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Expanded scope only way to tackle eye health issues, OA says

optometry scope of practice australia

Oral therapeutics, intravitreal injections and telehealth MBS items are among six areas Optometry Australia is calling for change so the nation’s “seriously under-utilised” optometric workforce can combat urgent issues looming over the eyecare sector.

The organisation last week released its new policy platform, ‘Working Together for Better Eye Care’, that has been developed to remind the government, vision sector and consumers about Australia’s serious eye health challenges, and to recommend practical ways they can be tackled.

OA president and optometrist Mr Darrell Baker said he feared Australia had become indifferent to the serious impact of eye disease.

Darrell Baker.

With an ageing population, eye disease was increasing, but he said the health system was failing too many Australians unnecessarily impacted by vision loss or blindness because they did not have access to timely and affordable eyecare.

“While we have frameworks, plans, reports, and surveys, we are still struggling with issues that were identified a decade or more ago – and many of them have arguably gotten worse,” he said.

“Public ophthalmology wait times in areas like cataract surgery are unacceptably long. Collaborative eyecare remains in its infancy. Only about 50% of patients with diagnosed diabetes get the eye examinations they need. Whilst significant progress has been made, we have not closed the gap in Indigenous eye health, with First Nations Peoples three times more likely to be blind or visually impaired; and a tsunami of age-related macular disease is rapidly approaching.”

As primary eyecare providers, Baker said Australia’s 6,000 optometrists had a crucial role, performing 10 million eye checks annually.

Increasingly, he said optometrists were collaborating with ophthalmologists and other health professionals in treating, managing and triaging patients with eye disease, as well as filling gaps where there was not timely access to care.

“However, Australia’s optometrists are seriously under-utilised compared to their counterparts in similar developed nations like the United States, the United Kingdom and New Zealand,” he said.

“‘Working Together for Better Eye Care’ identifies readily achievable actions that better utilise the skills of optometrists to enhance patient access and increase the efficiency of Australia’s eye health system.”

OA stated the only way Australia could get on top of a looming eye health crisis was for “optometrists to be allowed to practise to their full scope”.

As part of its Working Together for Better Eye Care, its six recommendations are:

  1. Integrating successful collaborative care models between ophthalmologists and optometrists into the mainstream health system for patients with stable glaucoma, pre- and post-operative cataracts, paediatric eye care and early-stage diabetic retinopathy.
  2. Permitting optometrists to prescribe oral medications for eye health conditions.
  3. Developing and piloting models of care that utilise optometrists to enhance access for patients requiring intravitreal injections for AMD and DMO, starting in outer metropolitan areas and regional, rural and remote communities.
  4. Developing a national strategy to ensure that people with diabetes receive eye examinations from their optometrists to enable the early detection and treatment of diabetic retinopathy.
  5. Implementing consistent ophthalmology referral guidelines, templates and pathways for common eye health conditions, with a facilitated transition to electronic referrals.
  6. Introducing telehealth MBS items for brief optometry consults where face-to-face visits are impractical and to enable ophthalmology reports and advice to be relayed to patients.

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