THE STATE OF OPTICIANRY

By Maryann Santos

Release Date: February 9, 2021

Expiration Date: February 9, 2024

Learning Objectives:

Upon completion of this program, the participant should be able to:

Define what an opticianry apprenticeship is.
Differentiate between formal education and apprenticeship in opticianry.
Describe the newest designation for opticians.
Discuss the results of The Summit.

Credit Statement:

This course has been ABO approved for 1 Hour, Non-Ophthalmic Course Number: SWJHI016. General Knowledge continuing education credit by the ABO/NCLE. To earn ABO/NCLE credit, please review the questions and take the test at 2020mag. com/ce. Note: As of January 2020, no tests will be graded manually. Please call (800) 825-4696 for more information.

This course brings a broad perspective of the profession of opticianry in the United States. The requirements to become a professional optician varies state to state and includes one or more paths among them: apprenticeship, certification, licensure and formal education. We will review the role of state societies, national associations and accrediting bodies relative to their promoting, mentoring, providing community and continuing education to advance the field of professional opticianry. This course will open the topic of the profession of opticianry to the industry as we share the challenges and efforts made toward the advancement of the profession, as we will lay out the ultimate vision for our profession.

One of the key challenges in advancing the profession is having consistent licensure/certification standards nationwide for education and continuing education. Table 1 illustrates the variances across the 50 states in education, apprenticeship, contact lenses fitting, CE requirements and access to state optician associations. More states are unlicensed than licensed. An informal count of the number of opticians in unlicensed states listed in the ABO database as ABO certified is roughly 10,000, demonstrating the desire of opticians to hold a professional designation representative of having met minimal competency levels in their field, even when their state has no requirements or standards. Note: Licensing requirements vary from state to state. Some states require nothing more than a fee paid yearly with no educational/ certification/apprenticeship requirements while other states require certification/degree and fee and continuing education requirements. Imagine this scenario in unlicensed versus licensed states: Rita and Roman can open up an optical store in Idaho with no credentials or licensure. However, in Connecticut, Jerome and Julia have to complete a four year apprenticeship no less than 8,000 hours or graduate with an associate’s degree in ophthalmic studies from a Board of Examiners for Opticians approved accredited college or university and have an Optical Shop Permit. Collectively, we must ask why.

According to the Vision Impact Research study, 3 out of 4 people wear corrective eyewear. Yet when asked, many are unaware of what an optician is or what level of skill is required. Where does the blame lie for this? Does the fact that most states are unlicensed contribute? We need a unified voice backed by minimal competency standards for all opticians across the country.

• Forty-two percent of the states require licensure for opticians. All of these licensed states have an apprenticeship program. Fiftyeight percent do not have a state licensure program.

• Twenty-six percent of the states have at least one college or university that teaches opticianry. Seventy-four percent of the states do not offer formal education. The northeast, down to Florida is home to most formal education programs. The small state of New Jersey has three programs, as well as Georgia and New York, and Florida has four.

• Twenty-four percent of the states allow for contact lens fitting. Twenty-six percent do not allow the optician to fit contact lenses.

• Sixty-two percent of the states have an Opticianry State Society. Thirty-eight percent do not.

• Forty percent of the states have a formal opticianry apprenticeship program. Sixty percent do not.

FORMAL APPRENTICESHIP

One of the main deterrents to obtaining a degree in Ophthalmic Optics is the lack of access to formal education, with few schools/ colleges offering a formal ophthalmic optics program. Many states lack any form of formal education programs in Ophthalmic Optics, while others have one to four locations to serve an entire state. Online/Distance Learning programs are beginning to emerge that require limited physical attendance, such as for the practical hands-on exam but there are few. Online opticianry programs require a mentor along with access to facilities with the tools and equipment needed to meet competencies. Achieving standardization in Apprenticeship Training programs nationwide becomes a key element of obtaining consistent training for a professional optician designation. Apprenticeships have been a form of occupational training since the Middle Ages. Most skilled trades have apprentices work for years under the tutelage of teachers who are often masters of their craft. Apprenticeships are still active today: plumbers, carpenters, masonry workers, sheet metal workers and ironworkers. Currently, 40 percent of the states have formal optician apprenticeship programs with variances such as the length of time and number of required hours. Below the Connecticut Department of Public Health website outlines their apprentice evaluation standards. The supervising licensed optician must certify that the apprentice satisfies these Connecticut state apprenticeship requirements.

