Hmmmm I made this entire script for a video but then decided to pull the plug on it because the nuance of it all was rather off shall we say? In any case, I figured it was a waste to do all that research and to do nothing with it sooooo here it is! For anyone to see and comment on. Maybe you’ll find it interesting though I’ll admit, it is somewhat dry.
TWN v CAD Optometry [Rough Draft for script]
Canadian Vs Taiwan Eye Exams
CH0: Introduction + disclaimers and background
For those who don’t know, J!NS is a popular Japanese optical brand with stores in many Asian countries. They’re best known for their “30-minute full-service eye exam.”
That means they pride themselves on getting you in and out of the store within 30 minutes with:
- A prescription for your eyes, and
- A completed pair of glasses.
Now, in Canada and the U.S., you don’t really see this kind of service… which begs the question: why not? Why do eye exams in North America take so much longer?
This is something my patients often ask—especially those who’ve traveled to Asia. The answer is usually kind of obvious… but also not so obvious. Just explaining it outright would be pretty boring, so instead, I figured I’d walk you through my wife’s experience at J!NS, compare it to what I would normally do in Canada, and then dig a little deeper into some key differences, keeping a few fundamental things in mind.
A quick disclaimer and some background about me: I’m a licensed, practicing optometrist based in Toronto, Ontario. I’m also familiar with American optometry and have completed some of their board exams, though I’ve never practiced in the U.S.
I’ve performed eye exams in Mexico and Moldova during humanitarian missions, where I worked alongside opticians and optometrists from various countries. I’ve also worked briefly at a university eye clinic in Hong Kong.
This video isn’t sponsored by anyone, and I have no intent to discredit or defame any brands or optical businesses.
Now, if you’re wondering why I’m sharing so much about my optometric background—it’ll become very relevant in the second half of this video.
But first, let’s get into my initial impressions of the J!NS visit.
CH1 (Revised — J!NS experience first)
When we first got to J!NS, the staff told us they could do the full exam in about 30 minutes. If your prescription is more complex, it can take longer, but 30 minutes is the average.
After agreeing to the process, we were led into a room filled with instruments — though really, there were just two types: an autorefractor and a phoropter.
The autorefractor has this almost mythical reputation, but in reality, it just estimates your prescription. I’ve tried a dozen different ways to explain how it works, but it always gets too complicated… so here’s the quick version.
First, some basics:
Think of your eye as a ball with a convex lens at the front. There’s a lot more going on in reality, but this will do for our purposes. At the very back of your eye is the macula — the spot where, if light hits it, you see clearly.
But because we’re all imperfect biological systems, the light often converges either before or after the macula.
- If it converges before the macula → you’re nearsighted and need a diverging (minus) lens to push the focus back to the macula.
- If it converges after the macula → you’re farsighted and need a converging (plus) lens to pull the focus forward.
(Insert rubber band demonstration here)
When you shine a light into an eye, the eye reflects some light back — this is called the retinal reflex (or “ret reflex”). Autorefractors use this principle to guess your prescription. I can’t give you the engineering breakdown, but I can show you how eye doctors do something similar manually with retinoscopy.
Nearsighted retinoscopy:
Light converges before the macula, flips, hits the curved back of the eye, and reflects back. When you move the light beam, the reflex moves in the opposite direction. That tells us the eye needs more diverging (minus) power.
Farsighted retinoscopy:
Light converges after the macula. The reflex moves in the same direction — but faster than the light beam. To fix this, we add converging (plus) power until the reflex is “neutral” — moving at the same speed in the same direction as the beam.
(Insert retinoscope footage)
The point: autorefractors measure your prescription without asking for your input, relying entirely on optics.
(Subtitle: We’ll skip astigmatism for now — otherwise this video would be three times as long.)
Ch2: Phoropter
The first thing we did at J!NS was the autorefraction. Then we moved to the phoropter. This model was more compact than the one I use in my clinic, but it does the same job: subjective testing of your prescription.
In a normal exam, we take the autorefractor’s reading, put it in the phoropter, and fine-tune it with the patient’s feedback. That’s because autorefractors, while optically sound, can be thrown off by things like cataracts, dry eyes, scars, or corneal conditions like keratoconus.
The operator at J!NS did exactly that — put in my wife’s autorefractor reading, then adjusted slightly up and down. We call this subjective testing, where we take the autorefractors information and then just see how well the patient can actually see. After this she moved on to testing with a RED and GREEN screen. And here is where I had my first tidbit of contention. It’s not a HUGE deal but for me, it did bother me here a little bit and I want to explain myself here a bit.
Most optometrists in Canada use an extra step called vertical prism balancing, where we drastically alter the prescription from the autorefractor, then dial in adjustments until we find the prescription that is MOST positive. This is because the most positive prescription is the one that causes the least strain.
Reducing eye strain is so important that sometimes we even do cycloplegia — using pharmaceutical agents (like cyclogel 1%) to fully relax the eyes and see the truest prescription. (Subtitle: We mostly do this for kids, and it’s the drop that makes you light-sensitive after the exam.)
This is pretty standard because it really tests the vision against the autorefractor’s values. It goes without saying that this is because we don’t trust the autorefractor that much. The reason?
The biggest flaw of the autorefractor is that it works best when the system is static, not dynamic. If the eye were designed to focus at just one distance, it would work decently. But our eyes can focus at various different distances.
If you’re looking at a distant object, then shift to something close, chances are you can see both in focus (assuming you’re young and your eyes are properly corrected). But when you shift between those distances, your prescription actually changes. When you’re looking far, your eyes are set to neutralize distant vision. When you look close, they adjust to help you see near. That change happens because of something called accommodation.
