An automated refraction (sight test) is a quick, safe, and accurate way for individuals who wear glasses to check their vision before purchasing a new pair of glasses. An automated refraction, however, is not an eye health exam. While the automated technology is very accurate at measuring an individual's visual clarity and determining the power of corrective lenses, it is not intended to identify underlying eye health problems that may affect vision that are more likely to be found during an eye health exam. Therefore, individuals with underlying health problems or eye-health risk factors need to have an eye health exam, which includes having their eyes dilated to examine the retina, having visual field tests, and eye pressure tests. An Ophthalmologist or Optometrist, not an Optician, conducts an eye health exam.
AUTOMATED REFRACTION FAQS
Why do people want automated refractions?
The vast majority of Opticians' clients are individuals who are long-time wearers of eyeglasses and contact lenses. They most often seek Opticians' services because they want to update their eyewear or to replace lost or damaged glasses.
In the past, Opticians were not allowed to check their clients' visual acuity and dispense new corrective lenses, even with a slight modification; they could only repeat the previous prescription. This meant the client who wanted to be assured of their visual acuity before paying for new glasses was required to return to the Ophthalmologist or Optometrist for a test that determines visual acuity. In many cases, tests for visual acuity are only provided as part of eye health examinations. This has been an unnecessary, cumbersome and expensive process for eyeglass wearers, who in British Columbia must pay approximately $90 for an eye test whether they need the full test or not. This meant that some individuals would not bother to update their eyewear or not have their vision checked at all.
What is an automated refraction?
An automated refraction is a computerized assessment of how the eyes bend and focus light to create an image on the retina. The process has been scientifically proven a safe, reliable, and reproducible test. It uses equipment and a sophisticated computer program to test and measure visual acuity. It also calculates whether clients would see more clearly with the help of corrective lenses and determines the strength of lenses needed.
This kind of equipment and sophisticated computer program is not new and is commonly used to test and measure visual acuity before laser surgery vision correction and in Ophthalmologist or Optometrist offices. In Optometrist offices, this equipment may be run by office staff before the client meets with the Optometrist.
In Optician offices, only the Optician runs this equipment. A number of automated refracting Opticians have been trained to use the equipment and have been offering it in their stores so clients can ensure the power of their lenses are exactly what they need before agreeing on a new pair of glasses.
What is the status of sight testing in British Columbia?
Opticians have been doing automated refractions since 1996, initially with the oversight of an ophthalmologist. However, Ophthalmologists decided they did not want to sign off on sight tests without personally examining the patient. The BC Supreme Court ruled in 2001 that Opticians had a right to provide automated refraction services. However, an amendment to the Opticians Regulations that governs Opticians was required to set the rules and regulations that apply to Opticians providing this service.
In March 2004, the provincial government announced its intention to amend the Opticians Regulations to enable Opticians to conduct automated refractions without the oversight of a medical doctor and to establish strict guidelines for eligibility that enable Opticians to give the tests to healthy, consenting adults, between the age of 19 and 65 with no risk factors or underlying health problems. The amendment would also allow Opticians, following a duly conducted automated refraction, to make modifications to the lens power, under specific criteria.
On May 1, 2010, the Minister of Health, the Honourable Kevin Falcon, signed into force the new Opticians Regulation. The amendments allow independent sight-testing by Opticians and implement a new shared scope of practice/restricted activities regulatory model for opticianry.
Who is not eligible for an automated refraction?
Under the existing College guidelines, potential clients with the following conditions are screened out and ineligible for automated refractions:
- Are under 19 or over the age of 65, since the leading causes of visual impairment are age related
- Have specific illnesses or health conditions, such as diabetes, macular degeneration, cataracts and cardiovascular disease, unless already under a doctor's supervision for their condition
- Have high risk health conditions for retinal detachment such as hypertension, recent trauma to the head, recent pain in the eye, or people with lens prescriptions of greater than + 8.00 diopters or - 10.00 diopters.
- Have specific visual symptoms such as recent onset of floaters, haloes, distortion, double vision, flashing lights etc.
- Have a history of any eye surgery.
In addition, clients who have undertaken an automated refraction will be referred to an Ophthalmologist or Optometrist for an eye health examination if they cannot achieve 20/30 or better vision or if their vision shows a change of more than plus or minus 1 diopter in a six month period or a total change of more than 2 diopters from the original prescription.
This screening criteria, which is currently followed by Opticians, along with the College Standard of Practice and a focus on effective training and communication with Opticians will ensure that automated refractions are conducted in BC in a safe and effective manner that benefits all BC healthcare consumers.
FREQUENCY OF EYE EXAMS
The Canadian Ophthalmological Society (Canadian Journal Ophthalmology, Vol. 42, No. 1, 2007) recommends the following frequencies for eye examinations:
- Children - below age 5
- At least one complete eye exam
- Asymptomatic (no symptoms) low-risk patients
- Aged 19-40 - At least every 10 years
- Aged 41-55 - At least every 5 years
- Aged 56-65 - At least every 3 years
- Aged 66 and over - At least every 2 years
- Symptomatic (with symptoms) patients
- All ages - any changes should be assessed by an Ophthalmologist or an Optometrist as soon as possible
- High-risk (family history, diabetes, previous visual problems) patients
- Aged 40 and over - At least every 3 years
- Aged 50 and over - At least every 2 years
- Aged 60 and over - At least once a year
Where do I go for more information about automated refractions?
The following links can provide you more in depth information about automated refractions:
To find an automated refracting Optician near you, click here.