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Expanded scope of practice highlights Optometry 2040 report

05/12/2018By Myles Hume
Minor surgery and prescribed injection treatment for macular disease may soon fall into an enlarged scope of practice for Australian optometrists, according to a new report that sets a 20-year vision for the profession.

Optometry Australia (OA) released the report, Optometry 2040 taking control of your future, at its 100th Anniversary celebration at Parliament House in Canberra on Monday night. It aims to provide an agenda and strategy to guide the sector towards a sustainable future over the next two decades.

The report highlighted seven key trends that OA believes will shape the future of the profession and eyecare, including the prospect of broadening optometric scope of practice.

“There are a range of areas in which optometry’s current scope may evolve to support them to best meet community need, including oral therapeutics, minor surgery, prescription of and treatment with injectables, and diabetic education,” the OA report stated.

“The trend toward two-tiers of optometric practice – a narrower, more traditional scope of practice, and a broader ocular health practice – is expected to continue, and ‘specialisations’ may become more prominent.”

The report also highlighted that expanding optometry’s scope of practice in treating ocular disease had already occurred in other countries.

However, scope of practice has also been a highly politicised and controversial issue. In the US, optometrists are able to perform eye injections and laser surgery in some states, but many American ophthalmologists believe they don’t have the required training for surgical procedures, and regularly cite issues with laser trabeculoplasty procedures as an example.

“Optometry 2040 is about taking control of our future and taking decisive action to shape the ongoing evolution of optometry in Australia.”
Lyn Brodie, OA

Commenting on the report, OA CEO Ms Lyn Brodie told Insight that evolving optometric scope of practice in Australia was “in no way” about replacing ophthalmology or ophthalmologists.

“[It’s] about ensuring that maximal use is made of their skills. Thorough investigation and long-term planning, in collaboration with the regulator, ophthalmology and educators, will be critical to determine what would best serve the community and how this can be realised through integrated eye healthcare approaches,” she said.

In compiling the Optometry 2040 report, OA spent more than six months consulting members, optometrists, ophthalmologists, ‘futures studies’ experts and other key influencers. Brodie said it would be used to reform government policy, regulation and education, as well as guide OA to best serve optometrists and the sector.

Other key trends

Technology will have a major influence on the future of optometry, as it continues to improve services for prevention, detection and management in eye health. As such, the report warned that optometrists needed to embed new technologies in their practices, and eventually move away from depending on optical sales to subsidise clinical care.

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“Reliance on optometry may also reduce as technologies increasingly enable other health practitioners to provide greater eye health assessment and patients to self-diagnose/manage aided by artificial intelligence and ‘non-human’ advice,” the report stated.

It also concluded that eyecare was becoming more consumer centric; big data was having an increased role in decision making and efficiency; the optometry workforce was becoming younger and more female; social demographics were changing through an ageing population and escalating rates of chronic disease; and that there is a need for alternative funding models with a shift away from the Medicare system.

In addition, the report reiterated OA’s concerns over an imminent oversupply of optometrists. However, the report didn’t address issues related to optometric maldistribution, despite acknowledging it as a problem for ophthalmology.

“In the short-term, we are focused on ensuring that the Commonwealth’s Visiting Optometrists Scheme continues to support access to eyecare for regional and remote communities and Aboriginal and Torres Strait Islander people,” Brodie told Insight.

“We are also looking at opportunities to build the optometric workforce providing outreach services and working in areas of unmet need.”

Brodie added: “Optometry is changing rapidly due to demographic, technology, economic, government, and societal forces. Practice models, working conditions, clinician training requirements, patient eyecare and communication are evolving at an unprecedented rate.

“Optometry 2040 is about taking control of our future and taking decisive action to shape the ongoing evolution of optometry in Australia.”

Meanwhile, at its annual general meeting on Sunday, OA appointed WA’s Mr Darrell Baker, as its new president, replacing Mr Andrew Hogan who also stepped down from the national board. Victoria’s Ms Kylie Harris has assumed the role of deputy president, filling the void left by Baker’s appointment.


More reading:

OA Full Report
Eyeball wars – patients, politics and profit


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