This is our fourth in the series, and will compare and contrast the Optician in the US and their international counterparts.

U. S. Optician's education, training, and licensure varies widely from state to state. The Professional Opticians of Florida (POF) define an Optician in the following manner:

"Opticians are licensed dispensing professionals who make, verify and deliver lenses, frames, and other specially fabricated optical devices and/or contact lenses upon prescription to the intended wearer. The Optician's functions include prescription analysis and interpretation, determination of the lens and frame forms best suited to the wearer's needs, the preparation and delivery of work orders for the surfacing of lenses and the fabrication of eyewear, the verification of the finished ophthalmic products and the adjustment, replacement, repair and reproduction of previously prepared ophthalmic lenses, frames and other devices. Opticians are licensed in 22 states, including Florida" (Professional Opticians of Florida, 2004).

There are currently 22 states that require Opticians to be licensed, and one, Texas, that has a voluntary registry. Opticians in other states require little to no education or training and generally learn on the job. They can achieve some level of recognition, however, through a national certification program through the American Board of Opticianry (ABO) and The National Contact Lens Examiners (NCLE). Other states require nothing else short of a pulse to legally function. Amazingly, dog-groomers and others with seemingly less responsibility than the Optician must be licensed.

International Comparisons of the Education and Training - Requirements for Opticians
Education and training requirements for Opticians in other countries may provide some possible insight into the status of the profession worldwide. The researcher felt that a review of other countries that recognize Opticians might be valuable as a comparison to scope of practice and other issues. Through this review, we will be able to compare the scope of practice for international practitioners compared to those in the United States.

Opticians in the England
The profession of Opticianry requires a number of steps prior to entering practice in the British Isles. Opticians in England and the surrounding nations of the British Empire can become either Dispensing Opticians or Ophthalmic Opticians. The UK Dispensing Optician is what we typically refer to in the United States as an Optician or Ophthalmic Dispenser, while the Ophthalmic Optician is similar to our Optometrist, but with substantially less education, but are now changing their education and training and their title to Optometrist. According to the Prospects UK there are five routes to take for entry into the profession as a Dispensing Optician, as well as additional education and training for specialization in specific areas of practice. Each of the five requires formal education. The five training routes are currently available:

• Three-year distance-learning courses run by the Association of British Dispensing Opticians (ABDO). It is a requirement that a qualified (licensed) Optician employ the student for the duration of the course. Practical experience is gained from the employment, while theoretical knowledge is acquired through the course, which includes compulsory block release attendance. The third year of the course forms the student's pre-registration year.
  

• A two-year full-time course at one of the training institutions. This is followed by one year's paid work, the pre-registration year, under the supervision of a qualified Optician.
  

• A three-year full-time course in optical management leading to the Association's Fellowship Diploma and a Bsc Honours degree in Optical Management. This option is currently available only via Anglia Polytechnic University (A-levels or equivalent are required for entry).
  

• Degree courses with Management are run by Bradford College and Glasgow Caledonian University (A-levels or equivalent are required for entry).
  

• Three-year day release courses are available at Bradford College, City & Islington College and Anglia Polytechnic University. These courses are linked to employment with a qualified Optician and incorporate the pre-registration year. Successful completion of the course, the pre-registration year and the qualifying ABDO examinations leads to registration with the General Optical Council (GOC). This registration must be renewed annually for as long as you wish to practice in the UK.

Many Opticians take further specialist training courses. The supply and fitting of contact lenses involves different processes from those for fitting spectacles and this area is not covered in the standard dispensing course. Opticians may take an additional course through the Association of British Dispensing Opticians (ABDO) if they wish either to specialize in this area or to add to their portfolio of skills.

Another possible area of specialization is in the supply of low vision aids. This expertise is more likely to be useful in a hospital setting than in a high street outlet. Again, a training course is available through the ABDO.

The majority of dispensing Opticians soon take on management tasks alongside their dispensing roles. Opportunities to move up the management ladder are most often found in the large multiple retailers, where it is possible to progress through store management into regional or head office positions.

Opticians in Australia and New Zealand
Opticians in Australia also have different requirements than in the United States. According to the Open Training and Education Network, Optical Dispensers as they are referred to in that country, were originally called "facial fitters", and their craft was learned on the job. Compulsory educational requirements were instituted in 1963 when licensing was established in New South Wales (Wilson, 1997). The Optician or Optical Dispenser in Australia is prohibited from fitting contact lenses, which is done in the offices of the Optometrists.

According to Kiwi Careers (2003), Opticians in New Zealand must have completed courses in Math, English, Physics, Chemistry and/or Biology. They would then find a position and begin to learn on the job. A certificate of study is required from the Open Training and Education Network, which is a distance learning institution serving Australia and New Zealand, but it is usually done part-time on the job. While this program is not a full-time educational experience, it is a requirement to practice. This is not the case in many states in this country. Opticians in New Zealand also are prohibited from contact lens fitting.

Canadian Opticians
Opticians in Canada require graduation from a provincially-approved educational institution. They are advancing to new areas of practice, and currently doing "sight-testing" in two provinces. This controversial move comes on the heels of significant work by the Opticians Association of Canada, and the institutions that provide education to the profession. They are essentially doing supervised refraction, and can be a model for the United States to follow. More about Canada to follow later in the series….

Why concern ourselves with the international marketplace? We need to clearly see where we stand in comparison. In most international markets Opticians are regulated and require a formal education. We need to follow suit. To provide higher levels of service we must look to education and training as the vehicle that takes us to the next level.

Opticianry needs to strategically plan for the future. In fact, it should have been planning consistently for years, to reach new heights. Clearly Optometry has evolved and changed to a medical model. Where are we going to be in the future? Will we still be focusing on taking PDs and seg heights, or look to expand into other areas? That is what must be decided, and now.

Next month, we will attempt to describe some of the theories of change that describe where Opticians are currently, and how they can effectively seek and implement change. I hope you are enjoying this series of articles as mush as I am writing them. I have a vision for the future of Opticianry, and through research have developed a number of recommendations to move into the future successfully. Stay tuned for more!