On 23^rd November 2012, the Optometry Board of Australia released a proposal to have therapeutically qualified optometrists have an expanded role in managing patients with glaucoma.

This raises the questions ‘what is glaucoma and how is it treated’?

The most common form of glaucoma, primary open-angle glaucoma (POAG) is an eye condition most prevalent in older people. When the fluid pressure in the eye goes up, it damages the optic nerve by ‘eating it away’, thinning the nerve over time. If left untreated (for a period of years generally…. it doesn’t happen overnight) is potentially blinding. The issue is that because it is painless, it will go undetected until the person presents for an eye test. Most people who have glaucoma are treated with eye drops to bring the eye pressure down….. it’s an ongoing treatment and it works most of the time. It is uncommon for glaucoma patients to require surgery to drain the fluid from the eye.

Currently if an optometrist finds evidence that a patient has glaucoma, the patient must be referred to an ophthalmologist. Then, if the optometrist has therapeutic qualifications (and about 30% of practising optometrists in Australia do), they can co-manage the patient’s glaucoma after the ophthalmologist has confirmed the diagnosis, initiated treatment and decided on a management plan. For the 70% of optometrists who are not therapeutically endorsed, the patient’s glaucoma will usually be managed entirely by the ophthalmologist on an ongoing basis.

What would it mean if therapeutically endorsed optometrists were able to initiate treatment and manage glaucoma patients unless they felt ophthalmological intervention was required? Realistically, not much at the moment as only 30% of practising optometrists have this qualification. It will become more significant in the future as all graduating optometrists will be therapeutically endorsed.

Image: paul_irish – flickr