OPTOMETRIC PRACTICE IN

PRIVATE SECTOR IN
MALAYSIA
Fariha Hana Abd Razak
BACKGROUND OF STUDY

 Optometrist is the primary eye care provider. The

foundation of the profession as an optometrist is to
provide comprehensive care of the visual system.
 The medical knowledge has advanced, therefore the
understanding of the eye, vision, ocular disease, and
related systemic disease is advancing as well.
 In most developed countries, optometrist is known as
primary eye care practitioner. The definitions of “primary
care” and “primary care optometry” include the
components visual care, ocular health, and care
associated with related systemic disorders (Hopkins D.
2006).
 It is stated in the Code of Conduct for Optometrists and
Opticians recommended by the Malaysia Optical Council
(MOC) that optometrist is responsible for comprehensive
eye checkup and will refer the patient to ophthalmologist
for further investigation of abnormalities found.
 Some of the optometrists in the developed countries
collaborate with ophthalmologists and general health
practitioner to provide comprehensive eye care to the
society, thus this illustrates optometrist as healthcare
workers (Sundling et al. 2007).
 Most of the registered optometrists in Malaysia are
practising in private sector.
 The weight of carrying the title as primary eye care
practitioner is the same between optometrists practising
in private sector and government sector. Optometrists
must establish and maintain the confidence and trust
between practitioner and patient depending on full
application of necessary professional skill, assurance of
confidentiality and on the environment.
PROBLEM STATEMENT

 According to Norhani Mohidin & Anisah Hashim (2011),

there are several problems that hampered
comprehensive eye care practices. Among the problems
are not enough equipment, public perceptions on
comprehensive eye examination by optometrist, public
awareness on the importance of routine comprehensive
eye examination, unsupportive employer.
 The aims of this study is to investigate the practices of
private optometrists in Malaysia. The objective of the
study is to identify the root problems that contribute to
the failure of administering comprehensive eye
examination among Malaysians.
RESEARCH OBJECTIVES
 The general objective of the study is to survey the
optometrist practice in private sector in Malaysia.

 The followings are the specific objectives of the

study.
To identify the root problems behind the
failure of optometrists in
performing comprehensive eye check up.
To identify preferences of optometrist in
practice
RESEARCH QUESTIONS

 What are the root problems behind the failure of

optometrists in performing comprehensive eye
examination?
 What are the preferences of optometrist in
practice?
SCOPE OF STUDY

The scope of the study is to investigate

the root problems behind the failure of
comprehensive eye examination and
preferences of optometrist in practice.
The respondents are the optometrists
practicing in private sector.
SIGNIFICANCE OF THE STUDY

 The study is significant to the optometrists with regards

to how to improve their practices so that optometrists
would attracted more people to get comprehensive eye
treatment and towards enhances the level of awareness
among the public on routine comprehensive eye
examination. By doing so it will catalyse the role of
optometrist as the primer eye care practitioners.
LIMITATION OF THE STUDY

Data was collected cross-sectionally.

Other than that, the data was collected
through postage which the return of the
questionnaire is in the mercy of the
recipients.
OPERATIONAL DEFINITION

1. OPTOMETRY

According to American Academy of

Ophthalmology (2011), Optometrists
are healthcare professionals who
provide primary vision care ranging
from sight testing and correction to
the diagnosis, treatment, and
management of vision changes.
COMPREHENSIVE EYE EXAMINATION

 A comprehensive adult eye examination may include, A case

history including past and present vision and medical issues, as
well as a detailed family history, An analysis of the patient’s
visual needs at home, work, school and play, measurement of
the visual acuity of each eye, individually and together, both with
and without corrective lenses at distance and near, diagnosis of
the refractive status or prescription (focusing power of the eye)
based on a combination of objective (measurements) and
subjective (patient responses to questions) techniques, binocular
vision assessment (ability to see using both eyes together), as it
relates to eye coordination, depth perception, and eye
movements, or in some cases, eye-hand coordination, colour
vision evaluation, assessment of the health of the eye itself both
inside and outside using a biomicroscope, ophthalmoscope and
a dilated eye examination when indicated,
Cont……

 neurological assessment of the visual system including a review

of the pupil reactions, ocular motility, and an assessment of the
peripheral vision, screening for glaucoma, including testing
pressure inside the eye, looking inside the eye at the retina and
optic nerve, as well as performing peripheral vision tests,
additional testing may be needed based on the results of the
previous tests to confirm or rule out possible problems, to clarify
uncertain findings, or to provide a more in depth assessment.
These can include, but are not limited to tests such as retinal
photography, gonioscopy, corneal pachymetry, optic nerve or
macular scans (OCT, GDx, HRT), ultrasound, contrast sensitivity,
and automated visual field testing.
PRIVATE PRACTITIONERS

