What is the difference between an Optician, Optometrist and an Ophthalmologist?

Opticians are health professionals trained to supply, prepare and dispense optical appliances, interpret prescriptions prepared by Ophthalmologists and Optometrists, and fit, adjust and adapt optical appliances.

Optometrists are health professionals trained to assess the eye and visual system, sensory and ocular motor disorders and dysfunctions of the eye and the visual system and diagnose refractive disorders. An Optometrist prescribes and dispenses corrective devices.

Ophthalmologists are medical doctors who specialize in eye and vision care, diagnosis and the treatment of eye disease and provide eye health exams, prescribe corrective lenses, prescribe and administer medication and perform surgery.

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When should I see an Optician?

  • If you wish to have expert advice about vision care products such as eyeglasses or contact lenses, if you are ready to invest in new eyeglasses or contact lenses, if you are looking for a source of general information about vision health or if you are in need of maintenance on your existing eyeglasses or contact lenses.
  • If you believe your prescription for eyeglasses or contact lenses need upgrading, you are otherwise healthy and have had an eye health examination at the recommended frequency; opticians in British Columbia and Alberta can provide you with refraction.
  • Of all vision care professionals, Opticians have received the most in-depth training in fitting, adjusting and dispensing of eyeglasses and contact lenses.  Opticians are the experts in understanding your vision problems and how a variety of optical products can resolve those problems.
  • If you are in doubt about which vision care professional you should see, speak with an Optician.  Opticians are accessible, approachable and you can feel confident that an Optician will refer you to an optometrist or a medical doctor as appropriate to meet your needs.

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What qualifications does an Optician have?

All Canadian Opticians must meet the same standard of competence, which has been developed, peer validated and published by the National Association of Canadian Optician Regulators.  There are over 800 competencies detailed in the National Competency Matrix.  Click here to view the National Competency document.

In addition all Opticians registered to practice in B.C., Alberta, Saskatchewan, Manitoba, Ontario, Newfoundland, New Brunswick, Nova Scotia and Prince Edward Island must have passed the National registration examination to qualify to practice in those provinces.  The National registration examination was developed with consultation from a wide variety of professionals.  It is validated and re-validated on a scheduled basis by an independent examination assessment company.

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Who do I contact if I have a complaint about an Optician?

Like other health care professionals Opticians are regulated and must meet a Standard of Practice.  Each province has a regulatory body that receives and adjudicates consumer complaints.  Click here for a list of Canadian regulatory bodies

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Am I required to purchase glasses or contact lenses from the same place that I get my prescription?

You should not feel obligated to purchase your glasses or contact lenses from the practice that has provided you with the prescription.  The prescription is your property and you should ask for and be able to receive that document without condition or stipulation.  The prescription forms a part of your medical record.  You should, however have your eyeglasses or contact lenses dispensed by a regulated vision care professional.

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What about my contact lens prescription?  Am I entitled to a copy of that document?

There is no such thing as a contact lens prescription.  Both eyeglass and contact lenses are based on the same prescription.  What many people misinterpret as a contact lens prescription is a set of specifications recording size, thickness, water content and adjusted power.  Any competent contact lens fitter should be able to fit you with a pair of contact lenses based on the same set of numbers – the prescription – that would be used to make a pair of eyeglasses.

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How often should I get my eyes tested?

The Opticians Association of Canada endorses frequency recommended by the Canadian Ophthalmological Society. Click here to see that summary.

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Can I sleep in my contact lenses?

With all contact lenses you should follow the wearing and maintenance schedule set out by the person who fit you with the lenses.  Although a specific contact lens may be designed for overnight use, some people will not be able to tolerate that wearing format. 

It is always best to consult with your practitioner before deciding to wear your contacts overnight.  Ordinarily the practitioner will want you to try wearing the lenses for a limited period of time in an overnight wear format and will then want to see you shortly thereafter to make certain the wearing schedule is right for you. 

If you do wear your lenses overnight but wake up with unusual crustiness around your lid margins, if you have trouble getting your eyes open, if you have redness of the white area of your eye upon getting up, if you have difficulty removing the lens from your eye, you need to see your practitioner immediately.

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Is there some reason why I shouldn’t purchase eyeglasses and contact lenses on the Internet?

The purchase of eyeglasses and contact lenses is an investment in a health care product.  When you purchase from the Internet you are investing your vision care dollars in a faceless clerk and perhaps even in a robot who selects your product and delivers it to you.  When you invest with an Optician you are bringing added value to your product from the knowledge, skill, trustworthiness and reliability of the Optician.  When you purchase from an Optician you can have the confidence of knowing that your Optician will be there for you should you have subsequent problems with your eyeglasses or contact lenses. 

Your Internet provider cannot provide you with this same added value but instead makes profit from relying on a regulated professional to do the necessary preliminary work-up as well as the important follow-up.  If you purchase your product on the Internet you should count on being charged a service fee if you need assistance from a regulated professional.

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I’m getting bifocals for the first time.  What are some of the questions I should ask?

You need first to distinguish between bifocals and what are popularly called ‘invisible bifocals’.  Bifocals are lenses that provide two areas of distinct vision – one for far and one for near.  They are characterized by a specific dividing line between far and near.  ‘Invisible bifocals’, are progressive power lenses.  The wearer is able to see clearly at more than two distances.  There are no lines to distinguish where the powers change but inspection of the lenses will show there are areas where powers are blended.