Accommodation is your eye’s natural ability to contract muscles, squeeze the lens, and bring the convergence point of light forwards. And here’s the key: forwards only. We don’t have muscles that can actively push the convergence point backwards. You can only accommodate forwards, then relax back to your original spot — you can’t go beyond that.
For this reason, we always want your distance prescription measured with your eyes fully relaxed, without any accommodation. That gives you the fullest range of accommodation you can get, and coincidentally, it’s also the prescription that gives you the least amount of strain.
Now, the autorefractor tries to simulate looking at a distance to measure your best distance prescription, but it can’t guarantee your eyes aren’t in a focused state during the test. A lot of things can trigger accommodation — sometimes just having something physically close to your face is enough. The best autorefractors have “fogging” systems to reduce this, but even the best ones… let’s just say the fogging leaves something to be desired.
Quick side note: Some of you might be thinking: If I’m farsighted, can’t I just use my accommodation to overcome my prescription? Yes — but you shouldn’t. Constantly accommodating strains the eyes, leading to headaches, migraines, and sometimes even double vision. Overworking your eyes is not a sustainable solution. Plus, as we age, we lose this ability through a process called presbyopia, which usually starts in your 40s.
In short, my main point of contention is that after putting the autorefraction numbers into the machine and just testing it a bit, they never used prism balancing with the values by drastically changing everything and then dialing it all back.
Instead, they did a different type of balancing. The technician only used what’s called RG balancing.
The balancing I referred to earlier (vertical prism balancing) is the one where we drastically alter your prescription and then slowly bring the numbers back in. RG balancing is different — it’s just pulling up a screen split into two colors and asking you which side looks clearer.
Professionally speaking, I would almost never just trust an RG-balanced prescription because it’s not very accurate. However, I do still want to talk about it, because I think it’s one of the coolest optical tests in theory.
Have you ever seen that famous image of Isaac Newton splitting light with a prism into a rainbow? That works because white light contains many wavelengths (colors), and each travels at a slightly different speed. In a medium like glass, you can separate them. In other words: colors travel at different speeds. Longer wavelengths, like red, don’t bend as much. Shorter wavelengths, like green, bend more. In between red and green is usually where most vision resides.
(Demonstrate how a convex lens is like two prisms stacked on top of each other.)
This is the concept behind red-green balancing. If you shine red and green light from the same distance, they land at slightly different points on the retina. Normal white light is roughly in the middle (“dioptrically equidistant”), so if your eyes are perfectly relaxed, the blur on the red side should match the blur on the green side.
- If red (around 620 nm) looks clearer → you need more minus power.
- If green (around 535 nm) looks clearer → you need more plus power.
J!NS used this to balance my wife’s prescription — which is neat — but it’s not reliable on its own. Cataracts, for example, can change color perception. Color blindness is another factor that can throw it off, and even in healthy eyes, the difference in clarity between red and green can be extremely subtle. It’s easy to miss.
In any case, they only used this type of balancing and then…that was it.
IF you’re still not convinced that the autorefractors are not enough, there is one last point to bring out. It’s a field of optometry called binocular vision. This is an entire field that revolves around how eyes perform differently when BOTH eyes are working together than when ONE eye is working by itself. That’s right, the whole, 2 eyes, is more complex than the sum of the parts, each eye individually. The autorefractor only looks at one eye at a time and not both as a whole system. Furthermore, RG balancing is also pretty much a monocular test as well. Okay, that’s all I’m going to say here because binocular vision in itself is like at least another video worth of explanations.
So far, my issues with the Taiwanese exam can be summarized as I didn’t like the way they balanced. They did do a form of balancing, yes, but it’s just a very quick and somewhat shaky version of balancing. That’s still somewhat passable. The next thing the technician did however, I don’t really understand at all.
Well…That’s not entirely correct, I do understand it, I just really don’t agree with it.
When I was scripting this video, I thought about really digging into what astigmatism is — but then I realized that alone could make this video at least three times longer. The way I learned astigmatism involved corneal higher-order aberrations modeled with Zernike polynomials — a very complicated mathematical formula that I really don’t want to unpack here.
So instead, I’ll give you a short, slightly detailed explanation with just enough context to explain why this is not such a great idea.
Astigmatism is basically your eye’s convex lens… not really being a perfect convex lens. So far, we assumed that the lens inside the eyes, causing the convergence of light, is uniform and smooth. In reality, it is not. For most people and especially those with astigmatism, the eyes are better represented as a sphere + a cylinder. (why is this the way our eyes work? VERY complicated answer involving biology and physics).
For simplicity’s sake, let’s assume your eye’s lens (the convex lens we’ve been using up to now) is like a perfect sphere — just to make it easy to picture. If you have astigmatism, your eye is shaped as if there’s a cylinder and a sphere combined together into one.
If you “slice” the eye along the rounded axis of that cylinder, you’d see that in one direction the curvature is like two spheres, while in the other it’s like a rectangle and a sphere. These two directions have different focusing powers — the “two spheres” direction converges more strongly, and the “rectangle” direction has less convergence.
The result is that instead of having one sharp focal point on the back of the eye, you get two points — both less sharp than the one ideal point.
Subtitle: This is why astigmatism usually shows up in your prescription as “cyl” (for cylinder) and “axis” (for orientation). The cylinder value tells the lensmaker how strong the correction needs to be, and the axis tells them at what rotation.
To correct this, we use an equal-strength cylinder lens to the cylinder you need to simulate the eyes, but rotated 90 degrees to cancel out the new cylinder you added. This essentially creates in your eyes 2 spheres. One new one made of the two cylinders and one original one what has been untouched. These two spheres create ONE IDEAL POINT again. BUT IT IS NOW IN A DIFFERENT AREA BECAUSE TWO SPHERES HAVE A POWER THAT IS DIFFERENT THAN THE ONE SPHERE.
