Optometrists are being urged to use their clinical judgment to determine their level of service, while ophthalmologists can continue with elective surgery in the wake of reimposed lockdown measures across parts of Victoria.
This morning Optometry Victoria South Australia (OVSA), Victorian Health Minister Ms Jenny Mikakos, and local ophthalmologists and optometrists have offered advice that bodes well for the sector, despite the reintroduction of Stage 3 restrictions affecting metropolitan Melbourne and the Mitchell Shire from 11.59pm Wednesday 8 July.
OVSA CEO Mr Pete Haydon told Insight that optometrists within the lockdown zone could continue to practise as they were under the previous Stage 3 lockdown. He said they were deemed essential workers under government guidelines, so could remain open.
“Optometrists need to use their own clinical judgment about whether they see patients or not,” he said.
“They need to make sure anyone with chronic conditions is seen if they can, they need to make sure people presenting with emergencies can be seen if they can, and they need to think about whether or not regulation refraction checks can be delayed if they can. But if they don’t want to delay them, they don’t have to.”
An email sent to members, OVSA stated that it received advice from the Victorian Department of Human and Health Services confirming optometry practices are not mandated to close over this period.
This means there is no enforceable directive from the Australian Government regarding exactly which clinical services optometry should, or shouldn’t be, providing.
“Provided optometrists actually undergo proper social distancing regimes in their practices, clean their equipment in between seeing people and adequately triage patients on the phone, then they can see them,” Haydon added.
Green light for elective surgery
Meanwhile, Minister Mikakos confirmed elective surgery could continue across the affected Victorian local government areas.
“As was the case previously with the stay at home directions, seeking and receiving health or medical care is a permissible reason to leave home so if you are booked in for elective surgery, that surgery will be able to continue,” she said, according to the ABC.
Victorian cataract and refractive surgeon Dr Anton van Heerden heads the Surgical Ophthalmology Services Department at the Royal Victorian Eye and Ear Hospital and is in private practice at the Armadale Eye Clinic, Mornington Peninsula Eye Clinic and Eye Laser Specialists.
With the lockdown not affecting elective surgery, he does not expect the impact of the new lockdown to be as significant.
“As long as optometrists are still seeing patients then our clinics should still continue to be busy,” he said.
“The first lockdown we weren’t getting many referrals because optometrists weren’t really seeing patients and that translated to our clinics being quiet. The other thing is that patients were scared in the first lockdown, so they didn’t leave home. I don’t know if that is going to be the same this time around. Ever since the restrictions have eased, we have been really busy; there’s obviously a backlog of patients, so I don’t think the impact will be as profound.”
Melbourne ophthalmologist Dr Laurence Sullivan, a founding director of Bayside Eye Specialists and Laser Sight, said his clinics had been adapted with hygiene and social distancing protocols and were well-equipped to work through the pandemic.
He is operating at two-thirds capacity and believes his clinics can continue to work safely.
“I have been told they have exempted elective surgery from being shut down or curtailed at this stage, so we are going to carry on doing normal surgery, which in some cases is only just coming back to full throughput,” he said.
Sullivan added even though his clinics weren’t in the COVID-19 ‘hotspots’, some elderly patients had been spooked in recent times and had sought to cancel surgeries and appointments.
Optometry response
ProVision CEO Mr Steven Johnston said that while the entire metropolitan Melbourne community will be disappointed by a return to Stage 3 restrictions, he felt ProVision members are much better prepared for the impact this time around.
“Our advice is for optometrists to use the skills and knowledge that they have acquired over the last three months, to continue to ensure the safety and wellbeing of themselves, their staff and their patients,” he said.
“June clearly illustrated that there is strong demand for our services so we should do our best to safely deliver that service to our patients.”
Johnston said most of ProVision’s 460 member practices will continue to benefit from being predominantly in strip shopping environments or destination practices as opposed to high traffic shopping centres.
“So we are very well positioned to maintain social distancing in conjunction with well-spaced appointment book management, and disciplined disinfection protocols. All optometry practices and their teams will need to be agile and quickly adapt to COVID-19 circumstances as they evolve,” he said.
Mr Peter Murphy, OPSM director of eyecare and community in Australia and New Zealand said at this stage the optical chain would have its key Victoria stores open for patients requiring urgent or critical care.
“As the situation is evolving very quickly, we are constantly monitoring very closely both the spread updates and the government response to ensure we are compliant to state regulations,” he said.
“We are also continuing supporting the local community’s eye health needs via tele-optometry, an innovative solution that offers free remote video consultations with an OPSM optometrist from the comfort of their own home.”
Eyecare Plus national business development manager Mr Philip Rose said the independent group is consulting with its Victorian members via video meetings. Its marketing team is also revisiting its assets that are being implementing around COVID-19.
“We will guided by the needs of members and provide assistance as required,” he said.
Further advice
With community transmission in Victoria higher now than at any previous stage in this pandemic, OVSA is encouraging all optometrists to review their infection control practises to ensure they align with the latest advice available via Optometry Australia’s COVID-19 resource hub.
It also noted that advice around mask use has changed in the last few weeks with the World Health Organization now recommending that health workers practising in an area of known community transmission or intense COVID-19 outbreaks should continuously wear a medical mask throughout their entire shift.
OVSA also advised that practices should continue using triage questions prior to consultations to assess risks that the patient presenting may have COVID-19. It said it may be appropriate to consider assessing whether the patient has travelled from a ‘hotspot’.
Haydon said it was important optometrists looked out for one another at this time.
“If stress levels and anxiety are elevated, help is available either through the normal systems such as Beyond Blue and Lifeline. There is also a lot of phycological and psychosocial resources available to members through Optometry Australia and Optometry Victoria South Australia,” he said.