The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the New Zealand Association of Optometrists (NZAO) are pressing on to improve accessibility to eyecare with a hui held recently on the future of cataract post-op care.

Hosted by RANZCO, the task at the Auckland meeting was to formulate a proposal seeking public funding to outsource cataract patients’ final post-surgery follow up to community optometrists, potentially freeing up 10,000 appointments in public hospitals per year, said Dr Justin Mora, clinical lead of RANZCO’s Vision 2030 and beyond Aotearoa and national co-lead of Health New Zealand’s Eye Health National Clinical Network.

Dr Justin Mora. Credit: Auckland Eye

“We perform about 23,000 cataract surgeries in the public system per year and having done some analysis, we estimate that about 10,000 of those would be suitable for community follow-up,” said Dr Mora. “These are the non-complicated cases and because they're so quick, they wouldn't necessarily translate to 10,000 extra hospital appointments, but it probably would allow for about 3,000 new patient appointments in the public system.

“Other advantages are about easily accessible and affordable care; the patient wouldn’t need to come to the hospital again for their final check-up. Instead, they can go to their community optometrist, someone local and with whom they may already have a long-term relationship… they may not even have to pay for parking,” he said.

NZAO president Haydn Treanor said while it was still early days for this proposal, there are opportunities for optometrists to share the load. “There are many areas in which community optometry can support the public hospital system – (such as) crosslinking, diabetes, AMD, glaucoma – but all of these are dependent on the communication and co-operation of systems. These will be some of the issues that will need to be addressed and resolved.”

Hadyn Treanor

The proposed change would also require clear and detailed inclusion and exclusion criteria, a patient communication framework and communication between hospital and optometrist and vice versa, all of which would require process and system support, Dr Mora agreed, adding he expects cost to become the main barrier to get the proposal across the line. “Saying that, I think this proposal will be something Health New Zealand might consider because they’re trying to encourage involvement of allied health professionals in routine practice and this is an opportunity to make it happen.”

Once finalised, the proposal will need to be circulated with NZAO members and Health New Zealand’s Eye Health National Clinical Network, with the intent to have it tabled with Health New Zealand later this year, Dr Mora said.

In addition to Dr Mora and Treanor, Drs Sarah Welch and Alistair Papali'i-Curtin, Health New Zealand’s Eye Health National Clinical Network national co-leads plus regional leads Drs Sam Kain and Erica Doucet also attended the hui, alongside Dr Liz Insull, RANZCO NZ branch chair; Renata Watene, NZAO vice-president; Inhae Park, NZAO councillor; and Chrissie Cowan, Eye Health Aotearoa co-chair and community representative, among others.