Because of this, whenever you play around with astigmatism. There needs to be an adjustment factor. Or…specifically, for every -0.50D of astigmatism introduced, I have to add in +0.25D of sphere power.
Now, if that all sounds complicated. Don’t worry. You won’t be tested on all of this. Furthermore, the process is similar to what you normally do with the main prescription as well. Just take the numbers of astigmatism from the autorefractor and then subjectively test it. Furthermore, because the eyes can’t really focus in or out when the point of convergence of the light is split up, you don’t even really need to balance. You just briefly test the astigmatism, then leave it alone.
And that is the reason why I was a bit confused when after objectively testing everything she needed to, the J!NS technicians still played around with the astigmatism and tried to reduce it as much as possible. She, specifically, asked if there were any major issues if she tried a prescription with a lower astigmatism value. The impression my wife and I got was that she was asking us if the vision with the lower astigmatism was still acceptable. My wife said that it wasn’t too different between a prescription that was slightly higher in astigmatism versus one that is slightly lower, though the lower astigmatic prescription likely caused a little bit of shadowing. The technician then just kept to it and used the lower value. Furthermore, this lower prescription also did not get the adjustment to the main prescription that was needed to neutralize the convergent light beams.
My best reasoning for why she did what she did is this: The higher the astigmatism, the more precise the measurements need to be and the more expensive the stock lens is to make. Therefore, it’s just easier to make lenses that are less astigmatic.
My second best guess? Whenever someone goes from having no astigmatism to having astigmatism, though they see better, it takes a minute to adjust into it. Sometimes, opticians rather not deal with the patients awkward transition phase and just give them less astigmatism even if it means the patients sees shadowing or starbursts around lights at night (common side effects of uncorrected astigmatism).
Now, thankfully, we are still, in the end, just talking about a few degrees of astigmatism but still. I want to emphasize that though these are concerns of mine, these were not gigantic red flags where I would actively be worried for my wife’s vision needs. However, it’s still unsettling for me because it seems rather suboptimal for the best corrected vision.
In any case. After all of that, the technician, at last, then put the prescription into a trial frame — essentially temporary glasses so that my wife can test it one last time.
It was okay but it wasn’t perfect. Sure enough, when we pulled out our Canadian prescription after the exam, we found some discrepancies. Mainly in that there was way less astigmatism than my wife needed. We told them, we appreciated their prescription and would definitely still pay them for their time but we insisted on the prescription from Canada we had. They said they would make us anything we like and weren’t the least bit offended by this.
In any case, that was the entire exam.
After this was all said and done, we went to a food court downstairs and after a short meal, went back upstairs to the optical shop and they had the glasses ready and made. That was all.
CH3 Impressions
Let’s start with the best part of the testing, then move on to the not-so-good parts. The service was fast. Just like they promised — 30 minutes, in and out, and your glasses are ready. A lot of online chatter praises this speed like it’s groundbreaking, but honestly, we have opticals in Canada that can do the same. Sure, it’s rarer here, but not unheard of. The tools, training, and equipment to pull off something like this are impressive and expensive — which is probably one reason Canada doesn’t offer it widely.
The other reason, in my opinion? Canadians buy more progressive lenses than single-vision ones.
A lot of life in the West revolves around driving. That means you need to see both the road ahead and your dashboard. When you get older and lose your near vision, you often end up with progressive lenses — glasses that correct both far and near vision in one pair. These lenses aren’t just about adding an “ADD” power; they also require measurements like segment height, reading zone, and separate near and distance pupillary distances. That means each pair has to be custom ordered. With so many variables, it’s impossible for clinics to keep stock lenses for every combination.
This is just speculation — and there’s a lot more I could say — but I’ll save that for another video if there’s enough interest. This script is already way too long.
Overall, the exam sequence wasn’t bad. There were things I didn’t agree with, but it wasn’t a complete farce either. Would I fully endorse their order of operations? Not really.
My wife is an ideal patient: an adult, experienced with glasses, and unlikely to produce misleading results. But for first-time patients or kids, I’d hope J!NS runs a very different exam. As it stands, their heavy reliance on the autorefractor is risky for those groups. The way the exam is set up, it works really well if nothing is wrong — but if something is wrong, I can see how many prescriptions could miss the mark.
And that brings me to the large elephant in the room: the J!NS eye exam checks nothing about eye health — and that worries me.
From my rant about the phoropter’s limitations, it should already be clear that eye disease can skew prescription results. And if that’s the case, glasses might not be the solution at all. In Canada, eye care isn’t just about the numbers — it’s about how well you see and why you see that way. We check for restricted fields, reduced contrast sensitivity, discomfort, headaches — signs that may point to deeper issues. Eye health and vision are quite related with one another and furthermore, we didn’t even mention an entire field of binocular vision either.
On top of that, in Canada, optometrists can prescribe painkillers, steroids, and antibiotics for minor ailments and infections. It’s a much more holistic approach, and I stand by it. We see prescriptions and eye health as being in the same boat — because in most cases, they’re directly connected.
With all of that in mind, why don’t you take a look at how optometry is run in Canada and compare it to how “optometry” is run in Taiwan. (I’ll mention why I’m air quoting later).
Ch4: Tying the Video into Taiwan’s Current Status
So, at this point in the original draft… the video was basically done.
I just wanted to talk about J!NS.
And we did.
It was a decent eye exam.
Sure, I had some critiques, but nothing close to a cardinal sin of optometry.
Even the balancing thing I kept pushing for?
Not really the end of the world.
I’d only worry about it with kids — since they often need balancing, fogging, and sometimes even dilating drops to fully relax their eyes.
But anyway… I digress.
