The recent arrival of non-surgical equipment targeted at primary eyecare professionals and a willingness to diversify optometry businesses through more privately billed services are driving greater interest in cosmetic procedures among Australian optometrists, Optometry Australia says.
However, practitioners seeking to broaden their scope by offering non-surgical, eye-related cosmetic services are being urged to consider any implications around their professional indemnity insurance (PII) cover, and remain on top of proposed regulations set to determine how such services can be marketed to the public.
The notion of optometrists performing cosmetic services is nothing new, but the advent of intense pulsed light (IPL) therapy and – during the past 12 months – new bipolar radiofrequency and micro needling to rejuvenate the periorbital region from aesthetics company InMode have prompted renewed interest in the area.
The trend has already taken off in the US where the industry has coined the term “ocular aesthetics”. Historically, these services were limited to surgeries such as blepharoplasty and other eyelid procedures such as ptosis, entropion and ectropion, but new non-surgical methods have allowed optometry to enter the picture.
OA chief clinical officer Mr Luke Arundel concurred, telling Insight the recent release of new non-invasive and non-surgical equipment for cosmetic procedures was likely the primary driver for some OA member optometrists to consider broadening the range of services they offer to patients.
“Many practices are also looking to decrease reliance on dispensing income through offering a range of privately billed services, which is an area Optometry Australia has been active in supporting members to introduce, with many resources available in this area on our website,” he said.
Arundel said Australian optometrists had been performing cosmetic procedures for many decades, including cosmetic shells or lenses for damaged or disfigured eyes, and coloured contact lenses.
“Or, as far as Medicare is concerned, fitting prescription contact lenses to any patient under +/- 5.00D,” he said.
“Optometrists have for many years also been assisting dry eye patients through application of IPL. Treatment of vascular lesions like rosacea may be an obvious complimentary adjunct with dry eye therapy. While in the early days, we will be monitoring with interest use of new devices in Australia which may be able to assist with non-surgical blepharoplasty through RF microneedling.”
Arundel said OA had fielded inquiries through its Optometry Advisor Help Desk, with optometrists curious about regulation, scope-of-practice, advertising rules and restrictions and coverage for techniques through PII.
Regarding the implications for PII, he added: “It would be sensible for optometrists to seek advice from their professional indemnity insurance provider, or financial advisor to ensure their PII covers all the techniques they wish to use if considering expanding into cosmetic work.”
Regulator review
Meanwhile, the Australian Health Practitioner Regulation Agency (Ahpra) is putting non-surgical cosmetic procedures under the microscope that will likely lead to clearer rules around who can perform them and guidelines on advertising.
Amid the crackdown, there is expected to be tighter regulations around the use of testimonials and how before and after images are used to demonstrate results.
Ahpra is concerned about the non-surgical cosmetic sector due to what it described as a lack of clear information about the qualifications and experience of practitioners, and advertising that minimises the risk and complexity of procedures or implies unrealistic results.
It’s also worried about the number of young and potentially vulnerable people seeking out non-surgical cosmetic services, financial gains that can sometimes outweigh patient wellbeing and safety, and ongoing cost and frequency of procedures to maintain outcomes.
Arundel said with this review under way, optometrists looking to move into non-surgical cosmetic services should be aware that current guidelines may change in the near future.
“As part of the association’s strategic plan to lead the sector, Optometry Australia does input into all consultations affecting optometrists and this consultation has been recently been extended to accommodate for the holiday season, with submissions closing on 1 March 2024,” he said.
“In addition, new National Safety and Quality Cosmetic Surgery Standards were launched late last year, following broad consultation with consumers, clinicians, services, professional and peak bodies, regulators, and other representatives of the sector. These standards aim to protect the public from harm and improve the quality of cosmetic surgery in Australia.”
Timeline and key points:
• In September 2022, an independent review is released regarding regulation of medical practitioners performing cosmetic surgery and made 16 recommendations – that were all accepted Ahpra and the Medical Board.
• In July 2023, the Medical Board’s new guidelines for doctors performing cosmetic surgery came into effect.
• Ahpra noted: “The comments by the independent review that the cosmetic surgery sector ‘is unique and somewhat of a health market disrupter, largely sitting outside of the existing health system frameworks’ are equally relevant to non-surgical cosmetic procedures.”
• For example, Medicare item numbers are not available for non-surgical cosmetic procedures, these procedures are not offered by the public health system and they are generally not covered by private health insurance.
• The draft guidelines emphasise practitioners’ responsibilities around informed consent, including financial consent, and consideration of patient suitability, including assessment for underlying psychological conditions such as body dysmorphic disorder (BDD).
• Ahpra said inappropriate advertising of non-surgical cosmetic procedures has the potential to pathologise normal changes in appearance, exploit vulnerabilities or insecurities of individuals, contribute to poor body image and create unrealistic expectations.
• Consultation ended 1 March 2024.
More reading
Queensland clinic first to introduce InMode’s dry eye treatment
New regulations expected for optometrists performing non-surgical cosmetic procedures
Ophthalmic sector watchful of Ahpra clampdown on ‘cosmetic surgeon’ title
