The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) has released its “top five” messages, as part of the Choosing Wisely Australia campaign.
The Choosing Wisely Australia campaign was developed by RANZCO’s member ophthalmologists and is aimed at ophthalmologists and other health professionals, with the goal of improving eye health practices through revisiting old practices based on current best-practice evidence.
The campaign messages are:
1. In the absence of relevant history, symptoms and signs, ‘routine’ automated visual fields and optical coherence tomography are not indicated.
The Choosing Wisely Australia campaign was developed by RANZCO’s member ophthalmologists and is aimed at ophthalmologists and other health professionals, with the goal of improving eye health practices through revisiting old practices based on current best-practice evidence…
2. AREDS-based vitamin supplements only have a proven benefit for patients with certain subtypes of age-related macular degeneration. There is no evidence to prescribe these supplements for other retinal conditions, or for patients with no retinal disease.
3. Don’t prescribe tamsulosin or other alpha-1 adrenergic blockers without first asking the patient about a history of cataract or impending cataract surgery.
4. Intravitreal injections may be safely performed on an outpatient basis. Don’t perform routine intravitreal injections in a hospital or day surgery setting unless there is a valid clinical indication.
5. In general there is no indication to perform prophylactic retinal laser or cryotherapy to asymptomatic conditions such as lattice degeneration (with or without atrophic holes), for which there is no proven benefit.
Back to the Future
Speaking of the campaign, RANZCO’s President, Dr. Bradley Horsburgh said, “Medical practitioners work on the cutting edge of evidence-based knowledge. It is incredibly important to keep asking questions, and to keep re-evaluating old procedures in light of emerging evidence.”
“As the medical experts in eye health issues, ophthalmologists are leading collaborative care arrangements, which also means identifying practices that may need to change to ensure good patient outcomes.”
Dr. Clayton Barnes, RANZCO’s Choosing Wisely spokesperson, has chaired RANZCO’s Choosing Wisely committee which embarked on a rigorous process of engaging the College’s membership to produce and refine the list of messages.
“The identification and development of the list has been a long and rewarding process. Through it, we were able to cast a light on some long-standing practices that can and should be changed, given emerging evidence.”