a consumer do if you do not see an APC in an Optical outlet?

You should ask for the APC to be shown to you, if they are not able to do so, then the outlet may be operating illegally. Even if it is shown to you, you must make sure that the person stated on the certification actually works in the outlet.

What if I suspect that the outlet is operating illegally? What is my right as a consumer?
The best way to handle this issue would be to lodge a complaint to the Tribunal of Consumer.


Next part i will talk about the Photo Name Certificate (PNC).

I stumbled upon an article recently while I was doing some research on Information Leaflets that I plan to do for work. Its an article by newsportal myMetro on Optometrist and Optician.

Although its in Bahasa Malaysia, its one of the few articles that one can find regarding this field.

Boleh jadi buta

Khamis, 10 Februari 2011

PETALING JAYA: Tindakan orang ramai yang terburu-buru membuat cermin mata di kedai tanpa merujuk kepada ahli optometri apabila penglihatan semakin kabur boleh memberi kesan buruk kepada mata termasuk berisiko menjadi buta.

Ini kerana jarak penglihatan yang semakin kurang jelas bukan sekadar disebabkan rabun, malah ia boleh berlaku disebabkan tanda awal penyakit seperti diabetes, tekanan darah tinggi, glukoma (masalah saraf optik mata) dan katarak.

Memburukkan keadaan, sebahagian juruoptik di kedai cermin mata tidak mempunyai tauliah pendidikan dalam bidang optometri tetapi sekadar mendapatkan sijil dikenali sebagai Fellow of the Association of Dispensing Opticians (Fado) dari luar negara dengan bayaran tertentu.

Dekan Fakulti Optometri Kolej Universiti Teknologi Antarabangsa Twintech (Twintech), Dr Nasuha Saabin berkata, jika mengikut etika, sijil Fado hanya melayakkan mereka memotong gelas membuat cermin mata saja bukan menjalankan pemeriksaan mata menggunakan sebarang peralatan termasuk menentukan tahap kekuatan kanta cermin mata.

“Jika mata sihat dan hanya mengalami masalah rabun tidak mengapa, namun jika penglihatan itu kabur disebabkan penyakit yang masih di peringkat awal maka ia membawa kesan buruk dalam jangka panjang.

“Disebabkan penglihatan tidak jelas pesakit hanya pergi membuat cermin mata manakala juru optik yang bertugas hanya menyiapkan cermin mata kerana mereka tidak tahu langkah yang perlu diambil untuk pemeriksaan kesihatan mata,” katanya. Dr Nasuha berkata, pesakit biasanya hanya menyedari penglihatannya terjejas akibat penyakit apabila keadaan semakin parah.

“Saya tidak tahu bagaimana proses sebenar mendapatkan Fado, mungkin mereka membayar untuk menjalani latihan, tetapi ia lebih kepada membuat cermin mata bukan menjalankan pemeriksaan penuh terhadap kesihatan mata yang berkait rapat dengan keadaan tubuh badan,” katanya ketika ditemui Harian Metro, baru-baru ini.

Beliau berkata, sudah sampai masanya kerajaan meneliti semula Akta Optik 1991 yang membenarkan juru optik yang tidak mempunyai latar belakang bidang optometri memberikan preskripsi cermin mata atau kanta sentuh.

“Perkara ini sudah lama berlarutan, sepatutnya pesakit mata perlu bertemu ahli optometri terlebih dulu, pakar optik itu kemudiannya akan mencadangkan kepada pesakit sama ada merujuk kepada pakar oftamologi yang terbabit dengan pembedahan mata atau sekadar perlu membuat cermin mata berdasarkan keputusan pemeriksaan yang dijalankan.

“Bagaimanapun perkara ini tidak berlaku, bukan saja di Malaysia tetapi banyak negara lain. Apabila penglihatan kian kabur kebiasaannya mereka terus membuat cermin mata sedangkan banyak sebab menjadi punca masalah itu,” katanya. Menurutnya, hanya terdapat 700 optometri di Malaysia berdasarkan kadar penduduk, negara memerlukan sekurang-kurang 3,000 optometri.

