The Christmas Eve deadline is approaching for submissions to a review of optometrist prescribing rights – described as a ‘pivotal moment’ for the optometry profession in Australia.

The Optometry Board of Australia (OBA) is proposing to:

• Expand the scope of prescribing for endorsed optometrists to include oral medicines used for common eye conditions, and

• Remove the reference to the scheduled list of medicines from the endorsement – but maintain a restrictive, regulated list of approved oral medications deemed in scope.

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 affecting the eye, and

• emergency treatment for acute angle closure, which can cause blindness if not treated within a few hours.

The consultation period on the Review of the Registration Standard for Scheduled Medicine closes on 24 December.

‘LONG OVERDUE’: OA

In welcoming the proposal, Optometry Australia confirmed that “no additional training would be required for therapeutically endorsed optometrists”, saying it represented “longoverdue recognition of the profession’s expertise and leadership in primary care”.

“Optometrists already carry the responsibility for identification and diagnosis of eye conditions, and this reform gives them the authority to complete management,” OA Chief Executive Officer, Skye Cappuccio said.

“It streamlines care, reduces unnecessary referrals, and positions our profession as a key part of the health workforce solution.”

However, she cautioned that maintaining a scheduled list of endorsed medicines would ensure optometry remains out of step with contemporary regulation of other professions, and is inconsistent with the approach taken internationally, including in New Zealand.

“A restrictive list slows access to contemporary treatments, adds unnecessary red tape, and risks patient care during medicine shortages. 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.

“Our stance is clear: we support an evidence-based, no list model. Therapeutically endorsed optometrists must be able to prescribe oral medicines for the purpose of practising optometry. This reform is a crucial step toward modern recognition of optometrists’ roles. We are committed to providing ongoing education to our members to support the delivery of best practice care.”

HEALTH PROFESSIONAL RESPONSE

The Australian Society of Ophthalmologists indicated it was consulting with its members at the time of going to print, and the Royal Australian and New Zealand College of Ophthalmologists said it would not comment publicly ahead of its formal submission. However, the Royal Australian College of General Practitioners (RACGP) urged caution.

RACGP Rural Deputy Chair Dr Rod Omond said that while the plan may be good for patient convenience, there are “certainly some risks”.

In an article on the RACGP website, Dr Omond said the proposed changes come with “the same problems as other practitioners starting to prescribe, such as pharmacists and nurse practitioners… it fragments patient care”.

“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 said it would be crucial to provide all information regarding consultations and prescriptions to patients’ GPs promptly.

“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.

The Pharmacy Guild of Australia, on the other hand, described the OBA proposal to allow optometrists to prescribe oral medicines as another positive step toward improving patient access to timely, affordable, and effective care.

National President, Professor Trent Twomey, said the proposal reflected a growing recognition that empowering qualified health professionals to practise to the full extent of their training delivered better outcomes for patients and communities – particularly in rural and regional Australia.

“When patients can access the right care from the right health professional at the right time, everyone benefits,” Prof Twomey said.

“This proposal aligns with the Guild’s long-held view that scope of practice reforms across health professions – including community pharmacy – are essential to strengthening Australia’s primary care system.”

The consultation documents can be accessed via the Optometry Australia website. OA has also provided resources to help members respond to the consultation document.