Bill Harvey: Master of puppets

When deciding the first topic for the new series of clinical practice primers that starts in this week’s issue, I decided to select pupil assessment after being asked the following question by a trainee: ‘According to my supervisor, you don’t have to do a pupil assessment as part of a routine eye test. Is that right?’

This weekend is the last chance you have to make your views known to the GOC about the need for changes to the Opticians Act. Even its name is anachronistic, and so most ECPs should welcome the opportunity for an update to the law that reflects the expanded roles we all play and are likely to embrace as advances in technology continue. I hope there will be similar consensus in disregarding attempts to separate out a refraction test from a health test. To suggest that anyone is able to assume that changes in vision are completely due to refractive error, and so ignoring influences from binocular and accommodative status, physiological changes due to age and functional and anatomical changes due to disease, is obviously madness. I am sure some business heads might see the appeal of using underpaid staff to operate an autorefractor, but I fail to see how this can in any way reflect any form of vision assessment.