Information for the General Public
A Doctor of Optometry or optometrist is a highly skilled and knowledgeable health care practitioner who is educated and trained to examine, assess, measure, diagnose, treat, manage and correct diseases and disorders of the human visual system, the eye and its associated structures.
Optometrists must complete a 3-4 year Bachelor of Science degree (B.Sc.) and a 4-year Doctor of Optometry degree (O.D.) before successfully passing the Optometry Examining Board of Canada Exam (that contains a written and OSCE component). Currently, optometrists provide the vast majority of primary vision care services in Alberta.
Specifically, optometrists:
- Examine, assess, measure, diagnose, treat, manage and correct disorders and diseases of the human visual system, the eye and its associated structures.
- Prescribe all scheduled topical and oral medications for eye diseases and conditions.
- Recognize, detect, refer and collaborate with physicians and other health professionals regarding related systemic diseases and conditions that manifest in the vision system.
- Prescribe and fit eyeglasses and contact lenses.
- Diagnose, assess and treat low and subnormal vision conditions with magnifiers, telescopes, other low vision devices, prisms and mobility training..
- Diagnose, treat and manage accommodative, binocular and perceptual vision disorders.
- Enhance workplace safety through ergonomic, lighting and environmental assessments; and, provision of approved safety eyewear.
- Conduct research and promote education in the vision sciences.
- Provide counselling to ensure life-long eye health.
In addition, optometrists must maintain their skill set and level of competency by completing the requirements of the ACO Continuing Competence Program through Continuing Education courses, participating in on-site Practice Visits on a regular basis and practicing a minimum number of days in each 3-year competency period.
Ophthalmologists are physicians who limit their practice to secondary and surgical treatment of specific eye diseases and disorders. They must complete a 2-4 year Bachelor of Science degree (B.Sc.), a 4-year medical degree (M.D.) and an additional 5-year residency specializing in eye surgery and secondary vision care consultations. They typically do not provide refractions or other primary vision care services.
Opticians are practitioners who design, fit and dispense eyeglasses and contact lenses that are prescribed by an optometrist or ophthalmologist. They develop their skill set by working in a retail optical dispensary while completing a 2-year correspondence course from NAIT that is supplemented by one evening lecture per month and two compulsory lab sessions per year.
A comprehensive eye exam, as performed by an optometrist, examines the entire eye and visual system including:
- the internal and external ocular health of the eye
- the central and peripheral sensory function of the eyes
- the integrity of the visual pathway
- the objective and subjective refractive status of the eye including visual acuities at near and far
- the binocular and accommodative function of the eyes
- the visual processing of information
- other signs of systemic disease or disorders
By examining the total vision system, optometrists can diagnose eye diseases and disorders such as glaucoma, cataracts, retinal conditions and other conditions requiring eyeglasses or contact lenses. In addition, a complete eye exam may also identify systemic conditions such as diabetes, high blood pressure and brain tumors. Achievement of 20/20 vision does not guarantee that a patient does not have any underlying sight-threatening vision or medical disorders or conditions. Many eye diseases do not manifest any pain, redness or other outward sign until irreparable damage has occurred.
A stand-alone refraction or sight test, as performed by an optician, is just one small part of a comprehensive or complete eye exam. A sight test does not assess or examine all other aspects of the human eye or other causes that may give rise to vision impairment or eye disease. In addition, due to many other factors, the “numbers” recorded from a refraction are not the same “numbers” that are written on a patient’s final prescription. Only by reviewing a patient’s complete vision chart can a prescription be issued that ensures clear and comfortable vision.
It is the opinion of the Alberta College of Optometrists that patients should be able to fill their optical prescription at the provider of their choice.
All optometrists have to abide by strict rules when prescribing or dispensing eyeglasses and contact lenses. They also have to maintain their skill and competency in these areas. Mail order and internet-based companies do not have to abide by these same rules and standards. Recent investigations report that many prescriptions filled by mail order or internet based companies did not meet the same strict standards required by optometrists.
The Alberta College of Optometrists recommends that patients who purchase glasses or contact lenses from mail order or internet-based companies return to your optometrist to have the eyeglasses and/or contact lenses verified. We also request that you ask your optometrist ahead of time what fee they will charge to verify if your prescription was ground correctly and/or properly fit your eyewear for purchases from mail order or internet based companies.