EVALUATION: Please rate the apprentice’s ability to perform activities in each of the following areas: (1 = Ready to Perform Competently Without Supervision; 2 = Able to Perform Competently Only With Supervision; 3 = Does Not Perform Competently Even With Supervision; N/A = Has not yet been trained in this area):

• Neutralizing and Producing Ophthalmic Lenses

• Mounting Ophthalmic Lenses to Supporting Materials

• Fitting and Adjusting Final Eyewear to Ultimate Wearer

• Repairing Optical Frames or Mountings and Supplying Repair Parts

• Measuring Interpupillary Distance and Multifocal Seg Heights

• Lay Out and Mark Up for Bench

• Keratometry and Interpretation of Corneal Curvatures

• Design of Hard and Soft Contact Lenses

• Neutralizing Contact Lenses

• Biomicroscopy

• Dispensing Contact Lenses to the Ultimate Wearer

• Obtaining Visual Acuity by Use of a Snellen Chart

The National Academy of Opticianry (NAO), which operates as a professional trade association with an executive director and board has a home study program called the Ophthalmic Career Progression Program (OCPP), to educate the apprentice optician on optical theory and formulas. The following states approve completion of the program toward apprenticeship hours: Arkansas, Arizona, Florida, Georgia, Massachusetts, Nevada, New York, North Carolina, South Carolina, Tennessee, Virginia and Vermont. Each state requirement is state specific.

All OCPP applicants must: 1. Be a high school graduate or in possession of a GED or foreign equivalent. 2. Be currently employed in an optical position, and 3. Have a qualified sponsor.

The value of the Ophthalmic Career Progression Program is recognized as: • Preparation for national certification and state licensure examinations.

• Substantive reference by the National Apprenticeship and Training Standards Committee for Ophthalmic Dispensing Opticians.

• A core for several state opticianry apprenticeship programs.

The Ophthalmic Career Progression Program has two primary objectives:

1. Increase the competency level of ophthalmic dispensers by providing educational opportunities for dispensers who are not attending formal academic programs, and
2. Improve eyecare through increased knowledge, skill and competency procedures.

NATIONAL LEADERSHIP

The Opticians Association of America (OAA) is the national organization representing opticians and is an active and thriving group whose mission is to be the “collective voice of the opticianry industry.” The OAA works with its members to ensure that opticians receive recognition, respect, opportunity and protection within the confines of the profession. The OAA works in multiple media formats to further a positive and informed brand image for opticianry in both local and national markets. They work to unite and strengthen the profession; all state societies would benefit by joining the OAA.

THE PROFESSIONAL REGISTERED OPTICIAN PRO OPTICIAN

During the 2019 OAA Leadership Program meeting, the OAA Board announced the National Optician Initiative. This program aims to ensure a high level of competency and consistency for opticians throughout the country. The program establishes the American Board of Opticianry Practical Exam (ABOP) and the National Contact Lens Examiners Practical Examination (NCLEP) as the officially preferred practical examinations for all opticians. This initiative would institute a new category of optician— the PRO, Professional Registered Optician—which would recognize all opticians through uniform testing for competency, regardless of state licensure status. This would also assist in creating a clear path of mobility for opticians who desire to relocate from state to state, even when moving from an unlicensed to a licensed state. Dibby Bartlett, OAA president in 2020, had this to say: “The OAA is tremendously excited about offering this new designation of PRO optician for non-licensed states. It encourages education and professionalism for the optician, as well as assistance with mobility. Additionally, a PRO optician helps to ensure consumer confidence.” As it is now with some states being licensed and some with no license required, it can be confusing to the public. The OAA believes that this new standard would provide access for opticians in unlicensed states to reach the same testing competency level as opticians in licensed states, and the PRO designation will create a clearer path of mobility for opticians who relocate to another state.