The real concern for me was this:
There was no ocular health assessment at all.
And that’s huge.
But if I just stop there, it doesn’t paint the full picture.
Because saying “the difference between Taiwan and Canada is ocular health” almost makes it sound like it’s just one thing.
And it’s really not.
I thought about showing you my exam room — where yeah, I’ve got a phoropter, just like you’d see in Taiwan…
But then, literally everything else in the room is tied to ocular health.
Still, that doesn’t quite get the point across either.
So instead, I looked for another way and that’s when I realized.. I already had the perfect way to show this.
By comparing Taiwan’s optometry scene — right now – with Canada’s.
YOu see, Taiwan’s optometry scene is currently in a transitional phase. Taiwan is changing.
It’s becoming more regulated.
And while that’s happening, priorities are shifting.
Everything is open for debate.
Everything is on display.
Taiwan is trying to bring Optometry into their country and optometry, as a profession is analyzed in minute detail to be brought in.
So, for the rest of this video…
That’s what we’re going to do.
We’ll compare Canadian and Taiwanese optometry.
And through that, highlight just how central ocular health really is to this profession.
CH5: What are Optometrists in Taiwan?
As I mentioned earlier, a huge chunk of optometry in Canada and the US revolves around primary eye care — things like eye disease management, ocular health assessments, and preventative care. So when we were at J!NS and the staff explained their process for getting a prescription, there was zero mention of eye conditions or ocular health. Sure enough, during the entire visit, nobody even glanced at the health side of my wife’s eyes.
Given that, and the fact that the entire experience was focused on refraction (getting a glasses prescription) and selling lenses, I assumed Taiwan’s eye care system looked like this: ophthalmologists for medical stuff, opticians for glasses, and no real “optometry” in the middle. (See slide.) In my little diagram, “refraction” is in the optician circle, and the “optometrist” circle doesn’t even exist.
This assumption wasn’t random. I’d met opticians from across Europe on a humanitarian mission — both East and West — who described exactly that kind of two-tier system. In my biased opinion, it’s smoother to have a middle profession (optometry) connecting the health side and the prescription side. But I also know building that system isn’t cheap or easy. You need infrastructure, regulatory bodies, and optometry schools, and all of that takes serious resources and coordination. Not every country has the means or political will to do it.
Canada and the US don’t run the “optician + ophthalmologist only” model because we believe eye health and prescriptions belong together. That usually gives a higher standard of care. But that’s not to say a two-tier model doesn’t work — it can, and plenty of countries do fine with it.
Another clue: I knew that in Japan, optometry isn’t officially recognized as a profession, and since J!NS is a Japanese chain, I assumed they’d follow the same model abroad. So in my head, this was obvious: J!NS works like this → J!NS is big in Taiwan → therefore Taiwan must not have optometrists.
When they did refraction for my wife without checking eye health, that assumption felt confirmed.
…Right?
Turns out… not exactly.
To my surprise, when I dug deeper while making this video, I found out that Taiwan does have a profession called “optometry” — and it’s in the middle of being built. In 2016, Taiwan passed the Optometry Act under its Ministry of Health and Welfare — essentially the equivalent of parliament or congress officially creating the legal framework for the profession.
Now, this is still early days, and the fine print matters — the profession isn’t yet identical to Canadian or American optometry. But Taiwan is clearly taking the leap toward better eye care and higher standards. And honestly? My first thought was: oh no… the growing pains this is going to cause.
Still, it’s exciting to see. And buried inside this very dry piece of government legislation is a fascinating roadmap for how Taiwan plans to roll out optometry as a profession. Let’s take a look…
CH6: The Taiwan Optometry Act
The Optometry Act is laid out in a bunch of “articles,” each with their own subchapters. Let’s walk through the highlights.
Chapter 1 (six articles) covers the basics: how opticians and “optometric personnel” are governed, the eligibility requirements to take the licensing test, and the structure of the test itself.
Here’s the first eyebrow-raiser:
Nowhere in the Act — or on the official Taiwanese government website as of June 2025 — does the word Optometrist appear. The official terms are optician and optometric personnel.
Sounds like a harmless bit of wording, right? Not in Taiwan. The naming choice has caused enough controversy to spark actual protests. The Optometrist Society of Taiwan (yes, that’s what they call themselves) and its chairperson, Huang Chun-chen (黃群宸), have publicly pushed for the title change, saying it would better represent the profession. Huang claims that during a Ministry of Health meeting in December 2024, most healthcare groups — nurses, physical therapists, medical examiners — supported the change. The only holdouts? The Medical Doctors.
So why gatekeep a job title? Because, globally, Optometrist carries professional and educational weight that Optician does not. The Ophthalmological Society of Taiwan — representing the country’s eye SURGEONS — points out that optometrists are healthcare professionals who complete postgraduate studies, which is very different from Taiwan’s current optician training.
In Canada (and the US), optometrists learn the eye—and beyond—with the express purpose of managing and treating eye conditions. For example, Canadian and American optometrists can prescribe medications. So when people ask me if an optometrist is an “eye doctor,” my response is: it depends on where you are.
In Canada, optometrists have been recognized as “doctors” since 1954. What makes us “doctors” in the public eye is that we:
- Check for eye health issues as well as prescribe glasses,
- Can prescribe medications for certain eye conditions,
- And—most importantly—we are highly regulated at every step for these privileges.
You know what really makes a doctor a “doctor”? It’s not just a desire to help people—it’s regulation and accountability. Regulations make the doctor.
If I give the Taiwan Optometry Society the benefit of the doubt, I think their real goal is to use the title to negotiate a broader scope of practice. The title might help with that. But in their public statements, they’ve also claimed that “people training to work as an optician in Taiwan are known as optometrists in countries including Australia, Singapore, Thailand, and the Philippines.”
