Opinion ID: 2454965
Heading Depth: 1
Heading Rank: 2

Heading: Adaptation of lenses

Text: It is equally plain that Curteman engaged and engages in [t]he    adaptation    of lenses    to correct defects or abnormal conditions of the human eye. To adapt means to make suitable or fit (as for a particular use, purpose, or situation)    to make suitable (for a new or different use or situation) by means of changes or modifications. Webster's New International Dictionary, Third Edition. Adaptation is the act or process of adapting, fitting or modifying or adjustment to environmental conditions. Idem. Adaptation is synonymous with fitting. The adaptation of contact lenses by one prescribing such lenses is the activity or process by which such lenses are fitted to the eyes of an individual. It includes all of the actions taken by Curteman in measuring and examining the eye of the patient, the insertion of the fluorescein dye, the placing of the lenses on the cornea, the giving of a wearing schedule, the examination of the patient and the eye after trial use of the lenses, and the making of any necessary modifications in the lenses to insure a proper fit. Curteman makes contact lenses suitable to patients; fits and adjusts them to the human eye; alters, changes the form and structure and modifies contact lenses to fit the needs of the patient. Dale Curteman conceded that his corporation is engaged in adapting contact lenses, in the following exchange: Q And would you state what business Dale Curteman, Inc. is engaged in? A The fitting, upon medical referral from medical doctors, of contact lens, artificial eyes and prosthetic appliances. Under Dale Curteman's own admission and under the plain and unambiguous language of the subsection Curteman is engaged in the adaptation of contact lenses to correct defects or abnormal conditions of the human eye. As we construe Chapter 336 and its several provisions the circuit court clearly erred in concluding as a matter of law that the activities and practices of Curteman do not constitute the practice of optometry in violation of Chapter 336. This construction is buttressed by the decision of this Court in 1963 in Ketring v. Sturges, Mo.Sup., 372 S.W.2d 104, that the same acts which the evidence in this case shows Curteman performed (established in Ketring by an agreed statement of facts), performed by an unlicensed layman (an optician), constitute the practice of optometry under the laws of this state, in the absence of any statute that would authorize opticians to measure the eyeball or to insert and adjust contact lenses. 372 S.W.2d, l. c. 113 [6]. (As previously developed, there is no such statute authorizing opticians or lay technicians such as Curteman to perform these functions.) We are further persuaded to this view from a consideration of the following cases from other jurisdictions: State ex rel. Reed v. Kuzirian, (1961) 228 Or. 619, 365 P.2d 1046, 88 A.L.R.2d 1284, in which under a statute defining the practice of optometry as the adaptation of lenses or frames for the aid (of the human eye) the Oregon Supreme Court held that a person who inserts, fits, and adjusts contact lenses into the eye of any person is engaged in the practice of optometry within the meaning of the Oregon law. Fields v. District of Columbia, (1967) D.C.Ct.App., 232 A.2d 300, in which under a statute including in the definition of the practice of optometry the adaptation of lenses for the aid and relief of visual defects, the District of Columbia Court of Appeals held that the procedures and acts of an optician (as to whom there is no licensing requirement) in the fitting of contact lenses in the manner shown to have been Curteman's method of operation constituted the adaptation of lenses within the meaning of the statute. New Jersey State Board of Optometrists v. Reiss, (1963) 83 N.J.Super. 47, 198 A.2d 816, in which under a statute providing that a person shall be deemed to be practicing optometry who shall employ any means for the measurement of the powers of vision or the adaptation of lenses or prisms for the aid thereof, the Superior Court of New Jersey, Appellate Division, held that a licensed optician who performed the same acts performed by Curteman was practicing optometry without a license; that the plain wording of the statutes made it clear that the fitting of contact lenses is within the professional scope of the optometrists but is an activity proscribed to the artisan trade of an optician or ophthalmic dispenser; that In violation of the letter and spirit of the law, Reiss adapted lenses to aid the vision and was engaged in the business of fitting contact lenses. Melton v. Ezell, (1967) 250 S.C. 183, 156 S.E.2d 871, in which under a statute providing that a person shall be deemed to be practicing optometry if he shall prescribe or fit contact lenses, in