Opticianry might be the only health care profession not making strides over the past few decades. While other professions standardized and increased educational requirements, certifications and licensure, the table below and data above show inconsistent levels of professional duties, responsibilities and training/education for opticians across states. This initiative by the OAA, along with state-run consumer campaigns, will help increase consumer awareness of what an optician is and will inform the consumer to look for the PRO designation.

Another positive stride in the profession is the creation and implementation of the ABO-NCLE practical examinations. As of the writing of this course, 12 states have adopted the exams as a way of licensure: Arizona, Florida, Georgia, Kentucky, Massachusetts, Nevada, North Carolina, Rhode Island, South Carolina, Tennessee, Virginia and Washington. The assessment covers dispensing and contact lens fitting. The main areas are lensmeter, ANSI standards, optical measuring, keratometry and biomicroscope. When more states adopt these standardized examinations, there will be consistency and room for reciprocity, allowing PRO Opticians to work in any participating states.

FORMAL EDUCATION

Over the past three decades, a group of dedicated optical professionals has been hard at work to strengthen formal education requirements, proven to improve upward career mobility for the professional optician.

The National Federation of Opticianry Schools (NFOS) is an organization that promotes formal opticianry education. Most formal opticianry programs are NFOS members, it is the choice of the institution whether or not they want to join. Opticianry programs include a certificate, associate degree, hybrid and online learning environments. Most programs are accredited through the Commission on Opticianry for Accreditation (COA). This is also an institutional choice whether or not to be accredited. Some states require it for licensure, and some colleges or universities want all their professional degree programs to be accredited. The COA evaluates opticianry education through the development of standards by “assessing educational effectiveness, encourages improvement through continuous evaluation and planning, and assures the educational community, the general public and other agencies or organizations that an institution has clearly defined and appropriate objectives, maintains conditions under which their achievement can be reasonably expected, appears, in fact, to be accomplishing and can be expected to continue to do so.”

Aarlan Aceto, OD, NFOS president, had this update to share: “The National Federation of Opticianry Schools is dedicated to promoting and advancing formal education in our profession. One of the priorities is to expand the availability of high-quality, evidence-based education to more areas every year. Despite the turbulence of the COVID pandemic, there is still an extraordinarily high need for educated and qualified opticians to serve our communities’ eyecare needs. We are currently working with representatives to open five new programs, including four in California and another in North Carolina.”

Without access, formal education is not a viable option for becoming a professional registered optician, and without the ability to attract students, Ophthalmic Optics programs at the college level cannot succeed. Expanding the availability of programs throughout the country is a key step that must synergistically attract students to the programs. The latter is an area in need of a strong nationwide campaign.

THE SUMMIT

Some readers may recall a group of opticianry stakeholders getting together a few years back in 2012 to create a shared vision, a practical strategic plan and a commitment to action to move opticianry forward. Sixty individuals represented all facets of the industry that partook in this strengthsbased strategic planning approach headed by Chairman Ed De Gennaro. Representatives included: ABO-NCLE, American Board of Opticianry; CLSA, Contact Lens Society of America; Corporate and private opticianry businesses and employees; NAO, National Academy of Opticianry; NAOO, National Association of Optometrists and Opticians; NFOS, National Federation of Opticianry Schools; Professional publications; SAO, Society to Advance Opticians; State Optician Societies; OAA, Opticians Association of America; Transitions; and The Vision Council.

Meetings were run by professional facilitators, and the following strategic areas emerged:

1. Branding and Consumer Confidence.
2. Healthcare Reform and Managed Care.
3. Education and Certification.
4. Collaboration among Opticianry Groups (unified voice), and
5. Refraction (emerging theme).

This collective body of dedicated opticians labored countless hours to unify this broad group to help advance our profession. One development from the Summit was the “consumer’s definition of an optician.”

An optician is a vision expert, a health professional specially trained to supply, prepare, and dispense optical appliances through the interpretation of written prescriptions. An optician is an integral part of the vision care experience and adheres to exacting standards in order to enhance your vision.

July 15, 2015 was the release date of the report titled “Opticianry, Creating a Plan for the Future, Developing a Profile of the Optician for the Future.” It summarizes the research study results derived from 3,000 opticians during the summer of 2014. This report is available in its entirety upon request. The report provides a technical description of the Optician Research Study and the results’ interpretation with 12 recommendations listed below.

