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Spotlight on Malaysian Optometry

According to a report titled, Malaysia Eyewear Market By Type (Spectacles and Contact Lenses), By Sunglasses and Eyeglasses and By Sales Channel – Outlook to 2021,* Malaysia is among the countries in the world where vision impairments like myopia, hyperopia and presbyopia are rising at an alarming rate.  Largely owing to the increased demand for prescription glasses, the eyewear market in Malaysia grew at a CAGR of 6.4% from 2011 to 2016. 

Malaysia’s optometry industry has come a long way, said President of the Asia Optometry Congress Datuk Murphy Chan, who is also advisor and former president of Association of Malaysian Optometrists (AMO). 

He said that in the past, optometry was viewed more as a business than as a profession. Today, people are more aware of the role of optometrists and the differences between the three “O’s” — optician, optometrist and ophthalmologist.

“The perception of the public very much depends on how optometrists conduct their professions,” he explained. “With the emphasis on the sale of spectacles and contact lenses and discount offerings, the optical industry would run into the danger of deviating to retail.”

Chan says besides the support of professional associations such as the AMO, the involvement and support of the government is also very important.

Growth in Optometry Graduates 

According to Dr. Tan Xuan Li, honorary secretary of the AMO, optometry is a relatively new profession in Malaysia. The number of eye care practitioners in the country has evolved from less than 100 in the 1990s to nearly 3,000 today.

“The increased number of optometrists has brought up the level of eye care service and delivery in the country. Unlike older days, vision testing is mostly conducted by opticians and assessment of eye health is not covered,” she said. 

There are currently about 2,700 registered optometrists in Malaysia, but the number of practicing optometrists is fewer. 

As per the report from Malaysia’s Ministry of Health in 2015, the ratio for optometrist per population in the country was 1 to 22,460 — compared to 1 to 8,000 in developed countries. Thus, more optometrists are needed to ensure sufficient eye care services to the community.

Chan is optimistic. “The WHO recommended a ratio of 1 to 10,000 for optometrist to patient. Therefore we need about 3,200 optometrists to serve the population. There are six universities that are producing qualified optometrists so I am confident that in three years, we can reach the number.”

A qualified optometrist in Malaysia would have gone through a four-year bachelor degree in optometry. He or she is required to register with the Malaysian Optical Council in order to practice legally in the country.

Tan believes optometry graduates will be in high demand in terms of job recruitment and entry salary. Those who further their education with master degrees and PhDs can go into different secondary specialties, such as specializing in orthokeratology, binocular vision or eye muscle problems and color-vision.

Raising Eye Care Awareness and Standards

In Malaysia, it is important to continue to raise public awareness on the services provided by optometrists, which includes a comprehensive eye check-up and ocular disease detection. 

Private optometrists should be encouraged to undertake continuous optometry education programs in order to keep abreast with the ever-evolving technology in eye and vision care. More optometrists in the government hospitals and clinics should be recruited to improve more comprehensive eye care services in Malaysia

“Continual education is a must. The knowledge that you know today may be obsolete tomorrow. Thus, optometrists must constantly upgrade their knowledge and skills,” said Chan.

Chan’s optometry center Eyecon was established in 2010 with the support from co-founders/optometrists who believe in re-branding the optometry practice toward a more professional and innovative approach. His eye care group also runs an academy to train their team with continual education.

Meanwhile, Tan says the AMO has been working very hard toward raising the awareness of the profession and has worked closely with the Ministry of Health since 2016. Plenty of efforts have been exerted to improve public awareness in the profession by the AMO via campaign, social media and public screening.

As an association that represents all optometrists in Malaysia, the executive committee of AMO seeks to work together to promote the roles of optometrists for eye care and vision care in Malaysia. 

“Among the efforts to achieve this objective is collaboration with universities, industrial partners, media, local and global association and practitioners,” said Tan.  The association has also organized international conferences such as Global Orthokeratology & Myopia Control Conference (GOMCC), Asia Optometric Congress, and public awareness campaigns, like National Eye Health Awareness Campaign (NEHA). 

She says among AMO’s outreach programs include providing many free large-scale vision screenings across the nation, many are in collaboration with NGOs (e.g., Lions Club and Rotary Club). 

“There have also been numerous invited projects for less fortunate groups like old folks homes, orphanages, underserved populations, etc. to request services for vision screening,” says Tan.

Chan applauds the AMO’s effort in organizing programs in education and public campaigns. With the support of the government and with local institutions producing more optometrists, he believes that the optometry movement is gaining momentum and will have a bigger voice. 

“It’s all about collaborations — optometrists need to work with the government and our industrial partners, and also to have all members from every state to participate,” he said.

Challenges and Advances

One of the challenges faced by the optometry industry, says Tan, is that the level of service delivery varies from one practitioner to another, as there is no standard or minimum for the clinic’s set-up.

“Also, there are no regulations on the mandatory eye examination. Thus, not all patients will be provided with full eye examination and it is due to unavailability of equipment or lack of time,” she said.

In Malaysia, optometrists are prohibited to use drugs, either for diagnostic or therapeutic purposes. Tan opines that the level of eye care to the public could be improved if optometrists could access diagnostic drugs for cycloplegic refraction or prescribe drugs for minor infectious eye conditions like conjunctivitis. 

