Allied Healthcare Update: Optometry

What does a trip to the optometrist mean today? Refractions? Glasses? Contact lenses? The scope of practice for optometry has changed immensely over the past twenty years, which has positively impacted the delivery of eye care nationwide.

A groundswell to change the scope of practice swept through the U.S. beginning in the early 1980’s, culminating with a standard practice platform at the turn of the 21st Century.

Optometrists nationwide provide comprehensive eye care with prescriptive authority. Treatment includes all topical eye drops for ocular conditions such as glaucoma, ocular inflammation and disease, eye lid infections, traumatic eye injuries and other conditions brought about from systemic disorders.

Oral prescriptive authority includes all legend medications on Schedule III through Schedule V. Corneal abrasions are treated as well as removing ocular foreign bodies. Skin lesions around the eyelids and adnexa are treated and removed.

How can an optometrist benefit patients seen in your practice? Optometrists use specialized diagnostics to accurately assess eye health and signs of systemic disease, then work to regain ocular health in partnership with the referring doctor.

Painful red eyes signal a wide range of eye abnormalities requiring specialized treatment. For example, inflammatory conditions such as iritis or uveitis require a slit lamp bio-microscope to diagnose and determine the correct course of therapeutic action. Treatments in these instances generally include antibiotic or antiviral eye drops and are often followed by a full systemic rheumatology work-up through the referring doctor.

Diabetic retinal disease is also an example of co-management between the referring doctor and the optometrist. Caring for patients with diabetes should routinely include an annual dilated eye exam. Optometrists evaluate retinal status through the dilated pupil and document findings with digital imagery. These images are reviewed by doctor and patient in the exam room with an explanation of current retinal status. In this way, digital imagery becomes a powerful motivational tool for patients if retinal hemorrhages are discovered. Retinal reports are sent from the optometrist to the referring doctor, which provide important feedback for proper diabetic management.

Any sudden change or loss of vision – especially when accompanied with flashes of light – may signal a retinal detachment which is an emergency referral. Patients over the age of fifty are at a higher risk of developing a retinal detachment.

Optometrists also assist children or adolescents with concerns about a change in their vision as well as geriatric patients with concerns about cataracts, glaucoma or macular degeneration. In addition, optometrists work in concert with ophthalmologists to manage cataract surgery during the pre- and postoperative periods.

As important members of the healthcare team, optometrists are able to provide a wide range of diagnostic and therapeutic eye care and should be an essential part of your regular referral list.

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