In March 2011, there are about three thousand (3000) registered opticians in Malaysia and about seven hundred (700) optometrists. These registered opticians are registered with Malaysian Optical council (MOC) as optician, whereby they are allowed under the Malaysian Optical Act (1991) to prescribe only spectacle to patients. They are not allowed to prescribe contact lenses unless they pass the qualifying examination offered by Malaysian Optical Council. According to International standard and practice in most advance countries of the world, these opticians are not qualified to prescribe spectacles and contact lenses to patients but are qualified only to dispense spectacles or contact lenses prescribed by the optometrists or ophthalmologists. These opticians are qualified to dispense spectacles or contact lenses prescribe by optometrists or ophthalmologists because they have obtained only a certificate in dispensing technology. The most common certificate of dispensing optician obtained by opticians in Malaysia is FBDO which stand for Fellow of British Dispensing Optician or FADO which stand for Fellow of Association Dispensing Optician. This fellowship is issued by the association after attending a course in dispensing technology for several months. In the United Kingdom, those with this fellowship are only qualified to dispense spectacles or contact lenses prescribe by Optometrists or Ophthalmologists, while in Malaysia under the Optical Act 1991, these dispensing opticians or commonly known as opticians and under the optical act 1991 with the clause; with the permission of the Health Minister are allowed to prescribe spectacles.
In 2011, the situation in Malaysia, remains the same and the Optical Act 1991 remains unchanged and the number of these dispensing opticians or opticians grows in number. Now there are about three thousand (3000) opticians in Malaysia. They have an association by the name of Malaysian Association of Practicing Opticion (MAPO) and Malaysian Optometrist Association (MOA). They have changed the word dispensing optician to practicing optician. Although according to world standard dispensing opticians are not qualified to examine eyes and prescribe spectacles, yet under the Optical Acts 1991, in Malaysia, they are allowed to prescribe spectacles. Although they are allowed only to prescribe spectacles yet there are some opticians who are also prescribing contact Lenses to the public. Because of monetary gain, these opticians have disregarded the safety and health of the patient’s eyes. Malaysian Optical Act must protect the interest of Malaysians consumers. Ministry of Health must do constant monitoring in order to prevent abuses on the optical acts. Opticians must not be allowed to prescribe contact lenses unless they have passed the contact lens qualifying examination conducted by Malaysian Optical Council (MOC). Laws should be made to protect the interest of the community at large and not the few. Laws must bring justice to prevail and injustice to perish. In my opinion it is about time for the Optical Act 1991 to be revised and modified. Our three thousands registered opticians should take a course in Diploma in Opticionary for three years or 6 semesters, in order to qualify them to prescribe spectacles in Malaysia. All practicing Opticion with FADO or FBOA are qualified to enter the course which can be conducted on part-time or full-time basis. At the moment there is only one college in Malaysia that offers a course in Diploma in Opticionary. Faculty Optometry of Twintech International University College with all the facilities and academicians is about to start the course of Diploma in Opticionary. With the grace of Allah, the Faculty is hoping to start the course of Diploma in Opticionary and Certificate of Dispensing Technology in July 2012. After completing the Diploma in Opticionary the Opticians can continue their study for two years and obtain a Graduate Diploma in Optometry. With this Graduate Diploma in Optometry they can register themselves as an optometrist with the Malaysian Optical Council. As an optometrist they are qualified to prescribe spectacles and contact lenses and other optometric services, as the other Optometrists with Bachelor of Optometry.
Twintech International University College will also start the course in certificate of Dispensing Technology probably in this coming July and the course takes about one year (3 semesters) of study and the entrance requirement is SPM at least pass in science subjects. Currently in Malaysia, Axismatic Professional Institute in Cheras offers a course that award a fellowship FBDO with 6 semesters. Certificate in Dispensing Technology awarded by Twintech will be equivalent to FADO or FBDO and, all those having FADO, FBDO or Certificate of Dispensing Technology should only be allowed to dispense spectacles prescribe by Optometrists or Ophthalmologists and not to prescribe spectacles or contact lenses. In future, all Optometrists or Ophthalmologists in the private practice who want to practice dispensing must employ only those with FBDO, FADO, Certificate of Dispensing Technology or Certificate in Optometric Assistant to dispense their spectacles. The current practice of employing only the form five school leavers to do dispensing must be put to a stop. In the future, we hope, we will only have Optometrists and Ophthalmologists to prescribe spectacles or contact lenses and the Dispensing opticians to dispense the prescription given by the Optometrists or Ophthalmologists.