Here’s where I have to pump the brakes. That statement doesn’t hold up — at least for Australia and Singapore, which I know well.
- Australia: Becoming an optometrist there requires either a postgraduate Doctor of Optometry program (entered after a science undergrad with specific prerequisites) or a long-form integrated optometry degree. Either way, you graduate as a Doctor of Optometry before you can practice. It’s a multi-year process far beyond the scope of Taiwan’s current optician training.
- Singapore: Their system is different, but still distinct from Taiwan’s. It’s a three-year program followed by a licensing exam — the Internationally Graduated Optometrist Evaluating Examination (IGOEE). This test covers clinical and medical optometry skills that simply aren’t part of Taiwan’s Optometry Act at this stage.
So, I’m trying to stay neutral here — there are gaps in my understanding, and this is still a developing profession in Taiwan — but from where I sit, the “other countries do it this way” argument is… not the strongest.
As of June 2025, the official English version of the Optometry Act still avoids the word Optometrist. And, to rub salt in the wound for the name-change advocates, every local news outlet covering their rallies has still referred to them as “opticians.”
Optometry naming crisis
Chapter 2: The Big One
Chapter 2 of the Act is where things start to feel important — but only in parts.
Articles 7, 9, and 11 cover where you can practice (your registered district) and what kind of setting you can practice in (firm, clinic, etc.). Article 11 also says you must join your local opticians’ association if you work there.
Article 7 sneaks in a small but good requirement: continuing education credits. This is something I also have to do to keep my license in Canada, so it’s nice to see Taiwan building that into the system.
Articles 8 and 10 are basically “no license, no practice” rules — standard stuff, nothing exciting.
But then… Article 12. This is where things get interesting because it defines scope of practice. And as much as I wish I could tell you it’s identical to what optometrists do in the West… it’s not. Honestly, it reads more like a division of labor between opticians and “optometric personnel” than the establishment of a Western-style optometry profession.
For Optometric Personnel, the scope is:
- Non-invasive refraction and related tests, including contact lens exams. If the patient is 15 or younger, the exam must be under the guidance of an ophthalmologist. Under 6? Not allowed at all. (This age rule is actually a good move, and I’ll circle back to it later when we talk about DPAs.)
- Fitting general contact lenses.
- Low-vision aid training.
- Other tests only if a physician has ordered them.
For Optical Technicians, the scope is basically the same, minus the low-vision part, and again with the under-15 and under-6 restrictions.
One more line is worth noting: if vision can’t be corrected with glasses, optometric personnel must refer the patient to a medical care institution.
So… what do I think?
Article 12 is short, narrow, and honestly a bit underwhelming if you’re expecting a full optometry scope. There’s nothing here about the medical side of eye care — no ocular disease management, no diagnostic drugs, no advanced clinical procedures.
On one hand, it’s a pretty limited toolkit. On the other, it’s a solid step toward quality control for refractions — more oversight on who can give prescriptions, and at least some structure to protect patients. And yes, it’s still more than what I saw at J!NS, so that’s progress.
Here’s the big-picture takeaway:
In Canada or the U.S., “optometrist” means you get both your glasses prescription and a full ocular health assessment from the same person — because the scope is built to include both. In Taiwan, this law creates a regulated, licensed role for refractions, but leaves the medical eye care firmly in ophthalmology’s domain. Neither approach is inherently wrong — they’re just designed for different systems. But it’s still a step forward. It raises the standards for refraction, it regulates who can hand out prescriptions, and it at least ensures there’s more structure than what I saw at J!NS. (Yes, that’s foreshadowing for the critiques coming later.)
Oh yeah, one last thing. After 12 there are still two articles here (13 and 14) which mostly refer to paperwork and notekeeping.
Chapters 3–5: Business, Bureaucracy, and… Fines
The next few chapters I’m going to skim because, frankly, they’re about parts of optometry I don’t live in every day — business ownership, corporate regulations, and association politics. Since I don’t own a practice (and my knowledge of Taiwanese business law is basically zero), I’ll keep it quick.
Chapter 3 covers the rules for opening any kind of eye-care-related business — including standard fees, clinic requirements, and the paperwork needed to get started.
Chapter 4 is all about the associations that oversee optometry in Taiwan: their rules, regulations, elections, board positions, and other governance details.
Chapter 5 is where things get a little spicier — the penalty section. Think of it as the “don’t do this unless you like paying big money” chapter.
Here are some of the notable ones:
- Working without a license? That’ll be NT$30,000–150,000 out of your pocket.
- Using the title of “optometric personnel” without the certificate? Same NT$30k–150k range.
- Running or advertising a fake optometric lab? Also in that same range.
- Leaking patient info? Yep — NT$30k–150k.
For licensed optometric personnel, fines drop slightly (NT$20,000–100,000) but come with the added risk of suspension or losing your license if you mess up badly. Offenses include:
- Testing kids under 6 (forbidden by Article 12).
- Failing to refer a patient when glasses can’t fix their problem.
- Making fraudulent statements or reports.
Optometric labs get their own list of no-nos (mostly around paperwork, naming rules, and supervision duties), with fines between NT$10,000–50,000 — plus potential suspension if you don’t fix the problem by the deadline.
Finally, there are fines for sloppy record-keeping, like not signing exam reports or failing to store prescriptions for the required three years.
Quick Western comparison: In Canada and the US, the dollar amounts vary wildly by province/state, but the same general principle applies: if you practice without a license, you can expect fines in the thousands, plus a permanent black mark on your professional record. Where it gets different is that in the West, penalties often focus heavily on patient harm — meaning if you skip a retinal health check and miss a serious disease, you’re not just facing fines… you might be looking at lawsuits or losing your license entirely. Taiwan’s fines are stricter on the business compliance side and lighter on the clinical malpractice side — which actually makes sense given how limited the scope of practice is right now.
