Regulations would lift restrictions on ‘sight testing,’ ordering lenses online

“Sight-testing opticians” in British Columbia may be permitted to independently conduct automated refractions for healthy patients, and spectacle and contact lens providers may be able to fill prescriptions without possession or verification of a current, valid refraction.

According to a news release issued by the Ministry of Health on March 19, the regulation change was to take effect May 1.

Antoinette Dumalo, president of the British Columbia Association of Optometrists (BCAO), said in an interview with Primary Care Optometry News that the British Columbia Society of Eye Physicians and Surgeons was taken by surprise when the proposed regulations were announced by the Ministry of Health.

“There has been no consultation with the eye doctors in British Columbia,” she said. “Under the Health Professions Act, 3 months consultation is usually given when a regulatory change of this magnitude is being considered. The Minister has the right to shorten that length of time and, unfortunately, it was truncated to 6 weeks.”

American Optometric Association (AOA) President Randolph E. Brooks, OD, stated in a letter to Health Minister Kevin Falcon: “We are unable to comprehend how any government could consider a proposal to allow a seller to dispense eyeglasses or contact lenses without possessing or verifying that a patient’s prescription is current and valid.

“In both the United States and Canada, [vision correction devices] are classified as medical devices,” he continued, “and as such they must be prescribed by an optometrist or medical physician who is licensed to examine the eyes, establish the appropriateness of wear and issue a proper prescription.”

Sara Moshurchak, president of the Opticians of British Columbia (OBC), told PCON that licensed sight-testing opticians will be able to independently conduct sight tests under the new regulations without the data being reviewed by an eye doctor.

“The new minister has decided that opticians are highly trained professionals that have quite a screening process for our patients and our customers, so we no longer need that secondary signature,” Ms. Moshurchak said.

The OBC met with government officials to advocate for changes to allow independent sight testing by opticians, she said, but the group was surprised by the deregulation of eyeglass and contact lens dispensing.

Specifics of the regulations

According to a news release from the Ministry of Health Services, the consultation draft regulations will allow opticians to independently sight-test healthy individuals between the ages of 19 to 64 and provide an assessment record of their refraction. To qualify for sight-testing, an individual has to have had one eye health examination before the age of 19 and another between the ages of 19 and 40.

Individuals are not permitted to be sight-tested if they have a history of glaucoma, retinal detachment, macular degeneration, diabetes, hypertension, diplopia, recent head trauma, injury or pain in either eye within the previous 3 months, prisms or refractive error exceeding 6 D in either eye.

In addition, individuals will be permitted to order contacts or glasses online without having to produce a copy of their prescription, sight-test assessment or contact lens specifications.

Efforts to stop regulations

To prevent these regulations from moving forward on May 1, the BCAO solicited support from eye care professionals across North America, including the AOA.

“We’re trying to mobilize optometrists to get the message to Health Minister Falcon that these proposed regulations put British Columbians at risk for asymptomatic eye diseases,” she said. “We want to form a committee where the three colleges – the College of Optometry, the College of Physicians and Surgeons of British Columbia (CPSBC) and the College of Opticians — and any other stakeholders can engage in meaningful dialogue so a solution can be found to balance the vision and health of British Columbians with free enterprise.”

Similar legislation proposed in 2004 and again in 2006 failed due to lack of cabinet approval and strong opposition from the BCAO, the Canadian Association of Optometrists, the AOA and the CPSBC.

“In 2007 the government changed the Health Professions Act so that cabinet approval is no longer required,” Dr. Dumalo said. “Now the decision to make regulatory changes is in the hands of the Minister of Health.”

Impetus for legislation

According to information provided by the Ministry of Health Services Communications department, an October 2009 court case in which the College of Opticians sued Coastal Contacts for dispensing contact lenses without a prescription was the catalyst of this most recent proposed regulation change.

“Coastal Contacts, a B.C.-based online eye wear seller, was found to be contravening the Opticians Regulation by selling contact refills without seeing a prescription,” according to the Ministry of Health Services. “Coastal was given until May 1, 2010, to bring its business model in line with the Opticians Regulation or seek regulatory changes by government.”

A statement provided by the Ministry of Health to PCON said, “If we had not acted, then this B.C. company with 120 employees, doing over $100 million a year in business, selling around the world, would have to relocate out of B.C. It made no sense to delay these changes when it is clear to us that this change is in the best interest of British Columbians by giving them more choice, without affecting the public’s health.”

In a prepared statement provided to PCON, Coastal Contacts CEO and President Roger Hardy said: “Coastal Contacts position has always been to serve customers in the most effective and affordable way possible, while maintaining public health and safety. We have always been a consumer-focused company and will continue to maintain that focus.”

For more information:

• Antoinette Dumalo, OD, can be reached at the British Columbia Association of Optometrists, 502 - 1755 West Broadway, Vancouver, BC, Canada V6J 4S5; (604) 737-9907; e-mail: adumalo@shaw.ca.
• Randolph E. Brooks, OD, can be reached at the American Optometric Association, 243 N. Lindbergh Blvd., St. Louis, MO 63141; (800) 365-2219; www.aoa.org.
• Sara Moshurchak can be reached at the Opticians of British Columbia, 400 - 1681 Chestnut Street, Vancouver, BC, V6J 4M6; (604) 677-6756; e-mail: info@opticians.bc.ca.
• The British Columbia Ministry of Health Services can be reached at (800) 465-4911; www.gov.bc.ca.
• Coastal Contacts can be reached at (604) 669-1555; www.coastalcontacts.com.