“Peluang kerjaya dalam bidang ini amat meluas tetapi disebabkan faktor tertentu tidak ramai anggota masyarakat yang mahu merujuk kepada mereka terlebih dulu jika menghadapi masalah penglihatan terutama rabun,” katanya.

Source : http://praya.hmetro.com.my/myMetro/articles/Bolehjadibuta/Article/index_html

Malaysia Today : Optometry Now

I have been asked many question about the eyecare industry and how it would shape up in Malaysia in the next 5-10 years.

Most common question by most aspiring eye care professionals would be :-

Should I study to become an Optometrist or an Optician??


If you are unsure what is an Optometrist compared to an Optician, read here

My answer would be take your Optometry course now and forget about the latter.


My reason is based mainly on a 3 factors :-

1) There is currently 6 (if i am still correct) Universities offering Optometry course in Malaysia. That means in the next 2-4 years, we would be churning out 200-300 optometrist per year. In the next 5-10 years numbers of Optometrist may well be at par with number of registered Opticians if not more.

2) As you know, the government are now discouraging the public to take up medicine that have been experiencing a glut in recent years. At the moment, the ratio of Houseman to Tutors are way off the charts resulting in the fear that the profession is suffering from a deterioration in quality. This will inevitably cause prospective student to look at other health related fields in Malaysia and Optometry is definitely up there. This may result in more universities offering Optometry courses and resulting in more Optometrist in the general market.

3) There is now a better awareness among the public between what is an Optometrist as compared with an Optician. This awareness will only increase as the years go by.

This 3 factors alone will propel Optometrist as the main eye care practitioner in the Optical Industry.

This in 7-10 years would result in the government to amend the Optical Act to make it compulsory for every optical outlet to have a registered Optometrist (like in Pharmacist to a Pharmacy). Many people are skeptic when i tell them this but i really beg to differ.

Furthermore, even before the act is amended, public awareness on the role of Optometrist as compared to an Optician is already on the rise. Not too long from now, i am sure most consumer may even insist that they have their eyes refracted by an Optometrist rather then an Optician.

This will also see the government tighten the already existing legislature on contact lens sales. At the moment all optical outlet are selling contact lens but the Optical Act states that only Optician with Pink Form and Registered Optometrist can dispense them to the general public. This may constitute to less then 50% (25% is my gut feeling if you include rural areas) of the optical outlets out there. An alarming figure indeed. As more Optometrist come out in the open market, pressure will be on the relevant department to enforce the already existing legislature.

For Opticians that have already been practicing in this industry, there will be challenging days ahead with the slowly but surely revolution of the industry. They will eventually have to work with Optometrist to ensure there is a more comprehensive approach in eye health care (if not also for their own livelihood). In UK, Optometrist are normally confined to their sight test room and sales are done by Opticians. This may be a good way forward.

One thing for sure, the change is coming and it is for the betterment of not just the industry which at the moment are degraded into somewhat a "pasar malam" culture but also to the consumer at large.

Focus Point admits mistake, offers IPO exit option

Finally, an official announcement from Focus Point (From Business Times).
So that means even after this fiasco, Focus point will only equipt 30 of its outlet with professionals that can dispense contact lens legally.

Makes you wonder about the other optical chains in Malaysia.

The below abstract can be found here



Focus Point admits mistake, offers IPO exit option


Focus Point Holdings Bhd has admitted that 38 of its stores have broken the law on contact lens prescription and it has offered investors the chance to get their money back.

The country's largest professional eyecare chain said 38 outlets were found to have dispensed contact lenses without the presence of a qualified optometrist or optician.

Although over-the-counter sales of disposable contact lenses is a common industry practice, this is against the Optical Act 1991. Focus Point said it has ceased doing so from yesterday, it said in a statement to Bursa Malaysia.

The group had to postpone its listing on the stock market at the eleventh hour on July 27 following an anonymous allegation about its business. One of the complaints is that there were instances when contact lenses were prescribed by unqualified staff.

"Prior to this cessation, as at December 31 last year, 38 of the group's 64 eye care centres were found to have been dispensing contact lenses over the counter without a qualified optometrist or optician," the company said.

