When the statement; Eye healthcare is bad medicine, is the opening gambit of a personal viewpoint from a consultant ophthalmologist there’s a fair certainty that the argument is not going to pan out well for optometry.
Anyone reading Michael Clarke’s BMJ piece would not have been disappointed in this view. In a rallying cry to ophthalmologists to get up from their slit lamps he highlights the wastage, lack of regulation and scatter-gun approach to screening of patients attending for NHS sight tests. While his observation that UK law leads to opticians making too many referrals, might be helpful, his inference that optical businesspeople use equipment as little more than technical selling point and refer at will is not. GPs don’t get off scot free either.
The responses from optometry (see the BMJ website) have clarified the legal obligations of optometrists but concurred that an NHS sight test requirement unchanged for half a century mixed with new technologies makes for a confusing and heady mix. If there is blame it lies with NHS structures and not with early adopters of technology ‘unrestrained by disincentives to refer’.
Optometry and ophthalmology have enjoyed a thawing of relations in recent years. Perhaps sensing that Clarke may have annexed an optical Crimea, the Royal College immediately sought to soften the blow. The answer, it said lay in education, training and feedback to optometrists within a joint endeavour, to reduce unnecessary referrals. Constructive utilisation of the optometrist workforce is the way forward and it pithily pointed out that if 30 per cent of referrals were not appropriate 70 per cent were
