Clinical FAQ

Like other health practitioners, optometrists are not legally obliged to treat patients unless it is an emergency or a contractual requirement. Discrimination laws prevent optometrists and staff from discriminating against patients on the basis of disability/impairment (e.g. COVID-19), race, religion, gender etc. However, you could refuse to see a patient if it is reasonably necessary to protect the health and safety of any person (including practice staff and your other patients). In determining whether discrimination is “reasonably necessary” you need to consider the up-to-date expert advice. Generally, if patients are presenting for appointments with virus symptoms, then they should be rescheduled for health and safety reasons.

Ideally, employers should arrange for communication to be sent to all patients, asking them not to attend the practice if they are unwell. And that patients should contact the practice to cancel or reschedule their appointment. That way, if a patient does present for their appointment with symptoms, it will be easier to manage the conversation.

Non-suspect patient: Has no respiratory symptoms, has not had contact with a COVID-19 positive person and has no history of overseas travel.

Suspect case: A patient whom has any one of the following;

• Recent travel to, including transit though, another country or state
• Any recent cruise ship travel
• Close or casual contact within the last 14 days with a confirmed case of COVID-19
• Respiratory illness symptoms or a fever

Confirmed case: A person who tests positive to a specific SARS-CoV-2 PCR test or has the virus identified by electron microscopy or viral culture, at a reference laboratory.

References:

• Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19) WHO
• Interim advice on non-inpatient care of persons with suspected or confirmed Coronavirus disease (COVID19), including use of personal protective equipment (PPE), Australian Government Department of Health

• Those who have come into contact with a person confirmed COVID-19 case need to follow advice from the Department of Health regarding isolation. They need to consider if their interaction with the confirmed case was “close contact”.  A close contact is someone who has been face to face for at least 15 minutes or been in the same closed space for at least 2 hours.  These people may enter a practice even when steps have been taken to exclude symptomatic and recently travelled patients as people may be contagious prior to becoming symptomatic.
• If this occurs, you must isolate yourself in your homes for 14 days after last contact with the confirmed case. While in isolation if you develop symptom of fever or respiratory infection you need to be tested for COVID-19.
• It is important to ensure that all staff that have been in “close contact” with the infected person also isolate themselves.
• Cleaning and disinfection protocols as per government advice should be followed to ensure that the practice is safe for staff and patients to return.

Optometrist along with other healthcare workers engage with higher risk populations and therefore should have a lower threshold for testing for COVID-19 if they provide direct care.  This applies for optometrists who see patients clinically, and does not apply to other staff.

Optometrists should be tested if they develop:

• a fever (≥37.5); AND
• symptoms of an acute respiratory infection (e.g. shortness of breath, cough, sore throat).

This is in addition to the standard requirements for isolation following travel.  More information.

Those who have come into contact with a person with confirmed COVID-19 need to follow advice from the Department of Health regarding isolation.  Although there is limited information about COVID-19 it appears that people are contagious from 24-48 hours before symptoms appear to 1 day after symptoms cease.

It is important for those that have been face to face with the person for at least 15 minutes, or in the same closed space for 2 hours self-quarantine.  This is likely to be the other staff that have worked with the confirmed person.

This may also include patients if they have spent more than 15 minutes face to face with the confirmed COVID-19 individual.

Cleaning and disinfection protocols as per government advice should be followed to ensure that the practice is safe for staff and patients to return.

To ease the burden on the health system and protect vulnerable people, Transport for NSW has deferred the need for drivers over the age of 75 to undertake a medical review to confirm they are fit to drive. During the deferral period, drivers over 75 who fall under a non-high-risk category are no longer required to undertake a medical review to renew their drivers’ licence. Drivers who are considered at high risk including those who require specialist review, police identified drivers, and heavy vehicle drivers are still required to undertake a medical assessment. The deferral is for a period of up to 12 months from Monday 23 March.

Optometry Australia will provide further information for other states as it becomes available.

Many vulnerable communities are limiting access for non-essential visitors, including health personnel, in order to limit the impact of COVID-19 on population groups such as Aboriginal and Torres Strait Islander people, who are considered to be at greater risk. As such, requests for the postponement or cancellation of scheduled outreach optometry visits are likely. As a first step, we recommend that providers confirm with their jurisdictional VOS fundholder, or community contacts, whether visits are to go ahead as early as practical.

If visits are cancelled or postponed, Optometry Australia understands that the Department of Health has recently advised jurisdictional VOS fund holders that funding may be made available to cover any non-refundable expenses. We encourage optometrists who find themselves out of pocket with costs incurred in preparing for these visits (e.g. pre-booked flights and accommodation) to work with their Regional Coordinator to arrange appropriate reimbursement.

As the COVID-19 pandemic continues, the Australian Department of Health has confirmed that allied health practitioners can (and should) continue face-to-face services to homes and residential care facilities, to service vulnerable members of the public, such as the elderly and those with disabilities.  However, practitioners are urged to be vigilant for signs of COVID-19 so not to put themselves or these communities at further risk.

Patient alert posters and social media tiles are available from both Optometry Australia and the Department of Health. Some of Optometry Australia’s posters have editable fields to suit your practice preferences.

The Optometry Board of Australia (OBA) released advice on 3rd April 2020, noting that the OBA will not take action if optometrists cannot meet the CPD registration standard due to the COVID-19 pandemic when seeking to renew registration this year. While the OBA acknowledged that optometrists may have difficulty meeting CPD requirements this year as a result of withdrawn/denied leave requests, conference cancellations and the re-prioritization necessary to meet workforce needs, optometrists are still encouraged to continue to do relevant CPD.

Similarly, the OBA will also be flexible with regards to CPR training requirements during the pandemic – if you are due to complete CPR training this year, the OBA requests that you complete CPR training when there is no longer an unnecessary risk involved in participating in a course. The OBA will keep a close watch on the situation to determine whether the 2021 renewal year is also affected.

During the COVID-19 pandemic, Optometry Australia encourages members to visit our Institute of Excellence to access the full suite of high quality educational content online.