To Fit, or Not to Fit? Words Matter.

Now that most opticians are back at work, the question as to whether we should be providing contact lens fitting is coming up often. The OOA has received numerous inquiries since the pandemic started.

Recently a member called saying he was in a quandary. He works in an optometric practice and part of his duties is fitting contacts.

Here’s his dilemma. The College of Optometrists of Ontario Return to Work Guidelines advises their members that they are fully welcome to fit contacts as long as they use appropriate PPE and are exercising their professional judgment.

The COVID-19 Update #20, posted by the College of Opticians of Ontario(COO) on September 24th, directs members to the Frequently Asked Questions, dated July 20, 2020, and to Return To Work Guidelines.

The Frequently Asked Questions (FAQ) document states-

“In light of this potential risk, the College strongly recommends that opticians refrain from performing initial contact lens fittings and any other fittings that require direct contact between the optician and the patient’s eye or eyelid at this time.”  

The COVID-19 Return to Practice Guidelines for Registered Opticians, updated on June 29, 2020, state-

“That opticians limit the performance of initial contact lens fittings, as fittings typically require close physical contact for a prolonged period of time, and it is generally not possible to use adequate PPE”.

So, taking the above “words” in context, it would be reasonable to surmise that the COO doesn’t really want us to do initial contact lens fits. As it turns out, the COO made a mistake by linking to the FAQs posted July 20, 2020. They meant to share the FAQs of September 30, 2020 which states-

“The College continues to recommend that opticians limit the performance of initial contact lens fittings at this time”.

This statement aligns with the Return to Work guidelines.

Why don't the words of the College of Opticians and the College of Optometrists line up? Same service ...same pandemic ...same government rules ...so why the difference? Are both colleges basing their recommendations on the same research and data?

The above demonstrates that “words” matter. The COO is showing us that there is a difference between “strongly recommends” and “recommends”. So where do these words fit in the list of words that regulators use? Must, Should. May. Recommends. How enforceable is the word Recommends? Under what circumstance would the COO refer back to their recommendation? How would this impact a claim against our Professional Liability Insurance? As professionals we need to use our professional judgement when deciding what to do, while taking into account the words of the COO. Because in the end, the COO is not telling you whether to do the fits or not. They are just recommending.

Something else our colleague must consider- When an optician is employed in an optometric office, he/she must first and foremost, abide by the Standards of Practice of the COO. This can be found in the COO’s Frequently Asked Questions dated September 30, 2020.

“As an optician you are required to comply with the Standards and Guidelines set by the College of Opticians. If you are working under the direction and/or delegation of an optometrist, you should ensure that you are also complying with your professional obligations as an optician.”