Dry eye in pharmacy

A member recently reported to Optometry Australia that they had noticed a local pharmacy advertising dry eye disease (DED) diagnosis and IPL treatment. The diagnosis of DED requires specialised ocular assessment, clinical oversight, and eye health practitioner expertise that falls outside the scope of pharmacy practice. Optometry Australia strongly opposes this provision of device-based (DED) diagnosis and therapy, particularly as these services are being provided by pharmacy ‘technicians’.

OA’s position is that the indiscriminate use of device-based DED therapies does not meet the core principles of Quality Use of Medicines, and poses a significant risk to patient safety and exacerbation of underlying conditions if inappropriately or improperly administered.

We believe eye care practitioners are best placed to deliver the assessment and longitudinal care required for successful DED therapy, by tailoring therapy to the disease subtype before following evidence-based guidelines for therapy.

TFOS DEWS III underscores that dry eye management is complex, nuanced, and requires advanced diagnostic and therapeutic decision-making. It provides an evidence-based justification for why a clear diagnosis of DED and it’s aetiological factors is required before therapy is initiated, and why IPL and other in-office treatments should remain under the care of optometrists and ophthalmologists.

DEWS III also stresses the importance of differential diagnosis and many conditions present with symptoms mimicking dry eye. Identifying and excluding these conditions requires slit lamp biomicroscopy, ocular surface staining, and sometimes advanced imaging – procedures that fall within the scope of eye care practitioners but sit outside pharmacy practice (or that of a technician).

Many OA members reported a similar service operating in a Victorian pharmacy in mid 2024, and after complaints were lodged this service is no longer operating.

We have lodged a complaint with health care entities against this pharmacy practice and would encourage any member noting DED diagnosis and treatment being provided (in any setting) without appropriate guidance from an Ahpra registered eye care practitioner to email OAHelpdesk@optometry.org.au so appropriate action can be taken to protect public safety.