This research aims is to review the optical act of Malaysia and compared it to another country which are Hong Kong, Singapore and Australia. Optical act is to enhance the profession standard and conduct of registration of optometrist and opticians in Malaysia. Optometrist in Malaysia is started in 1980 which started with diploma course and then it change to degree course on 1982 at National University of Malaysia. Purpose of this course is to support in eye care profession. This course is closely related to the optician and ophthalmologist and its act as a team on eye care profession.
In Malaysia, the standard of eye and vision care very low compared with other developing countries. It involved all ophthalmologist, optometrist and optician to increase the quality of eye and vision care. But, the role of optometrist and optician in Malaysia is not clear enough and their role was mixed each other especially on prescribe spectacle and contact lens. Many people in Malaysia think that optometrist only prescribe spectacle only. They do not know that optometrist have responsibility on management of vision anomalies. Even ophthalmologist also not knows the role of optometrist towards enhancing the standard level of vision care. This issue also very important for enhance the awareness of eye health to the Malaysian people.
The Malaysian government was put the optometrist, optician and ophthalmologist profession on optical act 1991. This act includes registration of optometrist and optician in Malaysia. Besides that, it also includes practice of optometrist and optician on eye care profession. It also includes the Malaysian optical Council. Malaysian optical act should protect importance of Malaysian consumer in eye and vision care. In Malaysia, they have two associations which are Association of Malaysian Optometrist that has been formed on February 1984 that related to optometry profession and Malaysian Association of Practicing Opticians (MAPO) that has been formed in 1985 which related to the dispensing opticians. In this research, I will review the journal that can show the influence of optical act and interest of optical act to the eye health in Malaysia and compared it with Hong Kong, Singapore and Australia.
Literature review:
Visual impairment: blindness and low vision
Based on the community eye health journal that entitled changing patterns in global blindness 1988 â€" 2008, the prevalence of visual impairments in worldwide was increased with increase of the population and ageing people in worldwide. This can cause increase number of blindness in world. They say that the cataract and refractive error is the major cause of blind and low vision in worldwide. From that journal, 37 million people was blind in 1988 and it increase to 45 million in 2002 to 2004. From 45 million, 8 million of people were blind caused by refractive error. In 2002, low vision cases also increase compared with 1988. 145 million of low vision cases are caused by refractive error (Foster, Gilbert, and Johnson 2008). This means that we must think how to prevent this problem from continuing to increase in the coming years. All members of eye and vision care must cooperate to each other in handling this problem to increase of awareness to the public (Zainal et al. 2002a).
Then, we focus on our country which is Malaysia. From this research; prevalence of visual impairment that reported from National Eye Survey Malaysia in rural and urban areas is 2.71% and 2.54 % respectively which higher at rural areas. On this research which is done at Sepang, Selangor, they found that out of 311 people in this study, 8.9% is visual impaired and 2.9% is blindness. The higher cause of visual impaired is refractive error which is 56% (Reddy, Rampal, and Nurulaini 2004), (Zainal et al. 2002b) (Thai and Yap 2010). From other study, higher prevalence of myopia on malay than Chinese in Malaysia and more than half of them is younger than 50 years of age. Refractive error problem must be concerned to control the increase of visual impairment in our country. In this study, they suggest the need of evaluation in eye care service in this country (Zainal et al. 2002a). In addition, at Sepang area, more than half of patient not sees eye specialist for the treatment. This shows the requirement for eye care facilities at this area (Reddy, Rampal, and Nurulaini 2004). Regarding this problem, we needs to review eye care service that involved optometrist, optician and ophthalmologist in Malaysia to increase eye and vision care quality (Zainal et al. 2002a). The needs of eye and vision care also increase with increase of eye problem in Malaysia.
Contact lens related problem
Based on article about contact related corneal ulcer that wrote by Malaysian Family Physician, incidence of corneal ulcer problem was increase especially that related to contact lens wearer. If this case is late in diagnosis and late to do treatment, it will cause permanent blindness to the patient. High risk of corneal ulcer on people that wear contact lens overnight, over time in wearing contact lens, dry eyes, smoking, lower socio-economic and poor hygiene in contact lens management (Loh, Fammed, and Ophthalmology 2010). In research that has been done at Twintech International University College of Technology, Faculty of Optometry entitled habits of contact lens wearers toward lens care in Malaysia, 56.92% did both rub and rinse lenses before storing it. Then, 45.15% did rub the contact lens case and only 22.45% rinsed the contact lens case with water. Besides that, less than half of respondents did not remember how often they were advised to come back for an aftercare and 29% said that there was not advice about duration on contact lens check up. Bacterial contamination of contact lens and cases can cause ocular infection or corneal ulceration that result on poor lens care (Bhandari and Hung 2012). To handle with this problem, we needs some eye professional to cure it. We also need to prevent it with increase the awareness to patient to know role of wearing contact lens.
