Abisha S., B. Optom, Aravind Fellowship in Clinical Optometry

Consultant Optometrist, Turakhiya Optics, Chennai, India

 

Introduction:

Being an Optometrist, it involves more than just giving a prescription and dispensing eyeglasses. This marks the beginning of a crucial process for both the dispenser and the customer. In this article, we will explore the significance of working in an optical store and how this experience contributes to an optometrist’s career.

Standardised Eye Testing in Optical Stores:

Globally, optical stores are often the first choice for eye examinations due to their accessibility. They serve as primary locations for detecting various eye conditions and diseases, making them essential for providing prescription glasses conveniently.

Evolution in Optometry:

The field of optometry is constantly evolving. Recent advancements such as tele optometry, myopia control, ocular imaging, contact lens innovation, vision therapy, low vision, and geriatric eye care reflect the ongoing changes that optometrists need to stay informed to provide the best care. (1)

Greetings and History Taking:

Building rapport and maintaining friendly but professional relationship and thorough history taking are critical in both hospitals and optical stores. Gathering information about previous glasses, eye surgeries, medical and family history is essential for comprehensive eye care.

Direct Ophthalmoscopy/Slit Lamp:

The use of a direct ophthalmoscopy or slit lamp for anterior segment examination is crucial for diagnosing common eye diseases. Optometrists must be adept at these examinations to identify and address potential issues.

Visual Acuity Testing:

Refraction, being both an art and a science, includes essential methods such as retinoscopy, duo-chrome, Jackson cross-cylinder, and binocular balancing. These cardinal rules ensure precise vision correction for patients. (2)

Common Complaints about Spectacles:

Troubleshooting common complaints like blurred vision, headaches, and ill-fitting frames is integral. Patient feedback helps in refining prescriptions and dealing with it appropriately and swiftly ensures better customer satisfaction. (3,4)

Statistical Analysis of Spectacle Non-Tolerance:

The statistical analysis of spectacle non-tolerance is 2.1% (95% CI: 1.6–2.7), with a range from 1.6% to 3.0%. Within this, 47.4% attributes to errors in refraction, 16.3% to errors related to communication, 13.5% to dispensing and lens design errors, 9.7% to fitting errors and non-adaptation, 8.7% to data entry errors, 7.4% to wrong frame selection, and 6.4% to errors in progressive markings.(5)

Ophthalmic Lenses and Frame Selection:

Optometrists should acquire knowledge about specific lens designs, myopia control for children, digital technology lenses, and various types of eyewear. Frame fitting is equally important, considering factors like refractive error, comfort, and cosmetic appeal. (6)

Table 1: Scenarios while Troubleshooting Progressive Lenses

Symptom Solution
Patient has narrow reading area. – Verify fitting height and PD measurements
– Verify ADD power
– Add pantoscopic tilt and decrease vertex distance
Peripheral vision blurs and moves. Adjust frames to decrease vertex distance and to increase facial wrap
Patient lifts head or glasses to read. Lenses are fit too low:

– Adjust frames to sit higher on patient’s face
– Adjust nose pads closer together
– Decrease pantoscopic tilt
– If necessary, refit lenses

Patient moves reading material off to side for better focus. PD is off or lenses are mounted incorrectly:

– Use lens cling to verify lenses are on iris
– Verify monocular PD measurements
– Have lenses remade with correct PD measurements

Distance vision is slightly blurry. – Increase pantoscopic tilt
– Decrease fitting height

Conclusion:

Independent practitioners in optometry require a minimum of one year of optical and retail experience, along with two years of clinical experience. Proficiency in selecting lens materials, frames, progressive marking, and designs is vital for a successful practice. (7) The experience gained in optical stores is invaluable for optometrists, shaping their ability to provide comprehensive and effective eye care.

 

References

  1. Robinson, B. E., Mairs, K., Glenny, C., & Stolee, P. (2012). An evidence-based guideline for the frequency of optometric eye examinations. Prim Health Care, 2(4), 121.
  2. Veasey C. A., Jr (1946). The Dissatisfied Refraction Patient. Transactions of the American Ophthalmological Society, 44, 281–295.
  3. Kalicheti, S., Talari, C., Krishna, K. M., Khatoon, A., Mamatha, K., Veerabathini, M., & Theratipally, B. (2023). Analysis of the Factors Influencing Spectacles Non-adaptation in Optical Stores. Acta Scientific Ophthalmology (ISSN: 2582-3191), 6(1).
  4. Brooks, C. W. (2023). System for ophthalmic dispensing. Elsevier Health Sciences.
  5. Santini, B., Rue, V. Y., & McCardle, B. (2021). UNDERSTANDING TODAY’S PROGRESSIVES: Help patients choose and use these lenses with fewer hassles and greater success. Review of Optometry, 158(6), 34-39.
  6. Bist, J., Kaphle, D., Marasini, S., & Kandel, H. (2021). Spectacle non-tolerance in clinical practice – a systematic review with meta-analysis. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 41(3), 610–622. https://doi.org/10.1111/opo.12796
  7. Sheen, N. J., Fone, D., Phillips, C. J., Sparrow, J. M., Pointer, J. S., & Wild, J. M. (2008). Novel optometrist led all Wales primary eye care services: Evaluation of prospective case-series. British Journal of Ophthalmology.