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using a manual refractor. To perform subjective refractions,
petitioner would have his patients sit in an examination chair
behind a manual refractor, view various charts through lenses in
the manual refractor, and answer a series of questions that
petitioner would ask them. Subjective refractions of patients
would take approximately 5 to 10 minutes each.
On disabled patients, however, petitioner occasionally was
not able to perform subjective refractions. For example, some
mentally handicapped patients and hearing impaired patients were
unable to understand and answer questions asked during subjective
refractions, and some physically disabled patients could not be
moved from their wheelchairs into petitioner’s examination chair
behind the manual refractor.
Although petitioner and hearing impaired patients could
write notes to each other during subjective refractions, it was
difficult for hearing impaired patients to look through the
manual refractor while reading notes from and writing notes to
petitioner, thereby affecting the accuracy of the subjective
refractions.
Prior to 1997, as a result of the above difficulties in
diagnosis, petitioner was not able to treat a number of disabled
patients, and petitioner referred those disabled patients to
other optometrists located in distant communities. In 1996, due
to petitioner’s inability to treat them, approximately 30
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Last modified: May 25, 2011