the same factual background demonstrated here, the Supreme Court of South Carolina held that the optician, rather than the referring physician, was the contact lens practitioner, and was engaged in the unlawful practice of optometry. We have read and considered the cases cited by respondents and the amicus curiae. Instead of extending this opinion by a case-by-case analysis we conclude that these cases may be distinguished, either on the ground that the facts or statutes involved are fundamentally and vitally different, or we disagree with their reasoning and philosophy. Respondents raise a constitutional point, claiming that the State and relators are attempting to enforce a construction of various sections of Chapter 336 so as to deprive respondents of their liberty and property in violation of the due process clauses of the state and federal constitutions. Chapter 336 is a regulatory act, enacted under the police power, for the protection of the public health, to assure high standards of professional competence. Head v. New Mexico Board of Examiners in Optometry, (1963) 374 U.S. 424, 83 S.Ct. 1750, 10 L.Ed.2d 983. Its wisdom is a matter for the General Assembly, not for the courts. Williamson v. Lee Optical of Oklahoma, Inc., (1955) 348 U.S. 483, 75 S.Ct. 461, 99 L.Ed. 563; Roschen v. Ward, (1929) 279 U.S. 337, 49 S.Ct. 336, 73 L.Ed. 722; Head v. New Mexico Board of Examiners in Optometry, supra. Respondents have not pointed out in what specific manner the General Assembly exercised the police power of the State in an unconstitutional manner, and we perceive none. We are sensitive to the fact that in many fields of medicine physicians and surgeons customarily use the services of ancillary lay assistants and allied health personnel, without whose assistance they could not meet the public need for health services or function as effectively as they can with their assistance. We know from this record that ophthalmologists customarily delegate to lay technicians the performance of services for their patients which we have found to constitute the practice of optometry. We recognize that Dale Curteman and the Curteman employees have been in the business for years; that their proficiency in the field is recognized by outstanding physicians; that their services are said to be important as a practical matter in meeting the needs of the public, and that our holding will interfere with many existing established customs and practices. Where established customs and practices are challenged and found to run counter to plain and unambiguous language of controlling regulatory statutes such customs and practices must give way to the law, which this Court must declare as it is and not as some would prefer that it had been written. If it is desirable as a matter of public policy that capable and proficient lay technicians be authorized to practice optometry by assisting ophthalmologists and optometrists in the performance of the acts and the making of the decisions necessary to provide the public with contact lenses, that authority must come from the General Assembly and not by way of judicial legislation. Accordingly, the judgment of January 13, 1970 is reversed, both on the information and counterclaim, and the cause is remanded with directions to enter a new judgment finding the issues on the information for State of Missouri and relators and against respondents; finding that the activities and practices of respondents and of the employees of the Curteman corporation (specifying same) constitute the practice of optometry without certificates of registration as optometrists, in violation of Chapter 336, V.A.M.S.; finding that the Curteman corporation has violated the franchise granted by the State and imposing a fine against the corporation under the authority of § 531.050, V.A.M.S. (which shall be nominal since no improper motives were shown, State ex inf. McKittrick v. Wymore, 345 Mo. 169, 132 S.W.2d 979 [3, 4]) but not decreeing forfeiture of the corporate charter; enjoining respondents and the employees of the Curteman corporation from engaging in the practice of optometry in this State in the manner shown in evidence, without certification, and enjoining them from advertising the fitting of contact lenses, as prayed for in the information; finding the issues on respondents' counterclaim for State of Missouri and relators and against respondents; declaring that neither respondents nor the employees of the Curteman corporation have any right to engage in the activities and practices or to perform the services for patients referred to them by physicians and optometrists, as shown by the evidence (specifying same); declaring that certified optometrists have the right to prescribe and adapt contact lenses to the human eye; and assessing the costs against respondents. STOCKARD, C., concurs.