An eyeglass (or optical) prescription is defined as the written record of the refractive error of the eye, including, if appropriate, reading add, prism and back vertex distance. Other eyeglass prescription specifications may also be included on the written copy as per the professional discretion of the prescribing optometrist. An eyeglass prescription can usually be arrived at and issued following a complete eye examination. In selected situations (such as fluctuating blood sugars, corneal infections, etc.); your optometrist may require additional testing to ensure the accuracy and stability of your refractive status before issuing an eyeglass prescription. This is just one of the reasons for requiring a complete eye examination as compared to a stand-alone sight test before purchasing new eyeglasses.
A PD is a measurement of the distance between the centers of your two eyes. It is required when fabricating eyeglasses to ensure that your eyes are looking through the center of your lenses. Eyeglasses that are not set to your exact PD can cause headaches, eyestrain, blurred vision and/or double vision. The measurement of a PD is considered one of the required procedures for fabricating eyeglasses and not one of the procedures of an eye exam. The individual or company that supplies your eyeglasses is responsible for measuring your PD and ensuring that your finished glasses are fabricated to this measurement. In addition, this individual or company is also responsible for measuring the fitting height for multifocals, selecting and adjusting an appropriate frame, selecting an appropriate lens material and selecting an appropriate lens coating or tint. As noted above, all of these services should be performed by the individual or company you purchase your glasses from.
The specifications for purchasing contact lenses are different than the specifications for purchasing eyeglasses. In order to issue a contact lens prescription, additional specialized testing and a contact lens fitting must be performed after completing a complete eye examination. According to Section 5(3), Schedule 17 of the Health Professions Act, after completing all the services required to dispense contact lenses, regulated members must offer the patient a written copy of the specifications of the contact lenses. In addition, patients must be instructed in proper contact lens insertion/removal techniques, wearing schedules, lens cleaning regimens and replacement frequencies in order to ensure lifelong healthy eyes.
The Alberta College of Optometrists Guidelines to the Standards of Practice states that all optometrists must write the date of issue of the optical prescription or contact lens specifications, as well as the expiry date of the optical prescription or contact lens specifications, on the patient’s prescription form. The expiration date for optical prescriptions and contact lens specifications is left to the professional discretion of the optometrist based on the medical and/or visual condition of the patient.
Coloured, tinted or patterned contact lenses have become a popular cosmetic item. They are considered safe only if they are properly fit by a competent and skilled practitioner and cleaned and maintained in a proper fashion. Improperly fitted or maintained contact lenses can lead to an eye infection and possible permanent eye damage.
If your contact lenses were purchased from an on-line or retail company that did not personally fit them to your exact required specifications and provide appropriate and required follow-up examinations, you are at risk for potential eye damage and permanent loss of sight.
BEWARE: Do not share your contact lenses, contact lens case, eye makeup or any eye drops with another person due to the potential transmission bacteria and viruses that cause serious eye infection and permanent loss of sight.
The perfect career is one where the practitioner looks forward to going to the office on Monday morning. The ideal traits of an optometrist include compassion and caring for others and a logical and analytical mindset. Optometrists are considered eternal students since they must continue to study and learn new skill sets and techniques to maintain their level of competence throughout their professional careers.
High School students should plan on taking a full course load that includes English, Pure Math, Social Studies, Chemistry, Physics and Biology. Additional recommended courses include Communication Skills, Computing Science, Calculus and a second Language. The remainder of your course load should include those subjects that interest you and potentially introduce you to other disciplines such as Philosophy, Music, Business and Drama.
Most Canadian Universities require a minimum average (usually 80% to 85%) for entrance to their Faculty of Science. A university-based 3 or 4-year Bachelor of Science (B.Sc.) is required for entry into Optometry School. For a complete list of required and recommended university courses for entry into Optometry School, go to www.opted.org. The list includes English, General Chemistry, Organic Chemistry, Biochemistry, Physics, Calculus, Linear Algebra, Statistics, Philosophy, Biology, Anatomy, Physiology, Microbiology and Psychology. Additional courses such as Genetics, Histology, Pharmacology, Computing Science and Communications are highly recommended.
