1:30min
Access to timely treatment can make all the difference when it comes to eye health. For Tasmanian optometrist Lisa Kingshott, providing comprehensive eye care doesn’t just come down to clinical skill – it’s also about having the right tools at hand.
Right now, Optometry Australia is calling 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.
Lisa’s experience shows firsthand why this change is so important for both optometrists and the communities they serve.
After being inspired to become an optometrist by her father, Lisa studied at the University of Melbourne and then built her career working across metropolitan Melbourne and regional Victoria. She eventually returned home to Tasmania to work in her family practice and enjoy the Tassie lifestyle with her own family. Over her career, Lisa has witnessed how prescribing restrictions on optometrists can create avoidable costs, delays and frustrations for patients, especially for those living outside major city centres.
In an interview with Optometry Australia, Lisa explains how expanding optometrists’ scope to include oral medications could improve patient care, reduce pressure on GPs and make treatment more accessible for people living in rural or regional areas.
Q: Can you share a clinical example where not being able to prescribe an oral medication limited the care you could provide?
Lisa: Recently, I saw a young adult with an infected chalazion. They live and work in a rural town 20 mins from my practice. They came to see me as they had a painful lid lump, which was increasingly red and swollen over the preceding day. I diagnosed infected chalazion with risk of preseptal cellulitis but couldn’t prescribe the oral antibiotics required to treat the lid infection. The patient couldn’t get an appointment with their own local GP for at least a week, so was left trying to find an appointment with a city doctor ASAP. This cost them both money (for the non-bulk billed GP consultation) and time (an extra trip in from their town the following day) which was very troublesome for them.
Q: How would the outcome of this case have changed if you had been able to prescribe the necessary oral medicines?
Lisa: My patient would have had faster access to the prescription they needed, and it would have guaranteed they got it (there was a risk they may not have followed through with the additional GP appointment). More importantly to this particular patient, they would have been bulk-billed rather than having to find the funds in their limited budget to pay a substantial fee for GP consultation.
Q: How does the restriction on oral prescribing affect your sense of professional autonomy or satisfaction?
Lisa: It’s frustrating to know how to help someone but not be able to do it!
Q: How would oral prescribing change your day-to-day practice? Would it reduce delays, referrals, or duplications in care?
Lisa: Having access to oral medicines would definitely change day-to-day practice by reducing delays and referrals. I’m not envisioning writing out multiple oral medicine prescriptions every day! But for patients with conditions that do require orals: meibomian gland dysfunction, recurrent herpes simplex keratitis, infected chalazions – all conditions within the scope of optometrists – being able to prescribe the appropriate treatment at the time of diagnosis would be of great benefit.
Q: Do you think that your training, education and experience have equipped you to prescribe oral medicines for the practice of optometry?
Lisa: Yes. I feel confident in providing safe therapeutic management of eye conditions, and orals are an extension of the topical medicines optometrists are already safely using. I would need to be brought up to date with exactly which oral antibiotics etc are currently available and most appropriate for each condition. I feel confident this CPD would be easily accessible when the time comes.
Q: Some decision-makers express concern about patient safety. What would you say to reassure them?
Lisa: Optometrists in Australia have been able to use and prescribe therapeutic drugs for around 25 years. We are a highly regulated profession with strict continuing education requirements. We would only be prescribing within our scope of practice, not suddenly managing new eye conditions or other body conditions with oral medicines.
Optometrists in New Zealand, Canada, the UK and the US, can already prescribe oral medicines. In New Zealand, where optometrists have comparable training to Australia, optometrists have been able to prescribe orals since 2014. An audit untaken of NZ optometrist prescribing showed zero evidence of out-of-scope prescribing or adverse medicine reactions. I think this is very reassuring and a good indication that patient safety would be upheld if Australian optometrists could prescribe orals.
Q: Beyond patient outcomes, what broader health system benefits do you see in enabling oral prescribing?
Lisa: It would reduce demand on GPs and ophthalmologists to see patients who are already at the optometrist and can be safely managed there. It would also enable better management of referrals from pharmacy presentations when orals are required.
Q: How would this change affect the community you serve?
Lisa: My patients would receive the treatment they need faster – with just one appointment (often available sooner with me than with a GP). They would avoid the financial cost of a second appointment, and the risk of not following through with the extra appointment. This change would definitely improve accessibility of eye care to the community.
Help us strengthen the case for oral prescribing rights
We’re seeking your stories to help demonstrate why oral prescribing rights matter for optometrists and the patients you care for. If you’ve encountered a situation where your ability to prescribe oral medications would have made a difference, we’d love to hear from you. Reach out to our advocacy team at policy@optometry.org.au.
Tagged as: Scope of practice