News

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Optometrist prescribing powers bolstered

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Optometrists will be allowed to prescribe oral medications if a new plan from the Optometry Board of Australia is successful.
 
On Monday, the Board revealed its proposal to expand endorsed optometrists’ scope of practice to include prescribing oral medicines for common eye conditions.
 
Currently, optometrists can only prescribe topical eye drops and ointments.
 
But under the plan, they would be allowed to prescribe from an approved list of medicines, including:

• antibiotics for people with bacterial eye infections
• antihistamines for people with eye conditions caused by allergy
• antiviral medicines for viruses effecting the eye
• emergency treatment for acute angle closure, a blockage in the eye that can cause blindness if not treated within a few hours.

Optometry Australia confirmed that ‘no additional training would be required for therapeutically endorsed optometrists’.
 
The Board says the change will offer patients greater access to care, particularly in rural and remote areas where people may have difficulty accessing a GP or ophthalmologist for a prescription.
 
‘These proposed changes would give you the choice of visiting an optometrist or your GP, for the same eye condition. This may reduce waiting times and out-of-pocket GP consultation costs,’ it says.
 
‘The Board believes this will help patients access the right care at the right time.’
 
However, RACGP Rural Deputy Chair Dr Rod Omond said that while the plan may be good for patient convenience, there are ‘certainly some risks’.
 
‘It has the same problems as other practitioners starting to prescribe, such as pharmacists and nurse practitioners, that it fragments patient care,’ he told newsGP.
 
‘This patient group, most of them are older and they don’t necessarily know what medications they’re on, and you’re starting an oral medication that may interact with medication they’re already on.
 
‘The prescriber may not necessarily be accessing the patient’s own record with their GP and therefore there’s a safety issue for patients.’
 
Dr Omond added that it will be crucial that all information regarding consultations with patients, and their prescriptions, is provided to their GP in a timely manner.
 
‘If they’re on a medication and it is not in their general record, the GP may not know about it when they next visit,’ he said.
 
Currently, there are more than 7000 registered optometrists in Australia with almost 80% of general registrants having an endorsement to prescribe scheduled medicines.
 
Under the proposed changes, that endorsement would extend to oral medicines.
 
Optometry Australia CEO Skye Cappuccio welcomed the progress, saying it is ‘long-overdue recognition of the profession’s expertise’.
 
‘Optometrists already carry the responsibility for identification and diagnosis of eye conditions, and this reform gives them the authority to complete management,’ she said.
 
‘It streamlines care, reduces unnecessary referrals, and positions our profession as a key part of the health workforce solution.
 
‘Optometrists are highly-trained, trusted health professionals and should be empowered to prescribe any appropriate medicine within scope – safely, effectively and for the benefit of every patient.’
 
The Optometry Board said that if the proposal goes ahead, the medications ‘will initially not be funded under the PBS’ but sold at private, non-PBS funded prices, which ‘will vary across pharmacies’.
 
‘The peak optometry professional association will try to get these medicines added to the PBS, to help make them cheaper and easier to access, but this isn’t guaranteed,’ the Board said.
 
Optometry Board of Australia Chair Stuart Aamodt said the changes will give people with eye conditions more options and reduce the need to see multiple practitioners.
 
‘The evidence demonstrates that optometrists in Australia are educated, trained, and qualified to safely prescribe both topical and oral medicines, but to date have not been able to offer their patients all treatment options,’ he said.
 
‘For more than a decade, Australian-trained optometrists who work in New Zealand have been able to safely prescribe oral medicines yet are not able to offer the same level of care here.’
 
But Dr Omond raised concerns about the plan’s risk of care fragmentation without one practitioner leading clinical care.
 
‘You really need someone who’s taking the generalist approach, just as a general practitioner is, and overseeing the whole patient, not the patient in bits,’ he said.
 
Public consultation on the review is now open, with submissions closing on 24 December.
 
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AHPRA optometrists prescribing rural and remote medicine scope of practice

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