Malaysian Society of Ophthalmology (MSO) and Malaysian Medical Association (MMA) wish to raise public concern over a growing trend, whereby optometrists are increasingly positioning themselves as the primary point of contact for eye care in Malaysia, a role that properly belongs to general practitioners and ophthalmologists within the medical system.
Optometrists play a valuable and long-established role in Malaysia’s eye care ecosystem, particularly in vision correction and the dispensing of spectacles and contact lenses.
Their expertise in refraction and optical dispensing is not in question. What is in question is the blurring of the line between this role and the practice of medicine.
Unlike medical practitioners, who are regulated under the Medical Act 1971 and required to complete a compulsory housemanship before independent practice, optometrists are regulated separately under the Optical Act 1991, and their four-year training does not include an equivalent structured clinical internship.
This gap in mandated clinical exposure raises legitimate questions about their readiness to take on diagnostic responsibilities beyond screening.
At present, optometrists are permitted to screen for eye conditions, not to diagnose them. MSO and MMA are concerned that this boundary is being eroded in practice, with some optometry outlets now using AI-assisted tools and medical devices to produce what amount to diagnostic assessments, often at additional cost to the patient despite this falling outside their permitted scope.
Some are even calling their practices as clinics and offering clinical services by optometrist consultants. Their consultation fees and setting of their practices are not regulated.
International Comparison
It is worth noting that in jurisdictions such as the United Kingdom, Australia, and parts of the United States, optometrists are permitted to practise beyond dispensing glasses and contact lenses, including diagnosing certain ocular conditions and, in some cases, prescribing therapeutic medication.
Crucially, this expanded scope is not granted on the strength of base entry-level training alone as in Malaysia. It is earned through additional structured training, that typically at least a year of further study, supervised clinical practice, and logbook-verified competency, in addition to the standard optometry degree, before independent diagnostic or prescribing rights for certain disease or procedure are granted.
By contrast, no such expanded role exists for optometrists anywhere in ASEAN or in most of Asia. In Japan, the profession of optometrist does not even exist in law; eye care is handled either by ophthalmologists (for medical conditions) or by opticians (for the fitting and dispensing of eyewear), with no intermediate diagnostic tier.
This comparison matters: where countries have expanded the optometrist’s role, they did so only after building in additional mandatory training, supervised practice, and a formal credentialing pathway, the safeguards that are currently absent in Malaysia.
Extending optometrists’ functions here without first establishing equivalent standards would be adopting the outcome of international practice while skipping the safeguards that made it responsible.
Risks For The Public
This trend carries several real risks for the public:
Diagnostic Accountability: Optometrists do not operate under the medical indemnity and disciplinary framework that applies to doctors. A missed or incorrect diagnosis in this setting currently carries no clear mechanism of medical accountability, which may delay patients from receiving appropriate and timely treatment.
Commercial Conflict of Interest: More than 80 per cent of optometry practices in Malaysia operates within a retail business model. Where diagnosis and sales sit under the same roof, there is an inherent risk that clinical recommendations may be shaped by commercial incentives rather than clinical need alone.
Cost Burden on the Public: Patients, particularly those from lower-income groups, may end up paying for screening-turned-diagnostic services and associated products, only to require separate consultation with a doctor or ophthalmologist regardless, effectively paying twice for their eye care.
Our Call To Action
MSO and MMA therefore call on the relevant authorities, including the Ministry of Health (MOH) and the Malaysian Optical Council, to:
- Reaffirm and enforce the existing boundary between optometric screening and medical diagnosis.
- Review the use of AI-based and other diagnostic-grade medical devices within optometry retail settings, and ensure such use is properly regulated and disclosed.
- Strengthen the clinical training and supervised practice requirements for optometrists, particularly around recognising conditions that require referral.
- Improve public awareness of the distinction between an optometrist and a medical eye care provider, so that patients especially those with limited means can make informed decisions about where to seek care.
MSO and MMA emphasise that this call is not a criticism of optometrists as a profession, but a call for clarity, accountability, and patient safety in a system where the roles of allied health and medical practice must remain clearly delineated.
This press statement was jointly issued by Malaysian Society of Ophthalmology president Prof Dr Liza Sharmini Ahmad Tajudin and then-Malaysian Medical Association president Dr R. Arasu.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
