The optometrist and primary eye care.

Ophthalmologists are strongly opposed to any move by optometrists to treat anterior segment disease. Or are they? This year the optometric journal Optician has been examining this question by gauging opinions from grassroots professionals and from their representative bodies. At a time when UK universities are oVering optometrists the first postgraduate courses in ocular therapeutics the results make interesting reading. According to a survey conducted by Optician in August 1996, half of UK ophthalmologists believe that opto-metrists could use ocular therapeutics given suitable training. Yet many clearly remain implacably opposed to the concept—49% of those surveyed saying they were against any suggested timescale for introducing such a move. Not surprisingly, optometrists' opinions are less divided. A similar Optician survey earlier in 1996 showed that 91% of UK optometrists surveyed would be interested in using ocular therapeutics, again given suitable training. There was widespread support for managing a range of conditions such as conjunctivitis, blepharitis, and dry eye. Despite their enthusiasm, many optometrists expressed concern over the issues of education, funding, and litigation and many rejected the notion of managing a wider spectrum of anterior segment disease. Yet eight out of 10 optometrists believed that a realistic timescale for a move into therapeutics was within 2 years. Adding a further piece to the jigsaw, a poll conducted by London's City University in 1990 but published in 1996 showed that 63% of general practitioners believed opto-metrists should treat external eye conditions such as conjunctivitis, with a similar proportion saying they should be allowed to prescribe broad spectrum topical antibiotics. The College of Optometrists supports an enhanced clinical role for its members and is already committed to developing higher qualifications in ocular therapeutics. Its policy is in line with the 'educate then legislate' tactic used by US optometrists in gaining approval for therapeutic use. The College is also to apply to the Medicines Control Agency to extend the range of ophthalmic drugs optometrists can use. But there is evidence that their case will meet with opposition from some of the medical representative bodies. Commenting on Optician's survey of optometrists' attitudes to therapeutic use, the Royal College of Ophthal-mologists said that the treatment of eye disease should only be carried out by medically trained doctors and that further 'medical' training for optometrists would only be helpful if they wanted to become doctors. The ophthalmic group committee of the British Medical Association added that they …