Currently in Malaysia those who are Optometrist will have the Green Certificate and they are license to practice the full scope of optometric practice. Optometrists will the Green Certificate are qualified to prescribe and dispense both spectacles, contact lenses, prisms and low vision aids. Registered Opticians with FBDO or FADO will have the Blue Certificate and they are license to prescribe and dispense only spectacles and those who have pass the qualifying examination for contact lenses with have on addition to the Blue Certificate, a Pink Certificate. Recently the Ministry of Health has asked all the practicing optometrists and dispensing optician to display their certificates in their practices. Malaysians must have the right to know and to choose who should be examining their eyes and who should be prescribing them, their spectacles and contact lenses. However our government must ensure that Malaysian public is guided in making their choice. Information on the availability of Optometric and Opticionary services in Malaysia must be made known to the public. Optician must not call themselves Optometrist and to those Opticians who try to mislead the public must be fined heavily. There should be programme in television and also in radio explaining to the public on the difference between Optometrists and Optician and career guidance talks in television and radio on how to become a Dispensing Optician, an Optician and Optometrists. There is very little awareness among the Malaysian public on eye health and vision safety. This happen because there is basically no or very little programmes in our television and radio on the subject of eyes health and vision safety. There are many young teenagers who are wearing coloured contact lenses which they have bought in the night market .Instead of visiting the Optometrists for their contact lenses; they bought their contact lenses from the non-qualified persons in the street. These teenagers probably have thought that buying contact lenses is the same as buying toothbrush. They do not know that contact lenses are medical devices which are safe to be used only when it is prescribed by an Optometrists or opticians with the Pink Certificates.
Our level of eye health and vision care is very low in Malaysia. Generally all Malaysians including the medical doctors and some ophthalmologists do not know the real role that optometrists can play towards achieving a high level of eye health and vision care in Malaysia. Ophtahlmologists are medical doctors who are specializing in ocular diseases and surgery while optometrists are not a medical doctors but specializing in detection of ocular diseases and the treatment of vision anomalies. Although Optometrists are not medical doctors but their knowledge in ocular diseases in both diagnosis and treatments are far better than the normal medical doctors. During their medical training, medical students are only posted in the ophthalmological department in the average for two weeks and this cannot make them better than the optometrists who are trained for four years. Optometrists learn about the eyes, including eyes diseases, vision anomalies, and treatment of vision anomalies for about four (4) years. In some countries in the west including Great Britain and United States have allowed Optometrist with certificates in Clinical management of eyes diseases to prescribe not only spectacles and contact lenses but also ophthalmic drugs to their patients. It would be much better if all patients with eyes problems in our hospital to be seen and examined first by an optometrists instead of ophthalmologists or medical doctors who are trained to become ophthalmologists. It is a mere waste of time on the part of the ophthalmologists; when after a through eye examination only to find out that the patients needs only a pair of reading glasses or distant spectacles. In this way the long queue of patients waiting to be examined by the doctors or ophthalmologists can be made shorter.
In our hospital, we should have a separate Department for Optometry and Ophthalmology. Department of Optometry must be in close contact with the Department of Ophthalmology. Department of Optometry will handle all the problems related to vision anomalies and treatment of simple eye diseases while the Department of Ophthalmology will handle all the problems related to diseases and surgery of patients who are referred to them by the Department of Optometry. All patients with eye and vision problems must be seen and examined by the optometrists before they can be seen and examined by the ophthalmologists. Optometrist should be made as the primary eye care professionals and they should work in close association with the ophthalmologists. Ophthalmologists should not look down to optometrists and regard them as their assistants. Optometrists are not a medical assistant to the ophthalmologists and neither they are inferior to the ophthalmologists. Both are professionals who are specializing in different areas of eye cares. Both professions should recognize their own strengths and weaknesses and willing to work hand in hand in providing the most efficient and effective eye and vision care to the public. In Malaysia we should made continuous education be made compulsory to all professional including optometrists and ophthalmologists. Attending continuous education should be made one of the requirements to apply for license to practice. There are optometrists who are no longer aware of the recent development in optometry and ophthalmology, because they have not attended any continuous education programmes since the day they have graduated as an optometrist.
In order to solve the current problem in the country, Twintech International University College of Technologies offers the course in Certificate in Dispensing Technologies which is equivalent to FBDO, Diploma in Opticionary, Graduate (Advance) Diploma in Optometry and Bachelor in Optometry (Hons). All those with certificate in Dispensing Technologies and all the current opticians in the country (about 3000 with no or with FBDO) who under the optical Act 1991 can prescribe spectacles should upgrade themselves to the level of becoming a truly qualified Optician by enrolling themselves to the course of Diploma in Opticionary(3 years course) offered by Twintech. After getting the Diploma in Opticianary, they can proceed to do Graduate or Advance Diploma in Optometry, offered by Twintech which takes another two years, and once they obtain the Graduate Diploma in Optometry, they are recognized to be the same as an Optometrist. We hope in time Malaysia will only have Optometrist and qualified Optician and qualified Dispensing Technologies. Contact us at TWINTECH
Prof. Dr. Nasoha Saabin
Dean of Faculty of Optometry
International University College of Technology Twintech
Kuala Lumpur, Malaysia