The Australian Society of Ophthalmologists (ASO) has voiced serious concerns regarding the Optometry Board of Australia’s 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.
Convenience Should Never Outweigh Safety
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.
any regulatory change must be evidence-based, safety-driven, and patient-centred
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.”
Another member said, “I have treated a patient on the renal ward who developed acute renal failure after oral antivirals. It was unexpected and very serious. The recognition and management of such drug reactions is the role of a medical doctor. These are not benign medications”.
Ophthalmologists undergo more than a decade of medical and surgical training, encompassing not only eye health but systemic diseases such as diabetes, autoimmune disorders, and infections that can manifest through ocular symptoms. ASO members have raised concerns that expanding prescribing rights without matching educational requirements may fragment care, create diagnostic blind spots, and delay proper treatment.
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.”
The ASO said ophthalmologists and optometrists work best in collaboration, where each profession’s expertise is respected and utilised to deliver holistic care. However, any regulatory change must be evidence-based, safety-driven, and patient-centred.
“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.”
The ASO will participate in ongoing consultation between the Optometry Board, medical specialists, and the public to ensure prescribing regulations maintain Australia’s world-class standards of eye health and patient safety.
