Optometry Australia (OA) has responded to the Australian Society of Ophthalmologists (ASO) “serious concerns” regarding a proposal to expand optometrists’ prescribing rights to include both topical and oral medicines.
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.
“Real Risk of Harm”
While the ASO acknowledged that limited topical prescribing, when supported by appropriate training, can enhance patient access, it said the current proposal exceeds what is safely achievable within an optometrist’s scope of practice.
In a statement the ASO said several of the drugs listed are systemic in nature, requiring a deep understanding of internal medicine, pharmacology, and multi-organ interactions that form the foundation of a medical degree.
A survey conducted by the ASO found strong opposition among its members with one stating, “Prescribing oral antibiotics, antivirals, and anti-inflammatory drugs is not simply a matter of treating the eye. These medications can affect the entire body, interact with other medicines, and mask or exacerbate underlying conditions. Without full medical training, there is a real risk of harm.”
any regulatory change must be evidence-based, safety-driven, and patient-centred
Another member noted, “We’ve seen what happens when shortcuts are taken in patient care. Convenience should never outweigh safety. The priority must be protecting patients, not expanding professional boundaries.”
No Shortcuts Here
Responding to the ASO statement, OA said it agreed that “patient safety must be paramount” however does not agree that “enabling appropriately endorsed optometrists to prescribe oral medicines for eye conditions is a ‘shortcut’, or that it weakens safeguards.
The optometrists’ peak body said that rather than “seeking to become doctors” the proposed change “is about removing an artificial barrier that forces patients into duplicate appointments simply to obtain a prescription for an eye condition which their optometrist has already expertly diagnosed and is managing”.
“Across Australia, people are waiting too long, travelling too far and paying too much for time-sensitive treatment,” OA said. “Enabling oral prescribing for therapeutically endorsed optometrists means more patients can begin appropriate treatment in a single consultation, rather than being sent elsewhere purely because of an administrative restriction on “topical” routes. This reduces preventable delays, avoids unnecessary out-of-pocket costs and supports continuity of care.
Citing comparable countries including New Zealand, the UK and the USA, which have enabled optometrist oral prescribing for years, OA said that when optometrists “can manage straightforward ocular presentations end-to-end, GPs and ophthalmologists are freed to focus on more complex and surgical care – where community need is greatest”.
Strongest with Collaboration
Both OA and the ASO have acknowledged that ophthalmologists and optometrists work best in collaboration.
“We are not opposed to collaboration,” said ASO CEO Katrina Ronne. “We are opposed to changes that put Australians at risk. The focus should be on strengthening existing partnerships, not weakening safeguards.”