There were instances where certain outlets dispensed contact lenses without the physical presence of these qualified personnel.

Focus Point said its remaining outlets were serviced by 13 optometrists and three opticians qualified to prescribe and dispense contact lenses. It currently has 144 outlets nationwide.

President and chief executive officer Datuk Liaw Choong Liang in a press statement issued later in the evening said the company has given its full cooperation to the regulators.

Focus Point said it has extended an exit option to investors who have subscribed for its shares under the public issue.

"Investors can exit, should they, for any reason wish to do so," the company said. Its new listing date is on August 23 2010.

Focus Point plans to have either an optometrist or optician qualified to prescribe and dispense contact lenses at each of its top 30 professional eye care centres

Contact Lens : Are optical outlet selling them legally in Malaysia?

I am encouraged to write this new post by a few of my friends as they have been reading about the Focus Point incident lately in the papers. (latest update can be read here)

The main question that was thrown to me was :

When I buy contact lenses in an optical outlet, how do I know the person selling me the contact lenses are legally allowed to do so (as in only registered pharmacist can dispense prescribed medication)?

Answer : I will explain the answer in 2 parts.

Firstly, in Malaysia, only 2 group of people are allowed to prescribe and dispense contact lenses to the public

1) Optometrist - This group of people holds a degree in Optometry and are fully equipped with expertise to examine your eye for any eye defects as well as dispense contact lens to you

2) Qualified Optician with "Pink Form" - This group of people holds a "Fellow of British Dispensing Optician" after finishing a year and a half course at Axismatic College after their SPM. On top of that they will also need to take a contact lens qualification exam certified by the Ministry of Health. Once qualified, they are given a pink form stating that they are qualified to dispense contact lenses. This "pink form" must be displayed prominently at the optical outlet.


So, how do we identify this 2 group of people when we enter an optical outlet?

The answer lies on the certification that is given out by the Malaysian Optic Council (MOC) that is the regulatory body of the optical industry.

Optometrist is certified with a green coloured form stating his name and qualification

Optician / Juru Optik is certified with a blue coloured form stating his name and qualification and IF he is qualified to dispence contact lenses, he will have another pink coloured certification stating that he is qualified to dispense contact lenses.

The regulatory body in Malaysia (MOC) has also in the past few years issued photo certification to be prominently displayed in optical outlet. This yellow coloured certification contains the photo of the Optometrist / Optician (Juru Optik) that is working in the outlet as well as his name and also what services that can be provided. Optometrist and Optician (Juru Optik) with pink form will have 2 sections, the first stating that he is allowed to prescribed and dispense opthalmic lenses (prescription spectacle) and 2nd section stating that he/she are allowed to prescribe and dispense contact lenses. If an Optician (Juru Optik) do not have a pink form, his photo certificate will only have one column stating he can prescribe and dispense ophthalmic lenses and frames ONLY.

To summarize, ALL Optometrist can dispense contact lenses BUT only Optician with a pink form are allowed to dispense contact lenses.

And how do we confirm that the person is either of the above?

Ask or look for the photo certification or at the least see if the outlet contain a green or a pink cert with the name of the person that is serving you.


Hope this clears the air.

If you want to know more about Optometrist and Optician, you can read my previous blog here

Optical Illusion

Stare at the 4 vertical blue dots of this picture for 30 seconds.

After that look at a clear bright wall or just close your eyes.

Tell me what happened :)

Cataract Surgery

I am in the midst of preparing a powerpower point presentation for "The Right To Sight" community project. One of the issues that I would be talking about is the prevalence of cataracts being one of the major contributor towards blindness among poor communities. It only takes a simple 10 minute surgical procedure in order to restore their sight.

Many people have asked me about cataract surgery so I have included a clip in my presentation.

I am also including it here as I am sure many people are curious what cataract surgery looks like and truly how simple the whole procedure is.

Warning: If you squirm looking at a bit of blood and faint at the sight of surgical procedures, do not proceed any further. You have been warned.

Optician and Optometrist are not the same

A lot need to be done to tell the public the difference between an optician and an optometrist. But when even the well informed media are not aware of it, then it does show a bad light for the profession as a whole. That alone sometimes justify the reason why most overseas graduated Optometrist resist the idea of coming back home to practice their trade.