The same website (www.opted.org) also has information regarding required entrance marks, male-to-female ratio’s, program costs and other required pre-requisites for each individual institution. All institutions rate applicants on their University Grade Point Average, their Optometry Admissions Test (OAT) score, personal interviews, letters of reference and extra-curricular activities through High School and University.
Eighty Percent of what a child learns is acquired through the visual system. Perceptual, learning and behavioural problems are often traced to vision problems. Such problems may also create barriers to childhood play and social development. It is extremely important that vision problems be detected as early in a child’s school career as possible.
Vision screenings performed in the school are not eye exams and can miss serious vision problems. The following check-list will assist classroom teachers and aides in identifying those children in their care who have vision problems. Teachers should encourage parents to have their child’s eyes and visual system examined by an optometrist.
| Observable Clues to Classroom Vision Problems
1. APPEARANCE OF THE EYES
2. COMPLAINS
3. BEHAVIOURAL SIGNS OF VISUAL PROBLEMS a) Eye Movement Abilities (Ocular Motility)
b) Eye Teaming Abilities (Binocularity)
c) Eye-hand Coordination Abilities
d) Visual Form Perception (visual comparison, visual imagery, visualization)
e) Refractive Status (Nearsightedness, farsightedness, Focus problems, etc)
Check list courtesy of Optometric Extension Foundation, Santa Ana, California, U.S.A |
Even before birth babies are able to differentiate between light and dark. At birth they can see shapes only in terms of light and dark, but by about one month they can see their first primary colour – red. While vision is less than fully developed, newborns can see objects at 10” to 12” distance (Mother’s face when nursing).
Just as babies learn how to crawl and walk, they must also learn how to use their visual system. At one month they should be able to follow a moving object. At three to six months they can focus on the object and begin to explore their visual world. By one year a child will begin to use both eyes together to judge distance and can grasp objects. The colour of an infant’s eyes should now be stable. Full co-ordination between the two eyes usually occurs from one-and-a-half to two years of age.
While most eye development occurs in childhood, the front of the eye can continue to grow into early adulthood. Vision needs will change according to the rate of development.
Approximately 80% of what a child learns is acquired through the visual system. Perceptual, learning and behavioural problems can often be traced to visual problems. All children in Alberta are covered by Alberta Health care for an annual eye examination until their nineteenth birthday.
A child’s visual health should be assessed at regular intervals by an optometrist, starting at 6 months, then at three years, before entering the school system, and annually while they are at school. If a child exhibits any of the following signs the optometrist should be consulted as soon as possible:
- Apparent loss of vision
- One eye turns either inward or outward
- Rubs eyes excessively
- Shuts or covers one eye
- Blinks more than usual
- Squints or frowns
- Has misaligned eyes after the fourth month
- Has bulging of one or both eyes
- Has recurrent eye infections
- Has red-rimmed, encrusted or swollen eyelids
- Has inflamed or watery eyes
- Frequent headaches in the forehead or temples
- Short attention span
- Avoids close work
- Holds a book very close when reading or writing
- Skips lines, frequently losing place when reading
- Repeatedly sits very close to the TV.
- Poor vision not only affects your child’s ability to learn. It can also create a barrier to childhood play and social development.
Child-play can be rough. Any of the following symptoms may signal serious eye injury. Seek immediate attention if your child experiences any of the following:
- Obvious pain or vision problems
- Cut or torn eyelid
- One eye that does not move as extensively as the other
- Abnormal pupil size or shape
- Blood in the white of the eye
- Something embedded in the eye
- Something under the eyelid that cannot be easily removed
A child’s eye exam usually includes:
- A review of the child’s health and vision history
- An examination of the physical health of the eye and visual system
- Tests for:
Refractive error – near-sightedness, far-sightedness and astigmatism
Binocularity – eye coordination, tests for crossed, wandering and lazy eyes
Focusing and tracking skills
Assessment of colour vision and depth perception
Contact Your Optometrist today for more information about children’s vision.
DON’T TAKE CHANCES WITH YOUR CHILD’S SIGHT.
ENSURE YOUR CHILD HAS AN ANNUAL EYE EXAMINATION.
By early adulthood the human eye is fully developed. However, vision changes as we age, and lifestyle plays a significant role in maintaining optimum vision. Wear sunglasses when out of doors.