According to Medical Dictionary (2009), is

the work of professional health care
providers who are independence of
economy or policy controlled by
professional peers except for licencing
and other legal restrictions.
Literature Review
Year Author Findings
2011 Norhani & Among the problems arises in private
Anisah practices is the lack of equipment they
have the basic essential equipment
such as Snellen charts or projectors,
ophthalmoscope, trial lenses, slit lamp
biomicroscope, keratometer and
retinoscope. However not many of
them having tonometer and equipment
for visual field assessment.
Literature Review
Year Author Findings
2011 Norhani & Every private practitioner optometrist
Anisah offers varieties of services such as
consultation, refraction and eye
examination, examination related to
contact lenses and prescription of
vision aids. About 87% of the
practitioners offer extra services that
related to binocular vision, limited
vision coloured vision and screening of
ocular diseases.
Literature Review
Year Author Findings
2007 Sundling Patients that being examined by the
et al. optometrists were referred to the
respective doctors for further
treatment. Some of them work
together with an Ophthalmology
METHODOLOGY
RESEARCH QUANTITATVIE ; SURVEY
DESIGN DESIGN
SAMPLING STRATAFIED RANDOM SAMPLING
TECHNIQUE
POPULATION PRIVATE SECTOR OPTOMETRISTS
(1230)
NUMBER OF 180 (BASED ON Krejcie & Morgan,
SAMPLES 1970)

INSTRUMENT QUESTIONNAIRE ( ADOPTED FROM

NORHANI & ANISAH, 2011)
DATA DESCRIPTIVE
ANALYSIS FREQUENCY AND PERCENTAGES
RESEARCH FINDINGS
LEVEL OF EDUCATION

96%

4%
0%

Degree Master Phd

YEARS OF SERVICE

2 ≤1 year
4%

1 to 5
years
36%
>5 years
60%
NUMBER OF TIMES
ATTENDING CME IN A YEAR

≥4 times
18% none
36%

2 to 3
times
20%

1 time
26%
AFFLIATION
others
2%

AMO
25%

MOC
73%
LOCATION

shopping
mall
22%

shop lot
78%
NUMBER OF PATIENTS/YEAR
100-199
6% 200-299
10%

300-399
20%
≥400
64%
EQUIPMENT AVAILABLE

100.0% 100.0% 100.0%

95.5%
90.0% 90.0%

72.2% 71.7%

48.3% 48.3%
42.2%
36.1%
22.8%
SERVICES PROVIDED

100.0%

82.8% 85.6%

42.8% 42.2%

30.0%
20.0%

consultation refraction CL binocular LV vision therapy others

examination examination examination &
aids
prescription
PATIENT HISTORY TAKING

100.0% 100.0%

71.6%

chief complaints ocular & health history family history

VISUAL ACUITY

100.0% 100.0%

75.0%

distance VA near VA ph/+1.00

PRELIMINARY TEST

100.0% 100.0%

84.4%

66.1%
58.9%

40.0% 36.7% 39.4%

30.0% 32.2%
25.0% 26.1%
REFRACTION METHOD

100.0%

88.3%

68.9%
66.1%

autorefraction retinoscopy subjective refraction binocular balancing

ACOMODATION ANALYSIS
46.7%
41.7%
36.7%

18.3%
16.7%
14.4%
12.8%
10.0%
OCULAR HEALTH
EXAMINATION METHOD
95.0%

55.6%

37.8%

30.0%

slit lamp biomicroscopy ophthalmoscopy tonometry keratometry

THE PREFERENCE ON
PRESCRIPTION TOWARS
PRESBYOPE
97.8%

79.4%

43.9%

single vision bifocal multifocal

LENS PREFERENCE
66.1%

52.8%
48.8%

42.8%

essilor hoya carl zies others

CONTACT LENS PREFERENCE

86.7%

36.7%

16.1%
13.8%

daily biweekly monthly conventional

CONTACT LENS BRAND
PREFERENCE
72.2%

51.7%

42.8%
36.1%

26.1%

Baouch & Lomb Johnson & Johnson ciba vision Oculus others
FACTORS CONTRIBUTE TOWARD
THE FAILURE OF COMPREHENSIVE
EYE EXAMINATION
94.4%
87.2%

30.0%

18.3%
13.3%
6.1%

lack of patient lack of forgot to perform employer's lack of skills others

equipment time certain discouragement
procedures
CONCLUSION
CONCLUSION

 The findings revealed that among the root problems

behind the failure of performing comprehensive eye
examination is due to lack of equipment in their
premises, patients attitude towards getting routine
comprehensive eye examination. Other reasons are lack
of skills and forgetting to perform certain important
procedures. This in line with the findings from other
studies elsewhere.
 The study also revealed that optometrists had performed
most of the essential procedure for eye examination. In
conclusion optometrists performed a comprehensive eye
examinations when they need to do one.