Antique laws putting eyes at risk

Although local optometrists trained abroad are taught to do specific diagnostic tests for certain eye diseases, antiquated legislation (Optician’s Registration Act) prevents them from doing so. A consequence of this is that members of the public must go to an ophthalmologist for what is regarded as routine tests. However, they may have to wait as long as two months for an appointment at a private facility and even longer in the public health service. One optometrist told Newsday one of her patients was given an appointment for 2005, “by which time that woman would have gone blind.” This untenable situation has caused a member of the public to write to the Permanent Secretary in the Consumer Affairs Division to complain. While she did not want her name used, the woman who suffers from myopia said in a letter dated September 9 that she waited for two months to get an appointment with an ophthalmologist for an eye examination.

At the end of August she called the doctor’s office only to be told there was an emergency and her appointment was cancelled. She was told the next available appointment was at the end of September. “The minimal cost for a basic eye test when visiting an ophthalmologist is $150. With each additional test such as a dilation of the pupil, the fee increases considerably. On the contrary a visit to an optometrist costs an average of $75 for a basic eye test and one can get an appointment in under a week’s time.” She said her own research has found that optometrists are not allowed to undertake certain diagnostic tests in TT because they are still operating under an ancient law which only allows ophthalmologists to do them. The Westmoorings resident said she became aware of the situation almost ten years ago when an optometrist trained in Canada told her that she was allowed to do pupil dilation in that country but on her return home was told she could not do it here.

She said further research into the issue found that despite much advocacy involving local and foreign professionals, they “are unable to get the law amended to allow them to undertake some basic tests for which they are trained, because of strong opposition by ophthalmologists.” The writer said in the meantime myopic persons like her who cannot afford the ophthalmologists bill run the risk of going blind because they cannot get an early appointment. It is uncertain when the legislation will be amended. Contacted last week Chief Medical Officer Dr Rampersad Parasram who is Chairman of the TT Opticians’ Registration Council which is responsible for developing appropriate standards said “on going discussions” have been taking place at the level of the Council. He declined to comment on the Government’s legislative agenda. Parasram said the issue will have to be looked at carefully. The amendments can be made in two ways, via a recommendation to the Minister for the registration to be reviewed or the Minister asking the Council to examine the legislation and make recommendations.

President of the TT Optometrists Association Lauren Robinson is skeptical because several attempts over the years have been made to get changes to the legislation. “We are at our wits end as to what to do next,” Robinson said.  The amendments have been “shelved” by Health Ministers. Robinson said optometrists in the United Kingdom, United States and Canada are trained to do diagnostic tests. She said no additional training is required since this is expected. Optometrists in TT cannot do a dilated fundus examination, which is done on diabetics, people with high myopia and for detecting early cataracts. Robinson would like to see a system whereby optometrists and ophthalmologists work together with optometrists doing “run of the mill diagnosis and difficult cases that need urgent treatment” are referred to the ophthalmologist. She said this would help ease the backlog of diagnosis screening, especially as TT has a high incidence of diabetes. By failing to amend the law, Government may also be infringing on the rights of the optometrist to fully use their skills. “As you land in TT your rights are taken away.”