OA Defends Oral Prescribing Push Against ASO Safety Concerns

Optometry Australia (OA) has firmly rejected claims that expanding prescribing rights for optometrists represents a "shortcut" to patient care, as the profession's peak body confronts serious concerns raised by ophthalmologists.

In a strongly worded statement, Optometry Australia president Dr Theo Charalambous responded to criticism from the Australian Society of Ophthalmologists (ASO) regarding the Optometry Board of Australia's proposal to extend prescribing authority to include oral medications for eye conditions.

The issue centres on whether therapeutically endorsed optometrists should be permitted to prescribe oral medicines, not just the topical treatments they currently provide under therapeutic endorsement.

"Not Seeking to Become Doctors"

Dr Charalambous stated that optometrists are proud of their professional identity as highly trained, autonomous primary eye care clinicians, pushing back against suggestions the reform represents professional overreach.

The OA president argued that current restrictions create unnecessary barriers, forcing patients into duplicate appointments simply to obtain prescriptions for conditions their optometrist has already diagnosed and is managing.

According to Dr Charalambous, patients across Australia are waiting too long, travelling too far and paying too much for time-sensitive treatment. Enabling oral prescribing would allow appropriate treatment to begin in a single consultation rather than requiring additional referrals purely due to administrative restrictions on medication routes.

Therapeutic Endorsement as Safeguard

Addressing safety concerns, Optometry Australia pointed to the existing therapeutic endorsement framework. Over 80% of the optometry profession holds therapeutic endorsement, which requires extensive accredited education covering systemic effects, contraindications, drug interactions, special populations and adverse event management.

Dr Charalambous emphasised that therapeutically endorsed optometrists prescribe under the same national prescribing competency expectations as other health professionals, and that expanding prescribing rights would not alter referral thresholds for complex cases requiring specialist care.

International Models Support Safety

Optometry Australia highlighted that New Zealand optometrists have been prescribing oral medications since 2014 with no evidence of mis-prescribing or over-prescribing. Similar models operate in the UK and USA.

The organisation pointed to Australia's own track record, noting optometrists have a long history of prescribing with minimal complaints or medico-legal claims.

Workforce Benefits

The reform is positioned as beneficial for the broader health system. When optometrists can manage straightforward ocular presentations comprehensively, it frees GPs and ophthalmologists to focus on more complex and surgical cases where demand is greatest.

OA CEO Skye Cappuccio has previously noted that the consultation documents recognise Australian optometrists are already highly trained, with no additional training required for therapeutically endorsed optometrists to prescribe oral medications within their scope of practice.

Broader Reform Context

The prescribing debate sits within broader full scope of practice reforms recently endorsed by Australian Treasurers through the National Competition Policy Federation Funding Agreement Schedule.

Optometry Australia CEO Skye Cappuccio welcomed this development, noting that Australian optometrists' skills and training are seriously under-utilised compared to counterparts in similar developed nations.

"We know that when optometrists are empowered to deliver full scope care, we see earlier detection and management of eye disease, better long-term outcomes, and a more effective allocation of health resources," Ms Cappuccio said.

The Optometry Board of Australia's consultation on expanding prescribing rights is currently open for public feedback on whether endorsed optometrists should be approved to prescribe both topical and oral medicines for common eye conditions.

The debate continues as both professions advocate for their positions on what represents the best model for patient care and safety in Australian eye health.