Warning on eye care

By MARTIN JOHNSTON health reporter

Optometrists are lobbying to close what they say is a legal loophole that will lead to more people going blind and possibly dying.

The Association of Optometrists national director, Lesley Frederikson, says the Health Practitioners Competence Assurance Bill will end restrictions on who could prescribe corrective contact lenses and spectacles.

In effect, only optometrists and ophthalmologists (eye doctors) - and not dispensing opticians - were now permitted to prescribe, she said.

But the bill - which will cover registration, competence and discipline for most health workers, from doctors to dieticians - leaves this open. It would allow registering authorities to define areas of practice and the necessary qualifications.



Dr Frederikson, who spoke to Parliament's health select committee last week, said these measures were insufficient to protect the public. Dispensing opticians would be able to independently test people's eyes using computerised Machines that automatically produced a prescription.

She was aware of at least one dispensing optician who wanted to do this.

Optometrists study fulltime at university for at least four years. Dispensing opticians, while working, study for about three years for an Australian technical institute qualification.

Vision tests without a full check of eye health would lead to missed cases of glaucoma, diabetic eye disease and age-related macular degeneration, the three main causes of preventable blindness, Dr Frederikson said. Cases of ocular melanoma, a potentially fatal cancer, would also be missed.

About 1500 people a year develop serious vision loss in New Zealand.

Association of Dispensing Opticians immediate-past president Peter Gates accused Dr Frederikson of scaremongering and simply trying to protect optometrists' commercial territory - claims she denied.

Mr Gates said dispensing opticians were capable of doing many eye-testing tasks under the oversight of an optometrist, leaving the detection of disease to the optometrist.

"There's the opportunity for a co-operative role here.

"The consumer doesn't have to have a full eye examination every time they want to change their lens power."

Mr Gates said opticians should be permitted to test and prescribe new lenses for patients who had consulted an optometrist or ophthalmologist within the previous five years.

Dentists have expressed similar fears to optometrists. The Dental Council worries that the bill would allow de-registered dentists to continue practising.

What's at stake

* Current law: Only optometrists and ophthalmologists (eye doctors) are permitted to prescribe corrective contact lenses and spectacles. Dispensing opticians cannot prescribe.

* Proposed change: The Health Practitioners Competence Assurance Bill covers the registration, competence and discipline of most health workers from doctors to dieticians. It would allow registering authorities to define areas of practice and qualifications.

* The concern: The Association of Optometrists says this does not protect the public. Dispensing opticians could test people's eyes using computerised machines that automatically produce a prescription. Serious eye diseases could be missed. Dentists have equivalent fears for patients in their sector.