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Optometry Board sees the light on glaucoma care

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Thousands of Australians suffering irreversible blindness will receive improved care after the Optometry Board backed down from plans to allow optometrists to circumvent ophthalmologists in the diagnosis and management of glaucoma.

In a major development, the Optometry Board has acceded to pressure and modified glaucoma guidelines that had been the subject of a fierce legal dispute between it, the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the Australian Society of Ophthalmologists (ASO).

AMA President Associate Professor Brian Owler said recognition in the guidelines that optometrists should not be able to independently manage glaucoma patients was a major advance in care.

“The revised Optometry Board guidelines will ensure that ophthalmologists will be the leaders of glaucoma management, with collaborative arrangements and clear referral pathways between the patient’s optometrist and ophthalmologist,” A/Professor Owler said. “Glaucoma patients are the winners from this arrangement.”

RANZCO and ASO had taken the Optometry Board to task over its move to allow optometrists to manage glaucoma patients without reference to ophthalmologists.

In a carefully-worded statement, the Optometry Board said that “collaboration and communication between treating optometrists and ophthalmologists after each patient consultation is in the best interest of patient safety and optimal eye health care, and is fundamental to the delivery of safe, high quality health care services”.

National support and education group Glaucoma Australia joined the AMA into welcoming the resolution of the dispute.

National Executive Officer Geoff Pollard said GA “supports an integrated eye-care system, with optometrists, ophthalmologists and other eye-health providers working collaboratively”.

“GA hopes that systems to ensure increased presentations for comprehensive eye tests, including a review of the optic nerves and not just an intra-ocular pressure test, will be strengthened from the renewed collaborative arrangements and result in a higher glaucoma detection rate,” Mr Pollard said.

A/Professor Owler commended the work of RANZCO and ASO “for their efforts on behalf of Australians with glaucoma and other serious eye conditions”.

He said the case underlined the need for clear, robust and transparent processes for assessing proposals to extend the scope of practice of non-medical practitioners so as not to compromise patient care.