The Australian College of Optometry (ACO) is joining Optometry Australia (OA)’s call for a $1 million investment into a collaborative eyecare pilot to reduce ‘drop out’ from routine intravitreal injections.
The ACO believes that a joint approach to treatment between optometrists and ophthalmologists will improve access and equity of eyecare to millions of Australians, reducing non-compliance with intravitreal injections often caused by geographic isolation and the cost of specialist ophthalmologist care.
It is lending its support to OA’s call for the government to invest $1 million to pilot a collaborative care model between optometrists and ophthalmologists.
Greater optometry involvement in intravitreal injection provision has also been mooted by the MBS Review Taskforce which has pointed to evidence of clinical need, maldistribution of clinicians and constraints on overall supply. It has recommended to the government that appropriately trained optometrists, nurse practitioners and GPs be considered for administering intravitreal injections, which has previously been opposed by ophthalmology bodies.
The ACO said the international evidence shows that optometrists can administer intravitreal injections safely and effectively. However, within the current regulatory environment this isn’t possible in Australia. The proposed pilot would look at how to make the best possible use of optometry in the care pathway to support better patient access, but would involve ophthalmology oversight and, most likely, a medical doctor injecting.
OA report a significant drop out rate of up to 20% in intravitreal injection treatment due to non-adherence and non-persistence, increasing the risk of permanent vision loss.
The proposed pilot would see locally-based optometrists support the provision of ophthalmology-led care of patients with sight threatening, age-related macular degeneration and diabetic macula oedema across two locations, including a remote Indigenous community.
ACO CEO Mr Pete Haydon said the organisation already has experience of a successful partnership between optometrists and ophthalmologists.
“For the past six years, we’ve worked with The Royal Victorian Eye and Ear Hospital’s Glaucoma Collaborative Care clinic to alleviate pressure on in-demand ophthalmologists and, most importantly, ensuring access and equity for patients in a timely manner,” he said.
ACO president Mr Rodney Hodge shared his confidence in a collaborative approach.
“As the demand for public eyecare continues to rise, we must ensure that the optometry profession adapts to meet the needs of the community,” he said.
“Gaps in competence and knowledge can be overcome with the support of our ophthalmology colleagues and the development of appropriate training for the profession. I am confident that we can rise to meet those challenges and provide the clinical care required to make a collaborative care model effective for all involved.”
When asked for comment the Australian Society of Ophthalmologists and the Australian Medical Association claimed to be unaware of the pilot program proposal and reiterated their position that optometrists were not suitably qualified to carry out surgical eye procedures.
As a leading provider of the Visiting Optometrists Scheme (VOS) in Victoria, the ACO is also supporting Optometry Australia’s call for investment of $18.1 million into the scheme over five years.
“The ACO has first-hand experience delivering care through the VOS and we know that the scheme is an integral part of closing the gap in eye care for First Nations People,” Haydon added.
“Further funding is certainly needed to better support these communities and we look forward to reaching more people who need our help.”
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