1. Aspiring Opticians should seek higher education levels, and employers should seek to hire Opticians with higher levels of education. Associate Degrees in Opticianry, Bachelor Degrees in any field and Graduate Degrees in any field are associated with higher performance. High school only is associated with lower job performance.

2. Opticians and their employers should invest in training. Still, the training associated with the greatest payoff in terms of higher job performance is programs held by academic institutions, apprenticeship programs and participation in specialized training such as the National Academy of Opticianry Ophthalmic Career Progression Program. Other types of training are not clearly associated with higher job performance, and sole reliance on on-the-job training may be associated with lower job performance.

3. Opticians should seek certifications, and employers should hire Opticians with certifications. The two most common certifications are associated with higher job performance: American Board of Opticianry Certification and National Contact Lens Examiners Certification.

4. Opticians should seek membership in professional associations, and employers should hire Opticians with professional memberships. All of the most common association memberships are associated with higher job performance: Opticians Association of America, National Academy of Opticianry, Contact Lens Society of America and (to a small extent) state associations.

5. Opticians should seek, and employers should sponsor continuing education credits.

6. To increase the job performance of Opticians dispensing spectacles, emphasis should be given to tasks involving determining the patient’s needs, inspection, adjustments and troubleshooting, in addition to explaining lens information and helping patients decide on choices.

7. To increase the job performance of Opticians dispensing contact lenses, emphasis should be given to tasks involving analyzing prescription information, verifying, assessing vision, conducting diagnostic evaluation and educating patients on lens insertion, hygiene, cleaning, adaptive symptoms, etc., in addition to selecting lenses and designs, and conducting follow-up visits.

8. To increase the job performance of Opticians dispensing spectacles and contact lenses, emphasis should be given to tasks involving planning and organizing, working without supervision, teamwork and customer service, in addition to selling products and merchandising.

9. To increase the job performance of Opticians dispensing spectacles, emphasis should be given to developing knowledge of ophthalmic products, instrumentation, dispensing procedures and ophthalmic optics, in addition to knowledge of ophthalmic formulas, principles of refraction and ocular anatomy/physiology/pathology.

10. To increase the job performance of Opticians dispensing contact lenses, emphasis should be given to developing knowledge of refractive errors, optical conditions/terms/principles, dispensing, follow-up, legal requirements and ocular anatomy/physiology, in addition to fitting and instrumentation.

11. To improve the job performance of Opticians and sales volume, businesses should adopt management best practices, such as: setting formal goals for Opticians for sales and productivity, holding performance feedback meetings, developing formal strategic plans for business growth, creating sales campaigns and using advertising, using financial sales incentives and training beyond just on-the-job.

12. Opticianry businesses should invest in the development of the job performance of Opticians because there is a clear financial payoff from doing so.

The report indicates a correlation between high performing opticians and financial value when businesses invest in the optician. Investment is in the form of education and training. Results show that the high performing optician had more than a high school diploma, were formerly trained at a college or university or had participated in a structured and supervised formal apprenticeship program. They were certified by the ABO-NCLE and participated in more continuing education courses. High performing opticians were involved members of a national professional association such as the OAA or NAO. Continuing education was found to be an important part of the development of the optician. It seems to make sense that the PRO designation requires individuals to maintain their ABONCLE certification through continuing education. The ABO and NCLE renewal requirements are 9 ABO-approved CECs (of which at least 5 hours are ABOapproved Ophthalmic CECs) and 12 NCLE-approved CECs (of which at least 6 hours are NCLE-approved Ophthalmic CECs).

MOBILITY (STATE TO STATE)

People move to different states for a variety of reasons. Some move to be closer to family, some move for health or economic reasons, and some move due to job market opportunities. The way it stands now, there are barriers for opticians to practice in individual licensed states due to their requirements. The OAA’s Professional Registered Optician (PRO) initiative would help mitigate these burdens by establishing the ABOP and NCLEP as the standard. It is essential to recognize the factors that limit people, restricting or barring entry into a profession where they have been practicing in another state.

