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A professional body of optometrists in the country spies with its little eye that some practitioners may have been behaving badly.
While no official complaints have been laid to the body as yet, over the past two years the Professional Board for Optometry and Dispensing Opticians has observed a “worrying” trend of complaints by conferences and industry engagements – that some optometrists and opticians aren’t doing what they’re supposed to do.
Currently registered under the board’s auspices are 3 977 optometrists, including about 500 dispensing opticians.
Among the trends that the board, which is under the ambit of the Health Professions Council of SA (HPCSA), has picked up is that some practitioners don’t perform clinical examinations according to the basic guidelines for eye examination, vision screenings or fitting of contact lenses.
The board said it was issuing its concerns as a warning not only to practitioners, but as education for patients.
Other complaints include said practitioners not using the minimum equipment list recommended when performing clinical examinations.
“Let’s say you’re going to the optometrist for a general check or eye procedure; there are certain things that need to be done. The first procedure is when they assess how far you can see and whether there’s pain in your eyes. You are then asked questions such as your eye history and so on. The second thing that must be done is checking the history of your prescription, which we call refraction,” Maemo Kobe, HPCSA board chairperson, explained.
“After that, they need to do an internal examination of the eye, which includes shining a specialised light in your eye to check if there are any conditions to be worried about.
“They also need to do a front or external examination of the eye, which, again, is done using a specialised light. Then they need to examine the pressure of the eye, just as doctors check your body pressure. They also need to check your visual field, which determines how wide you can see.”
But some practitioners aren’t doing these basics and are now being called out.
Another brow-raising trend being anecdotally complained about is the fitting and dispensing of contact lenses.
“Here, I have to say, the public is also a bit to blame. Once you get contact lenses over the counter, you must know that something is completely wrong and people didn’t do what they were meant to do.
“Before prescribing a contact lens, [an optometrist needs] to check the health of the eye and measure the eye. The contact lens has the potential to harm the patient or introduce certain conditions. If the integrity of the eye is already compromised and you put in a contact lens you might worsen the eye.”
“We are doing this mainly to be proactive. When we go to professional engagements such as conferences we get optometrists who complain about their colleagues and having to deal with the consequences of their substandard treatment of patients.
“We also hear people complaining and we pick up on certain trends from these reports we’re getting,” Kobe said.
In one case, a few years ago, Kobe said he came across a 21-year-old man who had been struggling with his vision and had pain in his eyes for three years. The patient had been given eye allergy medication and antibiotics when, in fact, he had glaucoma – a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. By the time the man reached Kobe’s practice he was blind and there was not much else that could be done.
“One of the biggest problems we have is that members of the public are not aware of the standard of treatment they ought to get and therefore do not complain. Practitioners also don’t want to tell on each other.
“The problem with the eye is that once your vision is gone, there’s nothing we can do about it. There are very few conditions that are reversible. However, if detected early we can stop the progression of [a debilitating] condition.”
The board has since requested that HPCSA conduct a compliance campaign to check whether practices across the country are working under the clinical and ethics guidelines.
. To lodge a complaint against a practitioner, contact the HPCSA on 012 338 9300 or e-mail legalmed@hpcsa.co.za.
. For matters relating to practitioner ethics, scope of profession and policy, e-mail adoboard@hpcsa.co.za.
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