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See you in court: eye doctors take on regulators

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Ophthalmologists have launched legal action against medical practice regulators in an escalation of a row over the role and responsibilities of optometrists.

In a significant development, the Australian Society of Ophthalmologists (ASO) and the Royal Australian and New Zealand College of Ophthalmologists have taken the Optometry Board of Australia and the Australian Health Practitioner Regulation Agency to court to block a move to give optometrists authority to diagnose and treat glaucoma without specialist oversight.

The Society said it had taken the extraordinary step of launching the action in the Supreme Court of Queensland in order to protect patient safety and wellbeing.

“ASO holds grave concerns that patient safety will be compromised by optometrists treating glaucoma without medical and specialised supervision, and in circumstances where optometrists are not sufficiently trained to do so,” ASO Chief Executive Officer Kerry Gallagher said in a 119-page affidavit filed in the Supreme Court.

The Society launched the action after the Optometry Board issued new rules allowing optometrists to begin treating suspected cases of glaucoma without first consulting with an ophthalmologist, and giving them authority to prescribe and administer Schedule 4 medicines that have potentially serious side effects.

AMA President Dr Steve Hambleton said it was disappointing that ophthalmologists had been forced into the position of launching legal action to help safeguard the quality of care provided to people suffering glaucoma.

Dr Hambleton said the Optometry Board had got it badly wrong in deciding to expand the scope of optometrist practice in this way, and should reverse course.

“In making these guidelines, the Optometry Board has failed to protect the interests of the Australian public in the detection and proper management of glaucoma and other serious eye conditions,” he said.

The ASO warned that, through its decision, the Board had overturned traditional medical practice and given approval for optometrists to assess medical conditions beyond their learning and experience.

It said that ophthalmologists study for seven years to become doctors, with a further five years of study to become medical eye specialists.

All up, they spend 12,000 hours in clinical training treating eye disease before being authorised to responsibly initiate treatment for patients.

The Society and the College said they had launched the legal action to seek a reversion back to long-standing collaborative arrangements for the treatment of glaucoma.

“There is a very real risk of inappropriate treatment of glaucoma patients by optometrists who undertake treatment outside of collaborative care arrangements with an ophthalmologist,” Dr Hambleton warned.

“This is not an example of health reform. This is an example of the fragmentation of health care, which is the enemy of quality care, the enemy of efficient care, and the enemy of affordable care.”

Adrian Rollins