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Study exposes ‘flawed’ eye tests
“People with poor eyesight may be coming away from eye tests with inaccurate prescriptions, a survey suggests”
Apparently Which? sent out 5 student Optometrists to a wide variety of practices, including multiples and independents, and the following findings were present:
The reasons for wrong prescriptions included missed tests such as a retinoscopy, which “measures the strength of the glasses needed”, and the Jackson cross cylinder test, which measures astigmatism - “a condition which means vision is blurred at a distance.”
However on a more positive note, none of the practices tried to prescribe glasses or Contact lenses to students who didnt need them.
The full text can be read at the BBC site here
What are your thoughts on being ”mystery shopped” like this?
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Jane Macnaughton // Aug 30, 2007 at 2:51 am
Any ‘research’ of this nature must be taken in the context that it is. This is, after all, a magazine which tells me which is the best hairdryer I should also buy, or which washing machine I should avoid.
First of all, there are as many inconsistencies with the article as there are with their research.
And I quote,
“Some practices offer a pre-screen, where a technician will carry out initial tests before you see an optometrist. These can include retinoscopy.�
Well, if practice staff are starting to perform retinoscopy, there yes, I would be rather worried indeed!
The article lists all of the tests that a ‘good’ optometrist should perform, but as we all know, there is more than one test for one condition. Furthermore, it is our clinical judgement together with the responses from the patient sitting in the chair that drive the need for further investigative techniques.
Lastly, (and this is a personal opinion of course and no reflection on any individual) but to use optometry students in this way is inappropriate and smacks of lack of judgement. These are individuals who must still complete their training. They are not ‘experts ‘and are still not in the position to argue which tests must be one by which practitioners. I spent last week coaching optometry students on the relevance of the tests that they perform on each patient. And all would agree that it takes the experience of the pre-registration year (and beyond) to fully appreciate the relevance of each group of tests; some test will naturally follow on from the information obtained during the examination, and some will be left out.
So, whilst I am still grappling with my new hairdryer (it is far too heavy to lift and far too bulky to be able to use), I argue that this article must be viewed with a critical eye: if there had been 1000 practices visited, by suitably qualified experts with specific objectives which adhere to strict academic research parameters, then yes, I would take a closer look.
The College of Optometrists has written a response, which sums this all up beautifully. In the meantime, I am off to Argos to take my hairdryer back.
‘The College of Optometrists welcomes anything that highlights the importance of eye tests and their role in maintaining good eye health. As the Which? investigation highlights, eye tests are also a vital general health check.
All optometrists are highly trained, postgraduate professionals. There are clear guidelines for professional conduct in place, to which all Optometrists have to adhere. Optometrists have a statutory duty to carry out whatever tests are necessary to determine their patients’ need for vision care and, like all clinicians, must rely on their own professional judgement, taking each patient on a case-by-case basis. For this reason, there cannot be a “one size fits all� approach to the eye test.
All practising optometrists are required by law to keep their skills and knowledge up to date to allow them to continue to practise. The issues raised by Which? must be viewed in context. Of some 17.5 million+ eye tests carried out in the last year, only a tiny fraction was the subject of complaint (0.0007%).’
Read the full response from the College here
david cummins // Sep 24, 2007 at 5:29 pm
I am intrigued by this Which? article.
There is a big difference between ‘research’ which judges the quality of a service when compared to that of a product. A service has a far more complicated and subjective nature.
Yes, this inquiry is flawed, but it does point towards an uncomfortable truth, of which we are all aware. All optometrists know of someone who ‘tests too quickly’. Many multiple practices love these individuals and cram in their appointments to maximise dispensing yield.
Yet these ‘happy go lucky’ fellows go on for years and hardly a person blinks an eye.
Where are the whistle blowers? Why don’t the public complain?
Maybe the profession should have self-regulation?
Perhaps this Which? survey IS positive in highlighting that quality does matter in clinical eyecare.
I would say that in general the advice on test length is good. After all, if an older relative was asking for advice where to go for an eye exam, what would you say? You would advise them to go to a practitioner who is likely to spend time with them, rather than rush them through.
I would also contend that practices need to look at ways of maximising the time that optometrists spend doing tests which ARE required, rather than unnecessary early recalls or doing refactions on people who are not even thinking of a new correction.
In the UK most practices operate on a single price / single package basis when it comes to their eye examinations and I think this is no longer making much sense. A young person with itchy eyes with no visual problems does not require a refraction (maybe VA) nor tonometry nor fields, and yet we sit them down and put them through our normal routine before we address their principal complaint!
We are in danger of ‘not being able to see the wood for the trees’!!
With therapeutics on the way, it is time that we apportion our time on a ‘needs’ basis, rather than asking ‘one or two’ all day for no apparent reason.
Maybe we should charge per minute like taxis? In fact lawyers do that too…mmmmm maybe not!
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