From Digital Journal of Ophthalmology, in eye and vision care services, three professionals were involved which are optometry, opticians and ophthalmologist. Each of this profession has there on responsibility but there are interdependent in both their specialties and their accessibility to patient. Nowadays, they have confusion about the responsibility of these three professions (Hall 2000).
Ophthalmologist
American Association for Pediatric Ophthalmology and Strabismus defines that an ophthalmologist is a medical doctor who can perform surgery and practice on medicine and visual system and in the prevention of eye disease and injury. An ophthalmologist can performed all eye services includes prescribe spectacle or contact lens to correct vision problem. They are a medically trained specialist who can deliver total eye care which is primary, secondary and tertiary of eye care.
Qualifications:
To qualified as an ophthalmologist, they must completed four or more years of college premedical education, four or more years of medical training, at least one year of internship and three or more years of specialized medical or refractive training with experience in eye care (Hall 2000). An ophthalmologist is a specialist who is qualified to diagnose, treat and manage all eye and visual systems and is licensed by a state regulatory board to practice medicine and surgery, diagnose general diseases of the body and treat ocular manifestations of systemic diseases (Hall 2000).
optometrist
Optometrist is involved in vision problem. They qualified to examine the eyes and to determine the presence of vision problem. Optometrists also have responsibility on determine visual acuity and prescribe glasses, contact lenses and eye therapies (Hall 2000).
At Hong Kong, in the legislation of optometry in 1996, the registration of optometry was divided into four parts. Registration on part I and II was allowed to fit contact lens but part III is not allowed to fit contact lens. Part IV is depends on their experience. Besides that, part I optometry is allow to use diagnostic pharmaceutical agents. While, other part of optometry can use staining agent (Cheung, Cho, and Edwards 2002)(Yung, Cho, and Yap 2005). Before this, anyone can practice on contact lens without optometry education and without any additional education, all licensed contact lens practitioner can prescribe ortho- K contact lens (Yung, Cho, and Yap 2005).
In Singapore, they have two categories of registration of optometry which are fully registered and provisionally registered. Optometrist that under fully registered is the optometrist that has at least one year experience and recognized qualification. While, optometrist under provisionally registered is the optometrist that less than one year experience and they must work under supervisor in one year (Thai and Yap 2010).
In Australia, optometrist is primary eye care and secondary to referral from eye screening program. The clinical skills of optometrist include case history taking, determination of refractive error, assessment of binocular vision and accommodation, assessment of the health of the ocular structures, visual field assessment; colour vision assessment; assessment of the basic neurology of the eyes and visual pathways, prescription and deliver of spectacles, contact lenses and low vision devices, use of ophthalmic drugs to facilitate diagnostic procedures (Kiely 2009). The first optometrists had their registration approved to allow them to engage in therapeutic practice is started on 2000 (Roth 2007).
Qualifications:
For optometrist, they not attended medical school. They must completed four years study in optometry that trained by qualified optometry college (Hall 2000). According to American Association for Pediatric Ophthalmology and Strabismus, after graduate in degree of optometry, an optometrist can continue study in a doctor of optometry (OD) degree which takes 3 years or more. They are qualified to performing eye exams and vision tests, prescribing and dispensing of lenses, detecting certain eye abnormalities, and prescribing medications for certain eye diseases.
optician
Optician is a technician who create, validate, and deliver lenses, frames, and other optical devices and contact lenses when the prescription to the intended wearer (Hall 2000). According to American Association for Pediatric Ophthalmology and Strabismus, optician is not allowed to diagnose or treat eye disease. Australian dispensing optician association states that a dispensing optician can dispense spectacles, fit contact lenses and other optical devices that prescribe by optometrists and ophthalmologists. They also advise patients on how to wear and care for their spectacles and contact lenses and selling it.
Based on articles wrote by Secretary, Singapore Opticianry Practitioners (SOP), they have various course that conducted by Singapore Polytechnic which are the Certificate of Performance in Ophthalmic Dispensing (COPOD), Advanced Certificate of Performance in Ophthalmic Dispensing (ACOPOD) and refraction. Another course that conducted by Singapore National Eye Centre which is Primary Eye Care Course also attended by some optician (Kwan 2006).