In short: Taiwan’s Optometry Act may have a narrower scope than in the West, but the penalties for ignoring the rules? Pretty robust.
Chapter 6: Additional Circumstances and Transition Period
Finally, we get to Chapter 6, which covers some important transitional rules — like what happens to people who were practicing opticianry before the Act came into effect, and how foreign degrees are handled.
One key point here is that if you were working in opticianry without formal qualifications before the Act was passed, you were given a grace period of about five years to get licensed. I think this is a smart solution — it prevents wiping the slate clean and lets people with experience adapt to the new system without getting kicked out overnight.
Here are some specifics from the Act:
- People who worked in a medical care institution or optical company for at least three years before the Act, and who graduated from junior college or above (with qualifications approved by the central authority), can take a special optician exam.
- Similarly, those with three years’ experience (with a high school or vocational school diploma or above), or six years’ experience plus over 160 hours of continuing education, can take a special exam for optical technicians.
- This special exam will only be offered up to five times within five years after the Act’s implementation.
- Those who pass and register their practice within ten years of the Act’s start may be exempt from certain penalties during that period.
- After ten years, registrations without proper licensing will be annulled and practices will have to close.
From Article 2, we also see the path for new graduates:
- Graduates from public or recognized private junior colleges in optometry, who complete internships successfully, can sit for the optician exam.
- Graduates from medical optic technique or optometry programs at vocational schools, also with internships, can take the optical technician exam.
This chapter is really about helping the existing infrastructure transition into the new system — but it’s also where Taiwan faces a big challenge. Licensing exam pass rates are reportedly very low right now, which puts some clinics at risk of shutting down when the new regulations fully kick in. It’s suspected (though not yet confirmed) that many of those failing the exams are practitioners who trained before the Act and didn’t have formal education.
So it’s a double-edged sword: better regulation means better eye care for patients, but fewer clinics might be able to operate, making exams more expensive and harder to find.
So, do you now understand optometry in Taiwan?
Summary: Understanding Optometry in Taiwan
Optometry in Taiwan is still very much a work in progress. The profession is officially practiced by what the law calls “optometric personnel,” who perform tasks similar to optometrists elsewhere, including prescribing glasses, fitting contact lenses, and assisting with low vision aids. However, Taiwan’s system currently focuses heavily on the refractive and optical side of eye care, with limited scope when it comes to the medical or health aspects of the eye.
Unlike in countries like Canada or the US, where optometrists provide comprehensive primary eye care — managing eye health, detecting diseases, and prescribing treatment alongside vision correction — Taiwan’s optometric personnel mainly cover the prescription and optical services. The recent Optometry Act is a significant step forward in regulating and formalizing the profession, but it still reflects an early stage in Taiwan’s development of full-scope optometry.
With transitional rules in place to bring existing practitioners into compliance, the profession faces growing pains, including low licensing exam pass rates and the challenge of balancing higher standards with accessible care.
In short, Taiwan is moving toward a more regulated and professional optometry field, but the journey is ongoing — and it will be interesting to see how this affects eye care services, both in quality and availability, in the years to come.
Chapter 7: Licensing Exam Comparison and Content Differences Between Canadian and Taiwanese Optometry
By now, you should have a clearer understanding of how Canadian optometry compares to Taiwanese optometry. I’ve outlined how optometry is practiced in Canada and provided an overview of how it operates—or is intended to operate—in Taiwan. The key difference I keep coming back to is the role of primary eye care and eye health assessment.
To really drive the point home, let’s compare the licensing exams required in Taiwan and Canada. These exams represent the final hurdle before entering practice, assessing your knowledge across the wide range of topics you’ll encounter on the job.
In Taiwan
To be eligible for the licensing exam to become optometric personnel, you must graduate from an optometry program that includes an internship. Then, you take a licensing exam composed of five parts:
- Eye anatomy and code of ethics
- Visual optics
- Optometry (general)
- Contact lens studies and ophthalmic dispensing
- Low vision studies
Each exam lasts an hour, and you need to score at least 60% on each to pass.
In summary: complete a 4-5 year university program, take five separate one-hour tests, and pass with 60% or more.
In Canada
To take the Canadian licensing exam, you must graduate from an accredited optometry school—which itself requires an undergraduate science degree and completion of prerequisite courses.
The Canadian licensing exam has two parts:
- Written exam
- Practical exam (OSCE – Objective Structured Clinical Examination)
The practical OSCE tests clinical skills, particularly in medical optometry, for which there is no direct equivalent in Taiwan since their system doesn’t emphasize the medical eye care side.
The written exam is a single 6-hour test covering a wide range of topics taught in the Doctor of Optometry program. Unlike Taiwan’s separate subject exams, the Canadian exam is more integrated. The Canadian exam’s exact topic list isn’t publicly detailed, but it closely aligns with the American optometry licensing exam, which many Canadian students use as study material.
Having taken both Canadian and American boards myself, I can say the American boards are much tougher, going deeper into content. But that’s a separate conversation for another time.
American NBEO Part 1 Topics (used as a benchmark for Canadian exams):
- Ametropia, Ophthalmic Optics / Spectacles, Contact Lenses, Low Vision
- Accommodation / Vergence / Oculomotor Function
- Amblyopia / Strabismus
- Perceptual Function / Color Vision
- Visual and Human Development
- Normal Health / Disease / Trauma of eye structures (Lids, Cornea, Lens, Retina, Optic Nerve, etc.)
