The World Council of Optometry (WCO) biannual General Delegates Meeting in Melaka, Malaysia in June brought together optometric leaders from WCO’s 75 member organisations in 40 countries around the world. They meet every two years to discuss eye care issues, establish policies and determine global protocols.
The objective of the conference was to provide practitioners with local and global views on public health issues; the challenges facing optometric education and scope of practice around the world. Delegates comprised of private practitioners, academicians, administrators, optometry students and foreign delegates.
In promoting the event the WCO outgoing president Mr. Robert Chappell said: “WCO has a pivotal role to play in ensuring the enhancement and development of eye and vision care worldwide … (and) I hope we will be able to identify how we can assist in making a positive impact on the status of optometry in South East Asia.”
Highlights from the sessions included:
Dr. Goh Pik Pin
Consultant Ophthalmologist, Selayang Hospital, Malaysia
The first plenary session on public health issue for optometrists concentrated on the role of the optometrist in screening for diabetic retinopathy (DR). She recommended optometrists play a proactive role in early detection and to refer patients to an ophthalmologist to better manage them. She also suggested the use of not only direct ophthalmoscope but also BIO, 90D lens with slit-lamps and fundus camera for the screening purpose.
Mr. Ron Fyfe
Chairman of WCO Public Health and Development Committee
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Ron Fyfe, from New Zealand, spoke on the global challenge for the optometry profession. He was awarded the 2008 International Optometrist of the Year by the WCO and chaired the committee that developed the WCO Public Health Toolkit for helping optometrists to participate in the ‘Vision 2020 – The Right to Sight’ programmes.
Ron said the important thing is to learn from each other and be prepared to adapt what has been proven to work well in one country to our own country’s need. The optometrist is best placed to oversee the elimination of refractive error blindness as well as the recognition of vision or even life threatening eye diseases to tertiary eye-care practitioners.
Professor Maurice Yap
Chair Professor of Optometry, Hong Kong Polytechnic University
Professor Maurice Yap spoke on optometric education in Asia. With over 25 years of being involved in this field, in Hong Kong; Singapore; N.Z and U.K., he shared on disparities of optometry schools and the certification offered in the Asian region. He noted that government funded universities in Australia, New Zealand, China, Hong Kong, Malaysia and Singapore, as opposed to those that are privately funded; tend to achieve greater standards of success in optometry practice.
He said Australia and New Zealand have already received certification for ocular diagnostics and therapeutics and said a good optometric educational institution is fundamental in the excellence of the profession.
Nelson Rivera
OD from ICEE
Standing in for Prof. Naidoo who couldn’t attend at the last hour, Nelson’s message was about global educational challenges: human resource, infrastructure, service delivery expansion, political will, publicprivate partnership and the expansion of the private sector.
He said: “developing and underdeveloped countries are facing shortages in rural areas as more personnel have migrated to developed cities” and “that the major cause of world blindness and impaired vision is uncorrected distance refractive error (data by WHO). Globally, there are 517 million uncorrected presbyopes and 153 million people with uncorrected distance prescription: a total of 670 million people are visually impaired because they don’t have a proper pair of spectacles. This represents a total of USD$269 billion lost in GDP loss.
” The WCO aims to create educational and employment opportunities via service delivery approaches that are integrated and sustainable. This in turn will eliminate visual impairment and avoidable blindness due to refractive error by 2020.
There are still shortages of optometry schools in developing nations and he proposes multiple levels of entry and exit levels where the first year will produce optical shop assistants; second year, optometric technicians, through to the fourth year, an optometrist and in the fifth year, a masters.
Peter Grimmer
Past Chairman of Optometrists and Dispensing Opticians Board, New Zealand
He gave an interesting account of a New Zealand perspective in the scope of optometric practice and a comprehensive view of how change to the regulatory Act affected the practice of optometry in New Zealand, and ultimately benefited patients.
He said in 1996, an amendment in the Act allowed the use of mydriatic and cycloplegic agents. Then in 1998, the New Zealand Association of Optometrists appointed Dr. Lesley Frederikson as the national director to actively pursue the aims of the profession. Five years later, a new legislation Health Practitioners Competence Assurance Act 2003 (HPCAA) which governs 13 health professions, one of which certifies the use of the name ‘optometrist’, not the practice of optometry. It is aimed at protecting the health and safety of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practice their profession.
This led to the definition of the scope of practice of an optometrist whereby contact-lens, low vision, diabetic retinopathy screening, paediatric optometry, behavioural optometry and orthoptics are core scope practices. The important aspect of this legislation allows the use of diagnostic medicine as diagnosis was a fundamental element in optometry scope of practice. Thereby before any prescription of glasses was given, a written diagnosis of eye disease or an exclusion of it is required. This restricts the person certified by the Act to practise within the scope and to prevent any other than these to do the same.
In assuring the competency, the Board sets standards of clinical competency, cultural competence and ethical conduct. Every two years an optometrist is required to fulfill Continuing Professional Development accredited courses totalling 15 hours to have their practising license renewed. Those who opt not to attend the courses can also perform a self-audit governed by a list of questions on their daily practices.
A Performance Assessment Committee was set up to formally investigate complaints or review the competency of a practitioner. Currently, the optometry course in New Zealand has a five year Bachelor of Optometry that includes therapeutics. Those who studied prior to this are able to undertake a bridging course for the module. He said optometrists who are certified in New Zealand are able to use therapeutic agents including all forms of steroids except glaucoma drugs.
In summary, Peter said optometry is a life long learning career and is a privilege and that proper legislation is vital to the profession.
Professor George Woo
Dean of Faculty of Health and Social Sciences, Hong Kong Polytechnic University
The incoming president of WCO spoke on the future of the optometry in South East Asia. Out of 1.745 million people in the region, 12.21 million have prevailing blindness. This causes not just individual burdens but also a burden to the family, community and ultimately the country in loss of revenue.
In line with WCO statements: “World Optometry – Enhancing Vision Protecting Heath” and “Global Competencybased Model of Scope of Practice in Optometry”, he challenged optometrists to extinguish the public misconception that an optometrist only sells spectacles and contact lenses. Because the quality of the optometric practices, education and legislation varies greatly in the region, there is still a lot of work to be done.
However, this must be done in accordance with adapting to the local needs, taking into account the existing infrastructure and resources. He indicated that the WCO and the APCO (Asia Pacific Council of Optometry) intend to work closely with WHO, local NGO’s and other agencies to increase access and awareness of primary eye care at the community level. He stressed the three-pronged approach: education, legislation and scope of practice.
Murphy Chan is an optometrist and member of the Association of Malaysian Optometrists who hosted the World Council of Optometry (WCO) biannual General Delegates Meeting in Malaysia.
