Practice of Optometry

4 components of moral life

1. awareness/sensitivity

2. reasoning/reflective skills

3. motivation/conviction

4. implementation

Is ethical = moral

yes

Civil discourse involves what?

When engaging: Humility, empathy, fairness, and practicality.

When responding: Receptivity, forgiveness, resilience, flexibility

The 4 C’s of civil discourse

Curious, Charitable, Conscientious, Constrictive

Is moral/ethical the same as legal

no, laws may guide us to moral correctness, but not fundamental determinant of what is morally correct

What is an optometrists?

• Primary care professionals for the eye

• Examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, they eye, and associated structures

• Identify related systemic conditions affecting the eye

Scope of Practice in Optometry

• Diagnose vision problems, ocular diseases, and systemic conditions with ocular manifestations

• Prescribe medications, low vision rehabilitation, vision therapy, spectacle lenses, contact lenses, and perform certain surgical and laser procedures

• Counsel patients regarding surgical and nonsurgical options that meet their visual needs related to their occupations, avocations, and lifestyle

Licensure

Scope of practice dictated by each state and individual state licenses needed.

Optometry Start

1895: Charles Prentice of New York tries to legalize practice of optometry through enactment of statute by state legislature.

1896: OH and NY defeat bills relegating refraction to medical doctors

What professions did optometry arise from?

Opticians, oculists, and ophthalmologists

When was the American Association of Opticians founded?

1897

When did the American Association of Opticians change their name to American Optometric Association (AOA)

1919

When and where did the first ODs pass state laws regulating practice of optometry?

1901 in MN

When and where was the last state to enact optometry law?

1919 in TX

What unique event occurred in 1937

Anti-commercial roots and Reader’s Digest article “Optometry on Trial”

When did optometrists have army commissions and staffed VA hospitals?

1947, during WW2

When did US Congress enact Medicare and Medicaid

1965, optometrists initially excluded from providing vision care services

The Significance of the LaGuardia Conference

The LaGuardia Conference marked a turning point in the professionalization of optometry, leading to:

• Optometry must abandon as a drugless profession

• Optometrists must continuously update its self-image and education to elevate the profession to a primary care provider

• Optometrists must organize to update optometric legislation

When did RI the first Diagnostic Pharmaceutical Agent Law get passed for optometrists

1971

When did federal law establish optometric services with expanded privileges in VA

1976

When did WV enact the first therapeutic pharmaceutical agent law

1976

When did US Congress expand Medicare to enable optometrists to provide vision care services for aphakic patients only

1981

When did OH pass Diagnostic Pharmaceutical Agent legislation?

1984

What significant changes did the 1986 Medicare parity legislation bring for optometrists?

It allowed ODs to provide services to non-aphakic patients under medicare but excluded refraction services

What state was lass to pass DPA laws?

MD in 1989

When were optometrists first allowed to perform anterior segment laser procedures under Board rule?

1988

What are ODs in Ohio not allowed to perform at the moment?

Lasers; Lumps & Bumps

When did OSU become a college of Optometry?

1968

OH scope of practice

• Administer or prescribe topical ocular drugs
• Administer or prescribe oral medications related to
eye including oral antibiotics, NSAIDs, carbonic
anhydrase inhibitors, antihistamines, and nutritional
supplements
• Prescribe systemic steroids, limited to treat allergic
inflammation of the conjunctiva, lids, and adnexa in
adults 18 years and older (Methylprednisolone only without refills)
• Prescribe controlled substances not to exceed a
single four-day supply (No more than 60mg of codeine and No more than 7.5mg of hydrocodone and Tramadol)
• Administer epinephrine by injection to individuals in
emergency situations to counteract anaphylaxis or
anaphylactic shock
• Diagnose and treat glaucoma with topical or oral
medications
• Co-manage ocular post-operative care
• Perform non-invasive procedures (not involve cutting
or infiltrating human tissue by mechanical means)
including foreign body removal, dilation and irrigation,
punctal occlusion, and eyelash epilation
• Prescribe and dispense glasses and contact lenses
• Provide and aid in care of ocular prosthetics
• Order laboratory tests required for examination,
diagnosis, and treatment of a disease or condition
related to the human eye

Grassroots Advocacy 101

Process of communicating with optometrists and asking them to contact their local, state, or federal officials regarding a particular issue.

AOA

American Optometric Association: Political arm of optometry, lobbying, education,

AOSA

American Optometric Student Association: AOA affiliate, political activity training, continuing education of students, career development, leadership training and experience, camaraderie across schools and colleges

Epsilon Psi Epsilon

Established Beta Chapter at OSU in 1920, only one still operating

AAO

American Academy of Optometry: provides education, support, research, and disseminate knowledge to advance optometric practice and improve patient care

NBEO

National Board of Examiners in Optometry: Maintenance of professional standards, licensing, standardized testing of students to guarantee entry level competence

ARBO

Association of Regulatory Boards in Optometry: Organizes state boards of optometry, Council on Optometric Practitioner Education (accredits optometric continuing education), and License renewal

NOA

National Optometric Association: Recruitment minority students for optometry, Deliver effective and efficient eye and vision care services to minority community

VOSH

Volunteer Optometric Services to Humanity: Facilitate provision and sustainability of vision care worldwide for people who can neither afford nor obtain such care

Practice Settings

• Private Practice

• Health Maintenance Organizations

• Commercial settings

• Government practice

• Academia

• Industry

• Government service

• Optometric Organizations

Other Credentials

• Residency

  • VA residency for VA position

  • Private practice

  • New skills vs more experience

• Graduate Degree

  • MS, MPH, MBA, MHA

  • PhD

4 common causes of blindness?

• cataracts

• macular degeneration

• glaucoma

• diabetic retinopathy

Risk factors for cataract

• age

• UV light exposure

Risk factors for Macular degeneration

• age

• race

• smoking

• gender

• family history

• UV light exposure

Risk factors for glaucoma

• age

• race

• family history

Risk factors for Diabetic Retinopathy

• Diabetic control

• High blood pressure

• high cholesterol

• Smoking

• Kidney disease

• Race