- Glaucoma
- Emergencies / Trauma
- Systemic Health
Now, I’m not going to go much deeper into this because, as I mentioned, a licensing exam is not a definitive guide to how a profession operates in the real world. However, it’s worth pointing out because, as a famous person once said: “Show me the incentives, and I’ll show you the outcomes.” If this is what the boards expect you to know to work, it likely influences what the average professional in the field actually knows.
Finally, you’ll notice that although the topics don’t align perfectly, I was able to match most of them. If you’re curious how I made those assumptions, keep watching—because the alignment required me to look into Taiwan’s optometry curriculum, which is exactly what we’ll explore in the next chapter.
When you line these topics up against Taiwan’s exams, you see some overlap—but also a significant gap. Even if the Taiwanese curriculum matches the quality of education for similar topics, its focus remains narrower—mainly on refractive aspects and basic contact lens fitting, with limited emphasis on medical or eye health depth.
But that’s the key word here: quality. To really understand the difference, we need to explore how deeply each country covers the topics in question.
So, how big is the gap?
At first glance, it might seem like Taiwanese optometry could be brought up to Canadian standards with a few extra lectures and exams. But that’s an oversimplification and not a good answer.
My thinking is that the gap is bigger than just curriculum content. Why? Because it comes down to two things: the quality of education and, more importantly, the intent behind the training.
Canadian optometry is built to deliver comprehensive primary eye care, including the diagnosis and management of eye diseases. Taiwanese optometry, as it currently stands, focuses mainly on refractive services and basic vision correction. Even if the same subjects are taught, Canadian programs teach them with the expectation that you’ll apply that knowledge directly in the clinic. In Taiwan, it feels more like a box you tick to graduate—a requirement to enter the profession, rather than a skill set you’re expected to actively use in practice.
In other words, while Taiwan’s system may require you to study physiology, pharmacology, and pathophysiology of the eye, these subjects don’t appear to carry the same real-world application as they do in Canada.
And since I don’t like making claims without checking the facts… needless to say, we need to go deeper. Which means we can’t just look at the licensing exams—we have to dig into the education itself.
Ch8: A Deeper Dive into Education
So far, we’ve made some assumptions based on licensing exams, and I initially thought that would be enough. However, the more I thought about it, the more I realized the comparison wouldn’t be complete without looking at optometry education itself. With that in mind, I decided to dig into Taiwan’s optometry education and curriculum—and that’s when I discovered an article about Wang Man-tang, often called the godfather of optometry in Taiwan.
First off, I couldn’t find much information about Wang Man-tang’s credentials anywhere—especially in English. I tried searching Chinese sites too, but the best I found was a memorial page. The original article mentioned he completed a master’s degree at the University of Iowa, but a healthcare master’s isn’t the same as being an ophthalmologist. Ophthalmologists are MDs specializing in eye care, which requires a longer and different path than a master’s. I’m not sure if Wang Man-tang was an American-trained optometrist either. So, take all of this with a grain of salt.
My best guess is that he was a highly respected eye care professional who earned most of his credentials in Taiwan and also completed a master’s degree in Iowa. That seems enough to lend credibility to his efforts. And what exactly did he want to do? He wanted to establish the Taiwanese Optometry Act. Interestingly, it was only when I started looking into education that I found the origin of this important legislation.
This might sound like a big revelation, but sadly, the lack of accessible sources—especially in English—makes it hard to know more. What I could find is that Wang Man-tang taught at Chuan Shan Medical University in Taiwan and likely influenced the optometric studies curriculum there. Regardless, since Wang Man Tang is a very influential figure and his legacy is at the Chaun Shan Medical University, it seems only natural that we look at this school as an example to see what a typical Taiwanese optometry school curriculum looks like right?
*Go to google slides*
At Chuan Shan Medical University in Taiwan, there are two optometry programs: a 4-year undergraduate program and a 2-year master’s program. The 2-year program is a post-undergraduate degree and isn’t required to practice optometry in Taiwan, so we’ll skip it here. From what I can tell, it’s essentially an expanded version of the 4-year program, likely with more in-depth research into the same course topics.
Now, I’ll admit—I’m biased here. The curriculum outline only gives a brief description of each course, which isn’t the most reliable foundation for a full analysis. On top of that, all classes at the school are taught in Chinese, so I have to assume there are a few translation gaps in the information I’ve found.
Still, I think it’s worth looking at, because even a high-level curriculum can help us start to piece together what’s really going on. With that in mind, let’s go over what’s being taught—at least from the slides and materials I was able to review.
Looking into year 1 for both sides. For the Taiwan side of things, for me at least, it feels like undergraduate courses. There’s basic biology and physics as well as optics and physiology. For the Canadian side of things, we jump straight into neurobiology. One of my least favourite courses and one of which I can personally attest to as being a course where day 1 will make you feel like your 6 months behind.
*editor note: maybe just speak from the slides here*
Now that we’ve gone over the courses—at least in brief—there were a few surprises. For one, Taiwanese optometry education covers more topics than I initially expected, including areas like pharmacology. These aren’t topics you’ll see on the licensing exam, but they are in the curriculum. If I put myself in the shoes of a Taiwanese optometry student, I can imagine resenting some of these “extra” courses I’d rarely use in practice. But if Taiwan truly wants to raise its level of eye care to match Western standards, these subjects are essential.
It’s refreshing to see that Taiwan’s optometry programs do include a solid amount of professional knowledge. That’s good news. But if we compare education alone, we leave out a crucial point: in Taiwan, optometry is still an undergraduate degree, while in Canada it’s a post-undergraduate program.
This difference brings us to two important points:
1. Extra prerequisites before you even start.
In Canada, you can’t just jump into optometry school out of high school. You first need three years of undergraduate study with a minimum 75% average—plus the Optometry Admissions Test (OAT). Those three years must include a mix of arts and science prerequisites:
- Arts: 1 English/communication course, 1 ethics course, and 1 psychology course.