When you are ordering eyeglasses you are making an investment in both the product and the person who provides you with the product.  When asking questions you are serving two purposes:
1. You are looking for answers to questions about the products that are available
2. You are trying to establish whether or not the person giving you those answers is knowledgeable, trustworthy, caring, understanding – in other words the type of person who will give you best advice and service.

The first thing to do is show the Optician your prescription.  This will provide the Optician with an idea of what products might be best for you.  Some prescriptions will perform better and look better with wise selection of frame and lens format.

The Optician should ask how you use your eyes.  What are the distances at which your work?  What sports do you play and what hobbies do you have? This will dictate which lens styles will work best for you.  All lenses have advantages and disadvantages.  The key is in finding a lens format where the advantages outweigh the disadvantages.  Often a two-pair solution is right for you – a work specific pair and a pair for general use. 

You should ask the Optician if any size or shape of frame would work best for your lenses.  If you do want to have progressive lenses there may be limitations to the depth of the frame.  As an example, some lens designs offer larger areas of near vision or intermediate vision than others.

Ask what visual experiences you may have when you wear progressive lenses for the first time.

All lenses require some period of adaptation by the wearer.  Your Optician should be able to guide you through ‘getting used to’ the lenses and give you tips about how to move your head and how to hold your reading material.  For those who work at a computer your Optician should be able to suggest ways you can alter your work environment to make it more compatible with your new lenses.

Ask what the pros and cons are for both bifocals and progressive lenses.

No lens format is 100% suitable for 100% of people 100% of the time.  The benefit of bifocals is that they have two large clear areas of vision.  You can easily find the reading area.  The lens is usually fit so that the demarcation line is in front of the point where your lower lid begins.  

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Will a product of lower price provide me with the same quality of vision as that of a higher price?

Prescription eyeglass lenses - There are many different types of lens materials and lens designs.  When you deal with an Optician you can be guaranteed of the accuracy of your lenses.  They will meet a National standard that has been investigated and peer reviewed.  What may cost more is if you want to have thinner lenses, or lighter lenses or coated lenses.  The additional features will add to the price of the lenses and may provide you with extra visual comfort but fundamentally no matter which lens you select it will be accurate.

Prescription eyeglass frames - There are also many different frame styles and materials.  A lesser-priced frame is less likely to have the design or structural features of a more expensive frame however there are instances when an Optician is able to take advantage of sale prices on premium frames and pass that savings on to you in the same way that Winners does with clothing and other household items.  A frame merely serves as a support for your lenses and it should perform that function well.  Any additional features about the frame are there to make you feel better about wearing your eyeglasses.

Contact Lenses – All soft contact lenses sold in Canada must meet Health Canada’s standards safe manufacturing and packaging. Rigid Gas Permeable lenses are manufactured in much the same way as eyeglass lenses – each one a custom fit.  Both types of lenses must meet a National standard for accuracy.

There are costs involved with the dispensing of contact lenses that the average consumer doesn’t consider but which relate to maintaining your good eye health.  In order to do a proper job of fitting a pair of contact lenses an Optician must perform several observations and take several measurements using specialized equipment.  In doing so the Optician is able to establish a base line of ‘normal’ for your cornea.  This base line will be used to compare to subsequent observations of the cornea after the contact lenses have been dispensed and worn for a period of time.   Your Optician is your resource for anticipating and resolving eye health issues before they occur.

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Why do I have to dispose of my disposable contact lenses?  They seem very comfortable on the day I’m supposed to throw them out.

When you put on a fresh pair of contact lenses they will feel very good.  Your vision will seem clear and you won’t even know you’ve got them on.  As you wear the contact lenses day after day, the contact lens surface and matrix slowly absorb your tears, debris from your eyes, and chemicals from cleaning or storing solutions.  This deterioration combines to make the lenses less comfortable and your vision less clear but the problem is you have no way of comparing how good they felt on that first day and how crisp your vision was, with comfort and vision on the 7th day or the 30th day.

The reason manufactures recommend disposal after a specific number of days is because they have done extensive testing on their lenses and have found that for most people the stipulated date of disposal is best in order to avoid problems.

Beyond that, your contact lens practitioner is in a better position to tell you whether or not you should stray from the recommended wearing regimen.  Each individual will respond differently to extended wear of lenses.

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What’s the difference between refraction and an eye health examination?

Either an ophthalmologist or an optometrist performs a vision health examination.  The purpose of the examination is to observe both the external and internal tissue of the eye to determine whether or not there are existing or incipient signs of eye disease.  Click here for the Canadian Ophthalmological Society statement on recommended frequency of eye health examination.

Refraction is a data gathering process whereby a measurement is taken of the optical system of your eye to determine whether or not your vision can be improved by the addition of prescription lenses.  Refraction itself is a mechanical process.

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What is a vision screening test?

A vision screening test simply assesses your visual acuity.  It measures your vision against what is considered to be 20/20 vision.  There is no ‘pass’ or ‘fail’ result for a vision screening test.  A vision screening test may include a test for depth perception, peripheral field of view, colour perception or fusion.  Upon completion of a vision screening test you may be advised to see an optometrist.

A vision screening test does not replace either a refraction or an eye health examination.

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