There was a good deal of evidence at this year’s Optrafair of the important role optometrists play and should play in the management of eye health. Much of this is being driven by the continuing advance of technology in ophthalmic instrumentation and the increasing number of community practices investing in them.
It also seems to be the case, judging by many a conversation at the various equipment stands, that practitioners are embracing the many training resources made available, both by the manufacturers and distributors themselves and by independent education providers.
This should address some of the grumbling we hear from the hospitals suggesting that ECPs see these new toys merely as showy profit-creation assets and inevitably lead to misinterpretation and over-referral.
If anything, the secondary care sector should embrace this community practice evolution. Examples of the sorts of anecdotes I heard at the show include the direct referral of an elevated retina clearly seen on wide-field scanning laser ophthalmoscopy which had previously been dismissed at a local triage centre.
Another practitioner had some wonderful examples of how OCT angiography software had detected conditions requiring treatment which may otherwise have been missed, and several practitioners reported having access to technology not available at their local eye unit.
Some practices have been incorporated into hospital management schemes and can readily provide screening and monitoring services, and in a few cases are able to intervene with direct management, so saving the hospital financial and time resources while improving accessibility for patients.
Sadly, there were almost as many stories of local ophthalmology resistance to optometry involvement. This highlights a well-known ambiguity in secondary care.
While espousing the benefits of optometry relieving the load on ophthalmology, so increasing the time available for them to concentrate on the more specialist interventions they alone are able to provide, too many ophthalmologists then go on to suggest optometrists are neither capable nor needed in this field and ‘should stick to selling glasses.’
