1:30min
For Queensland optometrist Jason Holland, working in a collaborative care setting has offered a glimpse into the future of optometry – one where oral prescribing is seamlessly integrated into everyday care.
As Optometry Australia calls on the Optometry Board of Australia to review and contemporise the Guidelines for the Use of Scheduled Medicines to enable optometrists to prescribe oral medications, Jason’s experience offers timely insight into why this change matters.
After more than a decade working alongside ophthalmologists in a multidisciplinary setting, he has witnessed how much smoother, safer and more efficient patient care can be when optometrists have access to the right tools.
In an interview with Optometry Australia, Jason shares what’s at stake when prescribing rights are restricted, why the profession is more than ready for this step and especially what this change could mean for patients.
Q: Can you share a clinical example where the inability to prescribe an oral medication limited the care that you could provide?
Jason: Early in my career, I worked in a more retail-facing setting where I didn’t have easy access to oral therapeutics. It could be exhausting. Since then, I’ve moved to where I am now – working directly with ophthalmologists in a multidisciplinary setting.
Dry eye is a big part of my practice and doxycycline is incredibly useful for patients who have concurrent rosacea of their skin as well as their eyes. Historically, I’d have to write to the GP and ask them to get involved, which would often mean delays, confusion and a lot of back and forth.
Now, I can collaborate directly with ophthalmologists and get patients what they need efficiently. If we could expand that prescribing scope for all optometrists, no matter where they work, that would remove barriers and streamline care.
Q: What impact does this have on patients?
Jason: Patient harm isn’t just about physical outcomes – it’s also about excessive cost, time and delays. Without prescribing rights, often the patient is required to take a referral letter to their GP, which could be questioned, challenged or declined. Not only does this lead to even more delayed treatment and intervention, it adds extra time, extra fees and sometimes for the patient, they have lost income from more time off work.
It also adds strain to the system. I spend time writing to the GP, the GP responds, I follow up again – all while the patient waits for treatment. That’s a real risk. And while that patient might ultimately get the care they need, I would argue that there is harm occurring because there is so much wasted time and wasted resources in getting that outcome. Optometrists who aren’t in a collaborative care setting have to deal with this all the time.
That’s a sad thing. These are medicines that optometrists could safely and easily prescribe, and right now, a lot of patients have a lot of delay in getting the right outcome.
Q: How would access to orals change your practice?
Jason: Personally, the change would streamline my day because right now, I’m constantly asking for prescriptions. More importantly, it would open the door for my peers outside of multidisciplinary settings to provide better care without unnecessary referrals.
In dry eye alone, I know there are two systemic tablets which would make a huge difference: Azithromycin and Doxycycline.
There are also cases where it’s time sensitive, like herpetic eye infections – in these cases, early intervention is key and the sooner we get these patients the antiviral, the better. But right now, we’re forced to delay treatment until the patient sees someone else.
Q: How did working in a collaborative care setting change your perspective?
Jason: It was humbling and a bit daunting. When I started, I felt completely out of my depth. But with mentorship from ophthalmologists, I built the confidence and skills I might never have developed in a standalone setting. That experience cemented my belief that safe, supported prescribing is entirely within reach for optometrists, especially if we embrace mentoring and professional peer networks.
Q: What can Australia learn from countries like New Zealand that have access to oral prescribing?
Jason: In New Zealand, oral prescribing is standard, and they’ve been doing it safely for years. One of our new team leaders recently moved here from New Zealand and was surprised we didn’t already have access to orals. Their experience proves it can work. We just need to keep pushing and show we’re ready.
Q: What drives your advocacy for oral therapeutics?
Jason: I’d just love to be able to offer patients greater efficiency. They could come to see me for a single consultation, just one appointment, and I could deliver holistic care from start to finish: tailored advice, the best topical treatment and, if needed, oral intervention as well. And it’s all done with me.
The GP would simply receive one letter from me with a full report of what’s happened. I really think that’s the best use of everyone’s time and resources. It’s cost-effective, efficient and truly holistic care. It would streamline my day, and it would absolutely improve the patient journey.
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.