The June 2018 Focus on Refraction column, “Home on the Range,” addresses a misconception among optometry students: some falsely believe their mission is to find a single, ideal refraction for each patient and prescribe accordingly. The column generated praise and disbelief, both of which are expressed in the following letter.

A Range of Emotions

I was so pleased by the very well-written article co-authored by Drs. Taub and Harris, and simultaneously so sad that there is a need for such an article.

My colleagues and I—those of us older than 60—earned the art and science of refraction and vision care in optometry school through the Optometric Extension Program Skeffington papers and study groups.

It is a shame that with the emphasis on medical optometry, refraction—the essence, heart and soul of optometry—and functional vision care have lately been neglected by most optometry schools.

New graduates have little experience with retinoscopes and prescribe whatever they come up with using a phoropter without considering the subtleties of optometry that differentiate our quality of patient care.

 I was told that what I consider to be basic knowledge (performing an optometric vision analysis) is now considered a niche practice. What a shame. Basic optometric visual testing is now referred to as a “specialty.”

 Thank you, Drs. Taub and Harris, but shame on you, colleges of optometry.

—Errol Rummel, OD, Jackson, NJ

Drs. Taub and Harris Respond

We are thrilled at the opportunity to write this column and, at the same time, disappointed at how far optometry has drifted from its core. Even though there has been a push toward the medical side of the field, we must treat each patient’s visual system as part of their entire body. Refractive care is not cut and dry and, time and time again, we find ourselves sending our students back into the exam room to perform more tests and spend more time with the retinoscope.

We urge ODs to acknowledge this challenge and meet it head-on. Do not simply allow your students, or yourselves for that matter, to rely on an autorefractor to spit out new prescriptions; this is a recipe for disaster. I (Dr. Taub) learned this lesson from Dr. Rummel 15 years ago when I worked for him, and have taken it with me through my career. 

Thank you, Dr. Rummel, for all that you do for your patients. Keep fighting the good fight.