Here's an article from the Star regarding pertaining to the subject matter.


Monday April 28, 2008

Opticians and optometrists are not the same

PETALING JAYA: Not many are aware about the difference between optician and optometrist, said the Association of Malaysian Optometrists.

Its president Dr Chung Kah Meng said the term “optometry” was widely used, and this has caused many people to be confused between the job scope of opticians and optometrists.

As such, he proposed that the term “optometry” should be protected under the Optical Act 1991, just like the term “optometrist”.

He said that to become an optometrist one needed to obtain a four-year degree while an optician only goes through a two-year course to get a diploma.

Dr Chung said an optometrist was qualified to examine eyes for defects or faults of refraction, and conduct tests such as measurement of visual acuity and refraction, visual field screening, and measuring intra-ocular pressure.

“We are automatically qualified to prescribe and dispense contact lenses too, while opticians have to sit for an exam conducted by the Malaysian Optical Council (MOC) before they can become contact lens practitioners,” he said.

He said a media report that said optometrists had failed the MOC exam was not accurate as only opticians had to sit for the exam.

Dr Chung said that in Britain opticians were not allowed to conduct eye tests and their role was to dispense spectacles as prescribed by the optometrists.

“But in Malaysia, there are not enough optometrists when the Optical Act 1991 was formulated, so opticians were allowed to conduct eye tests,” he said.

Update : Had a chat with a fellow optometrist and was told that all the Optician that took the MOC (Malaysian Optic Council) Contact Lens examination failed their practicals this year (and this is the first time they ever conducted such exams).

Whats an Optometrist

When I am asked about my profession, 90% of the time people have no idea what an Optometrist is. So I have decided to explain to everyone here the various eye care professions that is currently out there in the industry.

I totally plagiarised one of my old PowerPoint slides from a previous talk I did a few month back. So this is going to be dry... very dry.......

WHAT IS AN OPTOMETRIST?

Previously known as ophthalmic opticians, Optometrist are trained professionals who examine eyes, detect eye disease and problems, test sight, give advice on visual problems, and prescribe and dispense spectacles or contact lenses. They also recommend other treatments or visual aids where appropriate. Optometrist is trained to recognise eye diseases and referring such cases as necessary.

Optometrist study at university for at least three years. Once qualified, they have the opportunity to develop their interest in specialist aspects of practice such as contact lenses, eye treatment, low vision, children's vision and sport vision.

All Optometrist practicing in Malaysia must be registered with the Malaysian Optical Council, the profession's regulatory body, and listed in the Optometrist Register (Second Schedule). When choosing an optometrist, look out for the letters BSc or BSC(Hons) Optometry after his or her name. It means the optometrist is a fully qualified professional.

OTHER EYE PROFESSIONALS

DISPENSING OPTICIANS (OPTICIANS)
Dispensing opticians advise on, fit and supply spectacle frame and lenses after taking account of each client lifestyle and vocational needs. In Malaysia they are allowed to test the eyes for the purpose of dispensing prescription glasses.

In Malaysia, most Dispensing Optician study at Axismatic Professional Institute after finishing their SPM. The course last for a year and a half in which they will obtain the Fellow of British Dispensing Optician (FBDO) on completion. They are however, not allowed to prescribe or dispense contact lenses unless they further their studies and obtain recognition by the Malaysian Optical Council to prescribe contact lenses. They are not trained to detect eye disease.

All Dispensing Opticians practicing in Malaysia must be registered with the Malaysian Optical Council, the profession's regulatory body, and listed in the Opticians Register (First Schedule).

OPHTHALMOLOGIST
Ophthalmologist specialize in eye disease, treatment and surgery. Medically qualified, they mainly work in eye hospitals, private practice and hospital eye departments.

ORTHOPTISTS
Orthoptists generally work with ophthalmologist in hospitals and in the community. They are concerned with eye problems relating to eye movements and the inability of the eyes to work together. Examples of this problems are squint (strabismus), lazy eyes (amblyopia) and double vision (diplopia).

Hope i didn't bore you to death!