This is just a very brief look at periods of history that led a group of British Opticians in the 19th century to establish the profession of Scientific Sight Testing Optician, the Ophthalmic Optician, as opposed to the medically orientated profession of ophthalmology.
Throughout history there have been various theories about the eye, its function and its diseases. However histories relating to eye care have mainly focused on the story of medically trained physicians or changes in the design of spectacles. Some medical text books did describe the task of testing sight but this was from a medical perspective for medically trained professionals. Up to very recently physicians claimed that poor eyesight was always a medical condition that required medical interventions. Wearing corrective glasses was frowned on. Leeches and purgatives were a far better cure for short-sighted eyes than the wearing of spectacles.
Spectacles (as in paired lenses) are known to have been available since at least the 13th century. There are histories about spectacle making, and the use of lenses in philosophical instruments but little has been written about opticians (spectacle makers, lens grinders and makers of philsophical instruments) and their role in enhancing vision. Opticians might be jewellers, chemists, craftsmen or tradesmen (and occasionally women), artisans who made and sold all kinds of philosophical instruments, that is tools and instruments that allowed philosophers to examine and learn more about nature and natural phenomena.
Just as purchasers of philosphical instruments selected the one that they wanted so when it came to spectacles it was up to the buyer to select the ones they wanted.
- At first spectacles were only available with lenses that made objects look bigger. These could be used to correct 'old sight' as they improved near vision to older eyes.
- Over time opticians learnt how to make lenses that made things look smaller, which were used to improve the distance vision of younger customers.
- Over time some spectacle sellers started to use their experience to guide the selection process. Test charts started to appear that to a greater or lesser degree measured sight and indicated which pair of glasses came closest to restoring more normal vision.
It was not until the 19th century that opticians really started to combine their expertise in measuring the power of lenses with an interest in how vision could be enhanced through the use of lenses. Opticians were making retinoscopes and ophthalmoscopes for physicians and some started to use them to get a better insight into how the eye worked, why it didn't and how vision might be scientifically improved.
Opticians ability to use the ophthalmoscope upset the medical profession, especially those who wanted to use the Ophthalmoscope for their own reasons. They wanted to establish ophthalmology as a medical speciality at a time when medicine frowned on specialism. The ophthalmoscope gave oculists greater knowledge of the internal appearance of the living eye and new insights into how disease progressed in living tissue, and they used this to promote the importance of ophthalmology over general medical practise. Unfortunately the fact that mere trades people could also use the same tool to see the same things placed the claims of oculists to being pre-eminent physicians in jeopardy .
It did not help that sight-testing opticians were not unified in how they saw their businesses progressing.
- Some opticians were content to continue just making spectacles.
- Other opticians wanted to test vision so they could sell the most appropriate spectacles but they did not want to concern themselves as to whether poor vision was due to disease or simply a mechanical error of refraction (long or short sight)
- Others wanted to be more professional persons. They wanted to offer a service to their clients of scientifically correcting poor vision but they also wanted to be trained to recognise diseased eyes that needed medical intervention.
By the late-nineteenth century British opticians had formed into several organisations to promote their own views as to how the business of opticians should be protected. Eventually, in 1895, after much discussion the profession of optometry was finally born when a group of like-minded opticians formed the British Optical Association.