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Optometry scope-of-practice to be investigated in new scholarships

Optometry Australia (OA) has announced its inaugural LOOK scholarship recipients who will investigate overseas optometry models that differ from the Australian context, including expanded scope-of-practice in the US.

Optometrists Ms Nicola Mountford and Dr Shelley Hopkins will be the first to benefit from the Looking Outward on Optometric Knowledge (LOOK) program. OA launched the scholarship in February to fund overseas study tours that investigate optometric advancements internationally that are not available, or readily available, in Australia.

Due to COVID-19 travel restrictions, OA has awarded the scholarships to support virtual study tours and the recipients will complete at least 50 hours of desktop research and remote engagement with international colleagues in two areas of interest for OA.

Hopkins’ work will investigate the role of optometrists in school-based eye program. Meanwhile, Mountford, who practises at Queensland Retina Specialists, a newly established clinic in Brisbane that combines optometry and ophthalmology services, will focus on the expanded scope-of-practice in the US.

There, some laser therapies, injectable drugs and minor surgical procedures have been successfully delivered by optometrists in the US for more than 20 years, according to OA.

“The American optometry practice model is the most different model to our own, but does it work well?,” Mountford asked.

“For example, optometrists in Oklahoma have the most expansive scope of practice, with some injectable drugs for eyelid procedures and anterior laser privileges, but anti-VEGF injections are not an established part of optometry practice in the US and will not form part of my research.”

Mountford said patients in rural and remote areas could potentially benefit.

“Historically, expansion of scope for optometrists in Australia has mostly benefitted patient access to imperative care in rural and remote settings and my investigation of US models of practice would focus on any potential areas of benefit such as this,” she said.

She is also interested in bimodal modes of practice, where optometry and ophthalmology are incorporated in a symbiotic practice model.

“In the future, I could envisage optometry in Australia being somewhat of a bimodal profession, with more optometrists working in a supportive role within ophthalmology practices,” Mountford said.

“I’m interested in the incorporation of optometry in diagnosing neurological disorders, finding degenerative disease and treating neuropathic pain,” Mountford said.

School-based eyecare programs

Hopkins will investigate optometry’s role in assessing and managing children’s vision conditions through school-based eyecare programs, by comparing programs across the US, UK, Europe and Asia.

Specifically, she said her goal is to understand the strengths and weaknesses of different programs available in some states of the US.

“Evaluating these programs in terms of their screening protocol, eyecare team, coverage/age groups screened, follow-up procedures, costs and funding models will help inform the development of a model that could be applied in Australia,” she told OA.

Hopkins’ and Mountford’s OA-funded study’s come as the eyecare sector awaits the final Medicare Benefits Schedule Review Taskforce Ophthalmology Report which has been completed, but not released.

It raises the prospect of optometrists and nurse practitioners performing intravitreal injections, a proposal that has split the sector along ophthalmology and optometry lines.

OA has previously identified an evolving scope-of-practice as one of the key trends shaping the future of optometry in its Optometry 2040 report, including oral therapeutics, minor surgery, prescription of and treatment with injectables, and diabetic education.