- Invest in protective eyewear appropriate to any sport you play.
- Wear appropriate safety glasses while on the job.
- Eat healthy foods, including fresh fruits and vegetables.
- Do not smoke … smoking triples the risk of developing Macular Degeneration.
- Watch your weight and have your physician check regularly for early signs of Diabetes.
- If you work at a computer take frequent “eye breaks”, check the angle and distance of your computer screen, check your workspace for sources of glare. Symptoms of eye and vision problems linked to extended computer use include dry, irritated, inflamed or sore eyes, headaches and blurred vision.
- Schedule regular eye health and vision examinations with your optometrist.
Statistics (provided by the National Coalition for Vision Health)
- Number of Canadians developing irreversible vision loss:
- By age 65: one in nine (equal to the number of women affected by breast cancer).
- By age 75: one in four.
- In 2001, vision loss accounted for 17% of total disability in Canada.
- Amount of preventable vision loss in Canada: 75%.
- For people with vision loss, compared to general population the same age:
- Admission to nursing homes is three years earlier.
- Number of falls is twice as high.
- Incidence of depression is three times as high.
- Occurrence of hip fractures is four times as high.
- Number of deaths is twice as high.
- As a result of Age-related Macular Degeneration (AMD), 2.1 million Canadians between the ages of 43 – 75 are experiencing blindness or irreversible vision loss. This is equivalent to the number of Canadians with Diabetes, and 20 times the number of people with Parkinson’s Disease.
- Each year 78,000 Canadians are diagnosed with AMD, a number expected to triple within the next 25 years.
By early adulthood the human eye is fully developed. However, vision changes as we age, and lifestyle plays a significant role in maintaining optimum vision.Wear sunglasses when out of doors.
- Invest in protective eyewear appropriate to any sport you play.
- Wear appropriate safety glasses while on the job.
- Eat healthy foods, including fresh fruits and vegetables.
- Do not smoke … smoking triples the risk of developing Macular Degeneration.
- Watch your weight and have your physician check regularly for early signs of Diabetes.
- If you work at a computer take frequent “eye breaks”, check the angle and distance of your computer screen, check your workspace for sources of glare. Symptoms of eye and vision problems linked to extended computer use include dry, irritated, inflamed or sore eyes, headaches and blurred vision.
- Schedule regular eye health and vision examinations with your optometrist.
Statistics (provided by the National Coalition for Vision Health)
- Number of Canadians developing irreversible vision loss by age 65: one in nine (equal to the number of women affected by breast cancer).
- By age 75: one in four.
- In 2001, vision loss accounted for 17% of total disability in Canada.
- Amount of preventable vision loss in Canada: 75%.
- For people with vision loss, compared to general population the same age:
- Admission to nursing homes is three years earlier.
- Number of falls is twice as high.
- Incidence of depression is three times as high.
- Occurrence of hip fractures is four times as high.
- Number of deaths is twice as high.
- As a result of Age-related Macular Degeneration (AMD), 2.1 million Canadians between the ages of 43 – 75 are experiencing blindness or irreversible vision loss. This is equivalent to the number of Canadians with Diabetes, and 20 times the number of people with Parkinson’s Disease.
- Each year 78,000 Canadians are diagnosed with AMD, a number expected to triple within the next 25 years.
Alberta has 7 classes of driver’s licenses and each one has a slightly different minimum vision standard. The following summarizes the minimum vision requirements in each class:
| Class | Minimum Acuity Standard |
| 1, 2, 3 and 4 (emergency) | Better eye 6/9 and weaker eye 6/30 |
| 4 (taxi) and 5 (Commercial) | Better eye 6/12 and weaker eye 6/60 |
| 5, 6 and 7 | Better eye 6/15 |
| Class | Minimum Acuity Standard |
| 1, 2, 3, 4 (emergency) and 6 | 150 degrees horizontal and 20 degrees vertical |
| 4 (taxi), 5 and 7 | 120 degrees horizontal and 15 degrees vertical |
– Classes 3, 5, 6 and 7 must have corrected diplopia.
– All classes must be able to identify traffic lights.
For a list of the full physical and mental requirements, go to www.tc.gc.ca.