Editorial: Once again!

Abstract

Early in 1992 the newsletter of the Canadian Ophthalmological Society advised it5 members of "The increase of scope of Optometric practice". The newsletter outlined changes in optometric legislation throughout Canada and stated, "There will be a neverending battle to defend medical and surgical treatment of eye disease from non-medical practitioners." The Society also indicated that it has obtained literature and support from their American colleagues to presumably counter Optometry's goals.

For years ophthalmology has taken an adversarial political stance with respect to Optometry and our role in vision care delivery. There have been attempts to thwart advances in our profession, including the use of anaes­thetics for tonometry, the use of dilating agents for peripheral fundus evaluation (or to facilitate posterior pole evaluation) and the use of cycloplegics for refractive evaluation. Intriguingly, the use of these drugs has resulted in more effective and discriminating referrals to the very group that opposed their use. Of obvious signifi­cance, as well, is the benefit to patients of these advances in Optometry.

Once again we expect that our profession will be assailed for seeking further advances for the management of our patients. Lest I be accused of couching my terms, let me clearly state that the prescribing of therapeutic drugs by optometrists is an increase in our scope of practice that needs to and will occur. The rationalization of my belief hinges upon patient welfare, the education and training of our profession, our financially ever­flagging health care system and the increasing pressures upon ophthalmology (e.g., capping, clawbacks).

External pressures on ophthalmology have resulted in interesting changes to their practices,, such as involve­ment with the dispensing of spectacles, the expansion of noninsured services (laser K, RK.) and association with refracting physicians. Each of these changes in ophthal­mology practice also warrants comment, perhaps at another time.

By now ophthalmology must understand that the diagnosis and management of disease has never been solely the purview of medicine; perhaps chis is what concerns them. The position being taken by ophthalmol­ogy should not be surprising nor does it change my respect for their surgical and diagnostic abilities.