Abstract: UK optometrists and what they do

I thought some of our British readers might be interested in this one. It seems as though very, very few of our UK dry eye folk are satisfied with the dry eye care they are getting from ophthalmology. Maybe as optometrists increase the scope of their therapeutic practice they can be encouraged to play a larger role in dry eye just as is happening on a large scale in the US.

A survey of the scope of therapeutic practice by UK optometrists and their attitudes to an extended prescribing role.
Needle JJ, Petchey R, Lawrenson JG.
Ophthalmic Physiol Opt. 2008 May;28(3):193-203

Purpose: Recent changes in medicines legislation in the UK have broadened the opportunities for optometrists to use and supply therapeutic drugs. We set out to investigate the current therapeutic practice of UK optometrists and to elicit their views on an extended prescribing role. Methods: Members of the College of Optometrists were invited via email to take part in an online survey. The survey questions covered four areas: mode of practice, proximity and relationship to other providers of eye care, scope of current therapeutic practice and future plans regarding prescriber training. Results: Of the 1288 responses received (response rate 24%), over 90% were from optometrists working in community practice. Common, non-sight-threatening conditions were managed frequently or occasionally by between 69 and 96% of respondents. Blepharitis and dry eye were the most common (managed routinely by >70%). In terms of therapeutic agents used, large numbers of optometrists reported that they commonly supplied or recommended over-the-counter (non-prescription) drugs, particularly lubricants and anti-allergic agents. However, fewer respondents supplied antibiotics (only 14% supplying chloramphenicol or fusidic acid frequently). Overall, relatively few respondents (14%) expressed no interest in undertaking further training for extended prescribing, although several barriers were identified, including cost and time taken for training, lack of remuneration and fear of litigation. Conclusion: Significant numbers of community optometrists are currently managing a range of common ocular conditions using a limited formulary. Enabling optometrists to train as independent prescribers will further develop this role, allowing greater use of their skills and providing patients with quicker access to medicines.