Kindergarten referral pathways

In early 2023, Optometry Tasmania (OTas) contacted members to gauge interest in a program designed to improve the referral pathways for children screened for eye health in Tasmanian kindergartens. Due to the overwhelming response, we are convening a multidisciplinary workshop on 23 and 24 March 2024 in Hobart.

At the workshop, didactic and practical sessions will be run by a multidisciplinary team from Queensland Children’s Hospital including the Paediatric Optometry Alignment Program founders, and attended by optometrists from across the state, as well as ophthalmologists and orthoptists.

By way of background, in 2022, the Tasmanian government rolled out a school health nurse program across state schools. One part of this program is a vision screening for Kindergarten children between 4 and 5 years of age, performed by the school health nurse. This is positive news for Tasmanian children, as there is strong evidence that picking up eye disease early has the best outcomes. (1)

Currently, the screening protocol dictates that children in need of further testing are referred to the orthoptist at the Royal Hobart Hospital (RHH) or in Launceston – or for less serious cases they are advised to see any local optometrist.

Optometry Tasmania has been in discussion with Department of Health representatives to involve the existing wide network of Tasmanian optometrists, which is well placed and well qualified to assess paediatric cases. Our proposal is that the children who fail the school screening initially be referred to a local optometrist aligned with the program, who would then manage the patient according to the program protocol. Cases requiring tertiary assessment would be referred on to the appropriate Tasmanian Health Service (THS) eye clinic at the RHH or in Launceston.

A similar approach has been successfully implemented in southern Queensland for several years (2), and is expected to work well when adapted to Tasmanian requirements.

The aims of this proposal are to:

1) reduce barriers to access eyecare, including geographical distance

2) reduce the timeframe to access consultation with an eyecare professional (optometrist appointment is usually quicker than a RHH appointment)

3) help reduce pressure on the THS eye clinic waiting list and backlog

4) utilise the existing primary eyecare workforce appropriately

5) strengthen interprofessional collaboration in the sector by having a robust, transparent and evidence-based screening program.

As primary health care providers, optometrists are integral to public eye health in our state. Involving optometry in the kindergarten vision screening program would improve the effectiveness of this important program, thereby improving outcomes for Tasmanian children. (3)

If you would like to be a part of this milestone project or register for the workshop, please email sib.payne@gmail.com.

References:

(1) A review of paediatric vision screening protocols and guidelines – PMC (nih.gov)

(2) Paediatric Optometry Alignment Program | Children’s Health Queensland

(3) National Framework for Vision Screening for 3.5-5-year-olds – Vision 2020 Australia