Qualifications:
To work as dispensary optician, they have a minimum of three years academic training. In addition, dispensing optician is illegal if not qualified and register under GOC in United Kingdom.
Based on this review, there are different in practice and how they qualified the ophthalmologist, optometry and optician compared with our country which is Malaysia.
Problem statement
Malaysian optical act 1991 was introduced to control the practice of optometrist; opticians and ophthalmologist in provide vision care to people in Malaysia. There is confusion on the optometrist, optician and ophthalmologist job in Malaysia especially optometrist service and the level of our act compared with other countries.
Conceptual framework:
Malaysia optical act 1991
Compared with
Optometry practice Act 2007 (Australia)
Singapore Optometrists and Opticians Act
Optometrists board Hongkong
Registration of optometrist, optician and ophthalmologist
The practice of optometrist and opticians
Qualification of optometrist
Roles of optometrist, opticians and ophthalmologist. Based on
Objective of the study
General objective:
I propose to review Hong Kong, Singapore and Australian optometrist and optician act to find similarities and differences of our optical act with others county which are Hong Kong, Singapore and Australia.
Specific objective:
To improve optical act of Malaysia so that increase standard and professional design of vision and eye care. In addition, it functions also to enhance vision care quality to the resident in Malaysia and to know at what level of our optical act compared with other countries. I will achieve two goals which are
Find similarities and differences of Malaysia optical act with another country which are Hong Kong, Singapore and Australia.
Compare in term of registration, the practice and roles of optometrist and opticians and qualification of optometrist and optician.
Research question:
What is similarities and different Malaysia optical act with Hong Kong optometrist board based on registration, practice and roles of optometrist and qualification of optometrist?
What are similarities and different Malaysia optical act with Singapore optometrist and optician act based on registration, practice and roles of optometrist and qualification of optometrist?
What is similarities and different Malaysia optical act with Australia optometrist practice act based on registration, practice and roles of optometrist and qualification of optometrist?
So far, what level of our optical act compared with Hong Kong, Singapore, Australia?
Research hypothesis:
There is significant different between Malaysia optical act with Hong Kong optometrist board on registration and practice of optometrist.
There is significant different between Malaysia optical act with Singapore optometrist and optician act on registration and practice of optometrist.
There is significant different between Malaysia optical act with Australia optometrist practice act on registration and practice of optometrist.
Definition and operational terms used in this study:
AMO: Association of Malaysian Optometrist.
Optometrist: The primary eye care professionals who provide comprehensive eye examination and vision care services which includes prescription of glasses and contact lenses, treatment of the visual system in lazy eyes and in cases of binocular vision difficulties, and the detection of common eye diseases.
Opticians: persons that allowed to do eye testing for the purposes of prescription of lenses and spectacles.
Contact lens: a small lens usually made of a plastic material, worn in contact with the cornea or sclera and it function is to correct refractive errors of the eyes.
GOC: General Optical Council.
Primary care: the care a patient receives at first contact with the health care system, usually involving coordination of care and continuity over time.
Secondary care:Â treatment by specialists to whom a patient has been referred by primary care providers.
Tertiary care: treatment given in a health care center that includes highly trained specialists and often advanced technology.
Methodology
Study design:
Based on act and do comparison with another country of optometrist and optician board.
Study setting:
I do this research at UiTM Puncak Alam. This research will do by searching in the internet.
Study period:
This research about 10 months. I started to write the proposal on 17 september 2012 and will start to do research on march 2013.
Data collection procedures:
Find another country optometrist and optician act which is Singapore, Hong Kong, and Australian at internet.
Find another research that show impact of optical act of Malaysia and compare with another country.
Do comparison based on registration of Malaysia with another country registration procedure.
Do comparison based on practice and roles of optometrist in Malaysia with another country.
Find different on how they qualified the optometrist.
Research tools:
Compare it with optical act of another country. Then, find similarities and different it with another country which is Singapore, Hong Kong and Australia.
Gantt’s chart:
Plan
Date
Sept 2012
Oct 2012
Nov 2012
Dis 2012
Jan 2013
Feb 2013
Mac 2013
Apr 2013
Mei 2013
Collection data and optical act from other country
Draft research proposal
Complete research proposal
Do slide show for proposal presentation
Presentation for proposal
Collection of data to start the research
Draft research
Complete research
Prepare research presentation
Research presentation
