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Optometrists now able to prescribe drugs

Ontario is now allowing accredited optometrists to prescribe drugs for the treatment of several eye conditions and diseases, including glaucoma and infections.

The change in rules took effect last Thursday, and is being hailed by local optometrists as something that will reduce duplication in the health-care system while saving patients time and travel.

“It’s kind of a huge deal for optometry and for the patients with eye problems that they typically have to go to the emergency [room] or the clinic for,” noted Dr. Bruce Lidkea.

“It’s been a long time coming,” he remarked. “When I graduated from optometry in Indiana, Indiana already [had] legislation to allow optometrists to prescribe.

“When I was working in Minnesota when I graduated [in 1994], they had the legislation to prescribe.

“All 50 states and almost every province has this legislation in place. It’s unfortunate it’s taken this long,” added Dr. Lidkea.

“But it’s absolutely fantastic for our patient base that we can provide these services now.”

“I think it’s a wonderful thing,” echoed Dr. Robert Lidkea, who noted younger optometrists already have been trained to prescribe drugs while older ones now will have to undergo training—although he’s not going to do so.

“I would have to go away to school for 100 hours, which is like a month, and then write exams. At this point in my life, it does not make a lot of sense,” he chuckled.

“But for someone like Bruce, who has been trained recently, I think it’s a good thing.

“It will take the pressure off the medical doctors because we are more easily accessed, and I think better able to follow up than they can, with the equipment and everything,” he reasoned.

Dr. Lorelei Locker recalled hearing talk of allowing pharmacists to prescribe drugs 20-30 years ago.

“They’ve been dangling that carrot in front of us for so long, saying, ‘It’s coming, it’s coming,’” she noted.

“Well, it’s finally here.

“I think it’s wonderful. It allows more timely access to care for

patients with eye conditions,” agreed Dr. Locker. “And it will also free up some of the time in the emergency room and the doctors’ offices for other people, too.”

Dr. Tom Cousineau concurred.

“It’s going to improve care in the province,” he remarked. “It’s a win-win situation for everyone—ourselves, doctors, patients—because it’s going to alleviate some of these wait times in emergency rooms and so forth.

“Quite often, people had to be sent to emergency departments, and this way, we can handle it,” Dr. Cousineau explained.

“It negates some of the pressure there, and certainly the patients benefit from it.”

Previously, if a patient went to an optometrist with a medical health issue, the optometrist then would have to refer him or her to a medical doctor (general practitioner), which often meant emergency room waits.

If it was specifically an ocular disease issue, the optometrist would direct the patient to an opthamologist.

“Now, the only time we have to refer a patient that’s outside of our scope is for glaucoma that’s not primary open angle glaucoma, and the majority of glaucoma cases are primary open angle glaucoma,” noted Dr. Bruce Lidkea.

While the new system definitely is better than the old, Dr. Lidkea said the old system here “worked out reasonably well.”

“I think we’ve got a good relationship with most of the medical doctors in Fort Frances, and for the most part, with most of the medical doctors, we could see the patient here, call the medical doctor and explain the situation, and work with the medical doctor that way,” he explained.

“There were only a few that said, ‘No, I need to see that patient, and I need to diagnose and prescribe myself.’

“It wasn’t very time- or cost-effective for OHIP or the patient,” added Dr. Lidkea.

“This is going to make a big difference for the quality of care for health care in Ontario,” he stressed.

“This is great news for our patients and everyone in Ontario,” Dr. John Mastronardi of Windsor, president of the Ontario Association of Optometrists (OAO), stated in a press release.

“Most of our members have been educated and trained to prescribe medications for years,” he noted.

“We are pleased that the Ontario government has made changes that will broaden access to medically-necessary services across the province.”

Paul Ting, executive director of the Canadian National Institute for the Blind (CNIB) Ontario, also applauded the news in that same release.

“This will make great strides in the treatment of all eye care,” he said.

“Seventy-five percent of vision loss is preventable or treatable,” Ting noted. “Preventing blindness is an urgent challenge with an aging population, and this will drastically improve access to clinical care.”

“Optometrists in Ontario have long awaited this change which will allow them to offer patients one-stop health care for many eye conditions,” said Dr. Christopher Nicol, interim Registrar at the College of Optometrists of Ontario.

“This regulation will reduce health-care system costs and provide easier, quicker service for hundreds of patients across Ontario,” he remarked.

In related news, OHIP now covers a $300 surcharge on foldable implants when patients have cataract surgery in Manitoba.

Dr. Bruce Lidkea said this opens opportunities for patients who are cost-concerned.

“Patients still have the opportunity to go to Thunder Bay, Winnipeg, or to Kenora, but now it’s an equal playing field,” he explained.

Dr. Lidkea noted foldable implants are better than the older generation lenses because a smaller incision is made and the wound can heal without stitches.

With non-foldable implants, a larger incision has to be made and stitches have to be used to close it.

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