Expanding optometrists’ prescribing rights could save Australia millions, new report finds

A new report, The Value of Expanding Optometrists’ Prescribing Rights in Australia prepared by HTANALYSTS and commissioned by Optometry Australia has highlighted the key potential financial and health benefits of expanding optometrists’ scope to prescribe oral medicines for ocular conditions in Australia. Based on economic analysis of common cases of ocular conditions such as severe dry eye, herpes zoster ophthalmicus, and preseptal cellulitis, the report outlines health budget savings of around $50 million per year, patient savings of approximating $27 million per year, and significant improvements to productivity and access to care through optometrist oral prescribing.  

The report also highlights optimising utilisation of the specialist ophthalmology workforce through significant time savings in unnecessary onward referrals for minor conditions as a potential benefit of optometrist oral prescribing.  

It compares the patient journey, system and patient costs, professional time saved, and productivity implications of treating various ocular conditions currently and into the future, enabled by optometrist oral prescribing.  

Some key highlights of the analysis include: 

• Treatment of severe dry eye by optometrists with oral medicines has the potential to save over 700,000 GP visits per year, equating to over $30 million of federal funding, and $8 million of patient incurred expenses, in addition to almost 200,000 ophthalmology appointments being saved for more critical conditions. 
• Oral prescribing by optometrists to treat Herpes Zoster Ophthalmicus has the potential to alleviate $663,000 of avoided productivity costs.
• Treatment of acute angle closure glaucoma by optometrists, when a patient does not have appropriate access to emergency ophthalmologist care, would not only improve visual outcomes, but would also save around $8500 per patient in treatment costs.

In alignment with OA’s long-standing advocacy on the issue (see our 2021 Working Together for Better Eye Care policy platform), the Federal Government’s Scope of Practice Review – Unleashing the Potential of our Health Workforce – has acknowledged that there is ‘strong evidence of improved consumer access to care, consumer experience of care and health outcomes when health professionals are enabled to work to full scope of practice’ (1). 

Alongside, and in response to this report, OA has also released a Position Statement on Medicines, outlining in detail our position on the prescribing of medicines by optometrists. OA has called on that the Optometry Board of Australia to take action to review and contemporise the Guidelines for the Use of Scheduled Medicines, to enable therapeutically endorsed optometrists to prescribe oral medications for the purpose of practising optometry.  

Australia’s approximately 7,000 optometrists currently face significantly more limitations to their scope of practice than their counterparts with similar training in other countries. In contrast to Australian optometrists, overseas colleagues with similar training and expertise have been prescribing oral medication for many years: this includes the United Kingdom (since 2008), New Zealand (since 2014) and the United States (in all 50 states, the first of which commenced oral prescribing in 1977).(2-4). International evidence for the safety and efficacy of oral prescribing by optometrists is clear – there have been no complaints, notifications, or evidence of harm related to prescribing, nor have there been increased incidences of malpractice in these countries (3, 5-9). 

OA is dedicated to the continuous evolution of the profession of optometry, improved community eyecare, and a sustainable healthcare system. Acknowledging international evidence, we advocate strongly for a change to the current medicine prescribing regulations for optometrists, to enable prescription of any medication that is for the purpose of practising optometry and is in the best interests of the patient. 

OA CEO, Skye Cappuccio, welcomed the new analysis which highlights that such expansion of scope in Australian would have unequivocal, multifaceted benefits, stating that, ‘Oral and topical prescribing are within the current level of training and knowledge of therapeutically qualified Australian optometrists, so it is imperative that relevant regulations should allow therapeutically endorsed optometrists to prescribe medications for the purpose of practising optometry. This is in the best interests of their patients and will bring significant improvements to our overburdened healthcare system.’

Read more

• The Value of Expanding Optometrists’ Prescribing Rights in Australia (2025) an analysis of the economic and health system benefits of expanding optometrists’ prescribing rights 
• Optometry Australia’s Position Statement on Medicines (2025), outlining in detail our position on the prescribing of medicines by optometrists 
• Working Together for Better Eye Care (2021) a policy platform developed to ignite an important conversation about the timely diagnosis and treatment of eye disease in Australia

References

1. Australian Government. Scope of Practice Review. Unleashing the Potential of our Health Workforce.; 2024.
2. Needle JJ, Petchey R, Lawrenson JG. A survey of the scope of therapeutic practice by UK optometrists and their attitudes to an extended prescribing role – PubMed. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists). 2008 May;28(3).
3. Turnbull PR, Craig, J.P.,. Oral medication prescribing by optometrists in New Zealand. Clinical and Experimental Optomometry. 2021;104(3):425-7.
4. Cooper SL. 1971 – 2011: Forty year history of scope expansion into medical eye care. Optometry. 2012;83(2):64-73.
5. Duszak RS, Duszak R. Malpractice payments by optometrists: an analysis of the national practitioner databank over 18 years – PubMed. Optometry (St Louis, Mo). 2011 Jan;82(1).
6. Evgenia Konstantakopoulou RH, David  Edgar, Genevieve Larkin, Sarah Janikoun, John Lawrenson,,. Clinical safety of a minor eye conditions scheme in England delivered by community optometrists. BMJ Open Ophthalmology. 2018-02-20T20:35:39-08:00;3(1).
7. Optometrists and Dispensing Opticians Board. Annual Report 2023. 2023.
8. Optometrists and Dispensing Opticians Board. Annual Report 2024. 2024.
9. Spiegle L. How Scope Expansion is Shaping Optometry’s Future. Review of Optometry. 2025.