- Biological sciences: 2 biology courses (with 1 lab), 1 microbiology course, and 2 physiology courses.
- Chemistry: 1 general chemistry course (with lab), 1 biochemistry course, and yes—organic chemistry, the academic equivalent of a “final boss.”
- Physics & math: 2 physics courses (with 1 lab), 1 math course, and 1 statistics course.
By contrast, Taiwanese optometry programs—being undergraduate degrees—require only a high school diploma (or equivalent) and a qualifying GPA, with some schools also using GSAT scores. The Canadian pathway ensures applicants enter already well-versed in science, whereas Taiwan admits students directly from high school with no such background requirement.
2. The applicant pool is more seasoned.
In Canada, optometry students have already been through university life, maintained a GPA, and managed the independence required to succeed in a post-secondary environment. That’s a different level of readiness. High school grades—especially in Canada—are increasingly unreliable due to grade inflation, while university grades are a better performance indicator because they come from larger, more competitive cohorts. University applicants have faced bigger classes, fewer support systems, and greater expectations for self-reliance.
In short, while Taiwan’s optometry curriculum is broader than expected and includes topics beyond the licensing exam, its undergraduate structure—and the lack of rigorous pre-admission requirements—creates a fundamentally different training pipeline than Canada’s post-undergraduate model. Canadian optometry students enter with stronger scientific foundations, greater academic maturity, and more clinical intent behind their education, while Taiwan’s system, though promising, still leans toward refractive care. This difference in both structure and purpose is what ultimately shapes how each country’s optometrists are prepared for practice.
Chapter 9: Discussion
So, from my encounter with the J!NS optical, I thought Taiwan Optometry was okay but lacking mostly in their eye health department. Thankfully, it looks like this critique of mine is already being addressed, although, it looks like things are rather dicey.
After analyzing both the licensing exams and the educational curriculums of the field in Optometry, I can say for certain that they do have potential though I still do think they have a long way to go.
Personally, I don’t think the Taiwanese Optometry Association should focus their efforts on changing their English title to “optometrists.” I think their efforts are better spent elsewhere.
The first place I would think needs more attention is scope of practice because asking for a name change is kind of antagonizing the wrong people. I understand that some Canadian and American colleagues of mine would be offended if a group used the title “optometrist” without engaging in eye health beyond refraction. They worry it could muddy the waters and dilute the profession’s credibility. It’s a fair point. The challenge is that those most offended are often the ones on regulatory boards advocating for the profession, so in other words, they hold power and have voices. Given this, if Taiwan is trying to garner as much international support as possible to be recognized … .maybe it’s a good idea to not get on the bad side of the international scene. Politically, it just makes sense to build allies during times of change.
After reviewing their education system, it’s clear that graduates from both vocational and university programs have the education to support a broader scope of practice. If they could implement this and have the regulations to support it, I think everyone would be more comfortable with the scene. If Taiwanese optometrists had a broader scope, a title change would be more justified.
Another place where the Taiwanese Optometry Association can work on is coverage and availability, which are sort of the biggest issues at hand right now. Despite growing recognition and more schools producing graduates, there are concerns. On one side, they are saying that with the implementation of the Taiwanese Optometry Act, which is bound for full enactment in 2026, there will be restrictions on opticals in place which would limit the coverage of eye care. This argument is due to a study in 2017, where it was revealed that the pass rate for Taiwan’s optometry licensing exam, needed to practice after 2026, was around 25%.
From my research, it seems official optometry schools in Taiwan have graduates passing the licensing exam easily — over 90% on the first try. So, the low pass rates are probably due to previously unregulated practitioners trying to get licensed during the grace period allotted to them.
Since we examined the licensing exam of Taiwan and concluded that it was rather easy compared to the West’s licensing exams, it’s kind of a bad argument in my opinion. Because if you can’t even pass the easier exam, I shudder to think what kind of “eye exam” people have really been getting…
Ch10: Final thoughts
I first walked into the J!NS thinking I was going to get a red flag equivalent of an eye exam. It wasn’t the case. While it was not to the standard I may have liked, it wasn’t by any means a complete wash. It did have good service and was decent in selling a product. The only thing that did drive me on edge was that there are so many health checks that were completely ignored. When I looked into it, it looks like Taiwan themselves are addressing this and are working towards a better future all together for eye care. Despite the fact that there are growing pains from people wanting to get ahead of themselves to those who don’t want a lot of change, I still think the current transition state is optimistic. I, for one, am hoping to see Taiwan’s optometry scene flourish in the future.
Ending: now, in this video I decided to do something completely different. I mean, this video is essentially just light journalism about a current world event about a topic close to me. If this got your interest, leave a comment below on some other optometry related topics, university related topics or just general comments. I am new to this whole thing so am open to critique. Some topics in particular that could be interesting that I’ve mentioned in the video are:
- US optometry vs Canadian optometry
- What is astigmatism actually?
- When and why did Canadian optometry convert from an undergrad degree to a graduate one?
- What is presbyopia? And how are progressives really made?
- Binocular vision, what is it?
Progress and challenges of optometry conversion in taiwan
Regulating eye exams
Rejecting optometry and high failure rates of optometry
Taiwan optometry standardized testing
NBEO reference
Taiwan Optometry report
“mollyebrown,+Development+of+Optometry+in+Taiwan” (in drive)
Taiwan’s official optometry act
Taiwan’s first optometry licensing exam
Wang Man Tang Service notice? (OMD who drafted the optometry act)
Taiwan’s officially recognized vocational schools and universities (CSMU is on it)
Higher education and university or vocational schooling for optometry
CSMU optometry program
Memoirs of a tiger cub 
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