Brisbane optometrists Dr Ankit Mathur and Dr Garima Tyagi have launched OptoGuide, a clinical decision support tool for Australian optometrists and optometry students. It was first shown at the Optometry Clinical Conference in August 2026 and is now available by subscription, with a free trial.
OptoGuide runs in a web browser. The optometrist enters the patient’s symptoms and signs, and the tool lists the conditions that fit, with sight-threatening causes first. Each of the 139 condition records covers recognition, red flags, management and how soon to refer. From there the optometrist can write a prescription or draft a referral letter. The prescribing section covers 93 medicines. It shows which are within optometric prescribing scope, the PBS listings an optometrist can claim, and each drug’s contraindications while the prescription is written.
“In optometry, a 2022 Australian trial found that point-of-care tools for macular degeneration improved optometrists’ confidence and some aspects of their record-keeping”
Figure 1. Triage in OptoGuide. The optometrist selects the symptoms and examination findings (top), and the conditions that must not be missed are listed with the findings that support them (below). [Demonstration data shown].
For referrals, a directory lists ophthalmologists by subspecialty, along with public eye clinics, and links to their referral criteria. Dr Mathur said that as a clinician, the tool has proven very useful for his own work. “If I go to a city where I’m not usually working, I don’t know who the retinal specialists are, or who does oculoplastics or neuro-ophthalmology.”
Other sections cover systemic medicines and their ocular side effects, Medicare items, contact lenses, myopia, dry eye, binocular vision, paediatrics, macular degeneration, diabetic retinopathy, and fitness to drive.
A Tool Driven By Need
Dr Mathur said the idea for OptoGuide came from having to search many different sources during a consultation. “If there’s a change in Medicare, if you want to check co-billing, look up the side effects of a drug, find out whether a contact lens comes in a certain parameter, or check whether somebody meets the criteria for driving, you go to a different source each time,” he said.
“During a consultation, you need to be able to check a detail and get back to the patient. We wanted the information and its source close at hand,” Dr Tyagi added.
“The tool works from fixed rules rather than artificial intelligence, and each rule shows its source”
“You can’t open a book or therapeutics notes when a patient is sitting next to you, but you can open another window in your browser,” Dr Mathur said. “So a lot of the time you Google it, and Google search becomes your clinical decision support, which it is not meant to be. We don’t even know if it’s the best source.”
Research in medicine suggests doctors do the same. In a 2013 survey of three US internal medicine residency programs, 63% of the 167 residents who responded reported using Google at the point of care at least daily.1 In a 2020 review of 122 trials in medicine, decision support software increased the share of patients who received recommended care by 5.8 percentage points.2 In optometry, a 2022 Australian trial found that point-of-care tools for macular degeneration improved optometrists’ confidence and some aspects of their record-keeping.3 OptoGuide itself has not been tested in a trial.
Evidence-Based Fixed Rule Tool
The tool works from fixed rules rather than artificial intelligence, and each rule shows its source, such as a RANZCO (Royal Australian and New Zealand College of Ophthalmology) referral pathway, an Optometry Australia practice guide, a Centre for Eye Health chairside reference, or the Austroads driving standards. More than 700 sources are listed on a public bibliography page.
Figure 2. Each recommendation in OptoGuide names its source. For new flashes or floaters with no high-risk finding, Australia’ Eye Emergency Manual and a 2009 review in JAMA give different review windows, and both are shown. [Demonstration data shown].
No patient information is stored or sent anywhere. Prescriptions and referral letters are prepared in the browser and copied into the practice’ own software. The tool does not make a diagnosis; the clinical decision stays with the optometrist.
Dr Mathur, while teaching optometry students at Queensland University of Technology, found students wanted information that was easier to find. “We had to remember a lot of things. Students now don’t have to, and they don’t want to either.” OptoGuide’s study section includes optics, anatomy, a question bank and worked cases. Optometry students at every university in Australia can use OptoGuide free until the end of 2027, signing up with their university email address. Students can request their university’s code from OptoGuide at ankit@optoguide.com.au. Student accounts include everything except writing prescriptions and referral letters.
OptoGuide costs AU$29 a month or $290 a year after a 14-day free trial. New users who enter the code ‘mivision’ at sign-up get a 28-day trial instead; the code is open until 31 March 2027. Sign-up is at optoguide.com.au.
References
- Duran-Nelson A, Gladding S, Beattie J, Nixon LJ. Should we Google it? Resource use by internal medicine residents for point-of-care clinical decision making. Acad Med. 2013;88(6):788-94. doi:10.1097/ACM.0b013e31828ffdb7
- Kwan JL, Lo L, Ferguson J, Goldberg H, Tomlinson G, et al. Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials. BMJ. 2020;370:m3216. doi:10.1136/bmj.m3216
- Gocuk SA, McKendrick AM, Downie LE. Point-of-care tools to support optometric care provision to people with age-related macular degeneration: a randomised, placebo-controlled trial. Ophthalmic Physiol Opt. 2022;42(4):814-27. doi:10.1111/opo.12970
Disclosure
Dr Ankit Mathur PhD Grad Cert Ocu Thera, BS Optom and Dr Garima Tyagi PhD Grad Cert Thera, BS Optom are the co-founders and directors of OptoGuide Pty Ltd and have a financial interest in the company.
