Better Eye Care For All

21 Jun 2007

By Mr Khaw Boon Wan

Venue: Alexandra Hospital

Distinguished Guests

Ladies and Gentlemen

By some historical accounts, optometry and opticianry began in 13th century Europe, when spectacles were invented and when scientists began to understand the science of lenses. However, the practice of optometry and opticianry as a profession was a more recent development. In the US, the first legislation on optometry was enacted in Minnesota only in 1901.   

By now, almost all major countries have legislation in place to regulate their optometrists and opticians. Singapore has been an outlier as we largely leave the industry to self-regulate. There is an active and competitive market and consumers are free to choose. But there is also some confusion. Not many Singaporeans are familiar with the differences between optometrists and opticians. Some use both words interchangeably. Many probably regard all persons handling and selling spectacles as opticians. 

Occasionally, we receive complaints of poor standard of eye care by some opticians. Once in a while, our ophthalmologists get some poorly managed cases in their eye clinics and have to take corrective treatment.  

The Ministry of Health has realised that the status quo is unsatisfactory. But given the historical tradition of this trade, legislation cannot be done over night.  Several major pieces have to be in place.

First, we need to ensure that there are enough trained optometrists in the market. Otherwise, a premature legislation will merely force up costs at the expense of the consumers. In 1994, Singapore Polytechnic launched the first diploma course in optometry with a class of 40. By now, over 600 optometrists have been trained by Singapore Polytechnic. In addition, many Singaporeans have on their own studied optometry at university level overseas.

Second, in 1996, we took the next step to regulate the practice of contact lens when the Ministry introduced the Contact Lens Practitioners (CLP) Act. The implementation was smooth.

We are now ready to take the next major step. Last month, I introduced in Parliament the Optometrists and Opticians Bill. It will be debated next month and I hope to secure the support of the Parliament for the Bill, bringing Singapore on par with global best practice in eye care legislation. This will formally recognise the practitioners of optometry and opticianry as healthcare professionals. 

Good visual health is part of the total well-being of an individual. Until recently, I have enjoyed 20/20 perfect vision, without the need for any spectacles. But now I need the reading glasses when confronted with fine print. Reading the menu at candle-light dinner is particularly a hassle. However, this is part of growing old and we just have to take it in its stride. 

The primary purpose of our legislation is to ensure safe standards of eye care for the public. As professionals, your customers look to you to provide safe and quality care for their eyes and vision. Our proposed regulatory framework will require all optometrists and opticians to keep up with new developments and maintain a high standard of professionalism and ethics. 

In developing the regulatory framework, MOH has consulted widely. We have received valuable suggestions and advice from the public and the stakeholders, including the Singapore Optometric Association, Singapore Opticianry Practitioners and Singapore Polytechnic Optometry Centre. I thank you for your active participation.

We are mindful that regulation may disrupt existing optometrists and opticians, and we have taken great care to ensure that the legislation will be sufficiently inclusive. It will not unduly affect your practice. 

If Parliament supports the proposed legislation, MOH hopes to register optometrists and opticians in the second half of this year. 

For optometrists, those with recognised qualifications and at least a year of optometry experience will be fully registered. Optometrists with less than a year of experience will be provisionally registered; they will have to work under supervision for 1 year before they become fully registered. 

For opticians, those with work experience of at least 5 years will be fully registered as opticians if they pass a competency test. Those with 2 to 5 years of experience will need to undergo a part-time modular upgrading course. There may be some opticians who do not intend to do any refraction but wish to do only dispensing; they will need to undergo a competency test or failing which, an upgrading programme but without the refraction component. This will ensure that they can uphold safe standards in dispensing. 

Opticians with less than 2 years experience and henceforth all new entrants to the profession will need to attend a certificate course in opticianry in order to qualify for registration. We have asked Singapore Polytechnic to organise such a course.  

All registered contact lens practitioners will automatically be fully registered as opticians. If they wish, they can seek conversion to optometrists, either by passing a competency test or going through a 2-year modular conversion course depending on their years of experience. 

Even after legislation, we hope that all optometrists and opticians will continue to exercise concurrent professional self-regulation and strive to raise your professions to greater heights. We would also like to see the two professions work hand-in-hand to deliver the best results and patient outcomes in primary eye care.

I am therefore pleased to see the hosting of the National Congress of Optometry and Opticianry. Through such forums, you can share and expand your knowledge. This Congress is one of the many activities that the Alexandra Hospital organises in support of the professional development of optometrists and opticians. I also learn that Alexandra Hospital has allowed its eye clinics as clinical attachment postings for optometry students and existing practitioners. The others should also do the same.

This year, the Singapore Polytechnic has raised its intake of optometrists to 100 students. Other polytechnics have expressed their interest in offering similar courses in optometry and opticianry. As more trained professionals enter the market, consumers benefit through greater choices. This will also bring benefits to our busy ophthalmologists, relieving them to concentrate on higher-end ophthalmology practice and clinical research.  The end result is better eye care for all.

On this note, I wish you a fruitful Congress.

Thank you.