The population of America is transient and mobile. Currently, differences in licensing requirements create barriers and restrictions on the optician who wants to practice across state lines, often requiring that they retake competency exams, including practical exams. Uniform standards and criteria facilitate transferable certifications to allow an experienced professional to practice across states, with all of us talking the same language and exchanging ideas. A technical term in Oklahoma would be recognized and understood in New York. Minimal competency standards put pressure on incomes or salaries in the opticianry profession. When minimal competency is established and accepted by all states, the profession advances, and salaries increase.

Another inconsistency lies with CE requirements from state to state until all accept the ABOC, ABOP, NCLEC and NCLEP. CE requirements vary as some allow 100 percent CE online, others allow a percentage can be taken online, and others don’t allow any credits to be taken online. Now throw in the ABO certified opticians in unlicensed states, and CE access becomes an issue. Learning is moving to eLearning, and eLearning provides consistent access to all. States who do not have their own online platform can work with Jobson Optical Group, who will create a logo splash page for members and nonmembers to take CECs online.

WHY LICENSURE?

Every state should require a license for opticians to ensure that those dispensing eyewear to the public meets a standard of minimal competency. The premise behind licensure is also to protect public health and safety. The PRO, Professional Registered Optician, is a step heading in the direction of state licensure.

By taking and passing the ABO basic, NCLE basic, ABOP (practical) and NCLEP (practical), this demonstrates that the candidate has met various competencies showing the public that they understand the basics of ophthalmic optics and contact lens technology.

Following are randomly picked states illustrating the professions that require a license. These same states have no license requirement for an optician. Alabama: Cosmetologist; Louisiana: Interior Designer; Maine: American Sign Language interpreters; Oregon: Music Therapist; Utah: Hair Designer; and Wisconsin: Dance therapist. This list is not to discount or take away the education and training involved in the aforementioned listed professions; it is to highlight the need for the optician to be on the list. Note: Often, licensure of a given profession is simply a yearly fee paid, requiring no professional achievement, certification or designation. Additionally, no continuing education is required for license renewal. The licensure needed is one that ensures the public that the optician meets minimal competencies.

NO STATE SOCIETY?

If you are one of the 38 percent of the states without a collective voice in the form of a state opticians’ society, please contact the Opticians Association of America. Washington state optician Donna Hatch, Board of Director and Membership Committee member of the OAA, is the individual to contact. Donna and her committee are instrumental in guiding individuals and providing them with the tools needed to get an optician state society started. Some of the tools provided are steps on how to create a Board, creating a 501(c)(3), creating and adopting bylaws, along with information on how to conduct a Board meeting according to Robert’s Rules of Order and how to select Board members.

Besides being a collective voice for the opticians in your state, a state society represents opticians at the state legislature and follows potential laws that could affect the profession, develops and delivers continuing education courses and provides networking opportunities. In addition, most of the optician state societies are affiliates of the national Opticians Association of America (OAA).

NEXT STEPS

The PRO designation is voluntary and would not need to go through legislative changes. If a group of opticians or a state society in an unlicensed state wants to move forward toward licensure, legislative changes for the purposes of advancing opticianry must be at the state level. Here is a brief background on how the government is broken down at the national and state level. For our objective, we want to focus at the state level. Each state has its own Constitution and representative body. Actually, all states except for Nebraska are bicameral (meaning two legislative bodies), made up of the House of Representatives and the Chamber of Senators, just like the federal Congress. Your state representatives and state senators are the ones you need to contact about your state’s statutes and regulations on licensure. Work with your state optician society. They can contact your legislators as a united voice about licensure and most importantly, raise consumer awareness of quality standards of care in eyecare and the role of the optician. The vital message communicated to the consumer is that they can be confident in thseir optician serving their vision care needs because they have achieved national certification.

ADVANCING OPTICIANRY NOW

With the advancement of technology, the message the PRO designation sends to the consumer is that they can be confident that the optician is trained, educated and competent in all facets of eyecare, eyewear and contact lens technologies and dispensing. To take a quote from The Summit: “In order to truly move the profession of opticianry forward, we need alignment and getting everyone ‘traveling’ in the same direction.” We need to increase access to formal education and hands-on training. We need to establish a standard across the country with a designation that indicates the optician has met the requirements to earn the PRO designation. Please reach out to [email protected] with your thoughts on advancing the state of opticianry.