“The Malaysian Optical Council and the AMO have been pushing for the legal use of drugs for these purposes for the past five years,” she said.

Chan says the government has to step up its enforcement, such as to uphold the Medical Device Act and not allow the selling of products such as contact lenses outside optical centers. 

“We also need a clear Optical Act to differentiate the scopes of optometrists, opticians and ophthalmologists. A revamp of The Optical Act 1991 is long overdue and we are trying to get the government to amend it,” he says.

Tan says the AMO has pushed for the revamp of the Optical Act 1991 with effort from its Council’s representatives for the past few years.

Future Outlook

Malaysian optometry is one of the more established in the region, said Chan. The first Asia Optometric Congress was founded by Malaysian optometrist Dr. Chung Kah Meng in 2007 and it was expanded to ASEAN countries when the bi-annual conference was held in Singapore in 2014. It now includes many Asian countries and territories including India and China. 

“The Congress’ objective is: Asians helping Asia. We want to uplift the standard of delivery of eye-care in the region and standardize primary eye-care delivery of optometrists across the region.”

He says the most important specialty today is myopia control.

“By 2050, half of the world’s population will be myopic. One billion of the world’s population will have prescriptions of more than 5 diopters. That means we have a higher risk of having cataracts, glaucoma, retinal detachment and macular degeneration. 

“Myopia is the number one health problem in Malaysian schools today.  One in three primary one students is short sighted and another one has not been detected,” he said.

He encourages optometrists to work in a network to inspire and motivate one another, and also to build good working relationships with ophthalmologists and opticians. Optometrists should be trained to handle the primary care of eye health and ease the burden of ophthalmologists, said Chan.

“With the increase in the number of optometry practitioners in Malaysia, we believe more competent and comprehensive services can be provided to the public,” said Tan. 

She says the association is working on the “Primary Eye Care E-Symposium,” which is intended to refresh the knowledge and enhance the skills of eye care practitioners in Malaysia, making them prepared to become a primary eye care practitioner. 

Like many industries, the COVID-19 pandemic had impacted the optometry industry especially during the Movement Control Order (MCO) implemented by the Malaysia government. 

“The Association had appealed to allow operation of optometry practice during the MCO period with the recognition that optometry service is part of essential services. We then established the ‘COVID-19 Response Group’ which later worked out the SOPs for members to adhere to during this period,” said Tan. “Recently, the association has successfully gained recognition from the Ministry of Health (MOH) to categorize optometrists as front liners and to be included under Phase 1 of National COVID-19 Immunization Programme (NIP).”

Chan views the pandemic as a transformation period, where optometrists can reflect on how they could improve their practices, how to expand their roles and embrace digitalization. 

“I see it as an opportunity rather than a challenge. When we follow the SOPs properly, we can give our patients peace of mind. There are a lot of things we can do productively such as planning, communicating with patients, and expanding our network.

“Optometrists must have passion for their profession. The future of optometry depends a lot on the practitioners to get the right footing to ensure that the public will benefit from eye care services and fulfill their lifestyle needs,” he concluded. 

*Ken Research Private Limited. Malaysia Eyewear Market By Type (Spectacles and Contact Lenses), By Sunglasses and Eyeglasses and By Sales Channel – Outlook to 2021. Available at https://www.researchandmarkets.com/reports/4463208/malaysia-eyewear-market-by-type-spectacles-and. Accessed on April 2, 2021.

Tan Xuan Li

Dr. Tan Xuan Li obtained her BOptom (Hons) from International University College of Technology Twintech (IUCTT) and further ventured into MSc (Clinical Optometry) at National University of Malaysia (UKM). Upon completion of her MSc, she was appointed as a lecturer and optometry consultant at the Department of Optometry, UCSI University. Then, she embarked on further study for her PhD in Optometry with UKM. She has since rejoined academia with SEGi University as a lecturer in 2019. Prior to lecturing, she served at UM Specialist Centre as clinician with a pediatric ophthalmologist.  Her PhD thesis project was on the establishment and effectiveness of a preschool vision-screening program in Malaysia. She was under MyBrain15 scholarship for both her master’s and PhD studies. She has received a research grant for her PhD project from the Centre of Research and Instrumentation (CRIM), UKM and sponsorship from Essilor Vision Foundation.  [Email: tanxuanli@segi.edu.my]

 

murphy profile 2021 photo 1.0

Datuk Murphy Chan Hian Kee graduated with first class honors with a Bachelor of Optometry from University Kebangsaan Malaysia in 1990. He started his career working with two optical centers. Chan pursued his optometry specialty in Orthokeratology in 1999 and was a member of the National Eye Research Foundation, USA. In 2000, he obtained his diploma from the Varilux University, France, for the specialty in progressive lens design. His optical center Eyecon was established in 2010 to rebrand the optometry practice toward a more professional and innovative approach. In January 2011, Eyecon was awarded the International Franchise License by the Ministry of Domestic Trade, Co- operatives and Consumerism, Malaysia. Chan is president of Asia Optometric Congress and past president of Association of Malaysian Optometrists (2012-2018). Since 2005, he has been invited by Industry Multinationals as the Asian presenter in providing continual education in this region.  [Email: murphy@eyecon.com.my]

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