Following the Optometrists and Dispensing Opticians Board’s (ODOB’s) 2023 targeted consultation on extending hospital optometrists’ scope of practice to include intravitreal injections, the New Zealand Association of Optometrists (NZAO) has agreed to take on the work to progress the scope expansion and the development of a relevant training programme.

Elmarie Stander, ODOB’s outgoing chief executive and registrar, confirmed the body met with Ophthalmology New Zealand (ONZ) and other key stakeholders to discuss the proposed scope change for hospital optometrists. “We drafted a targeted consultation to consider feedback on what such a training programme (prescribed qualification) would look like. The board resolved to hand this project over to the NZAO, who took this on.”

A total of nine key stakeholders were consulted by ODOB in September 2023, including the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and Te Whatu Ora, said Hadyn Treanor, NZAO president . Of those nine parties, all but one had responded by the 31 October 2023 deadline, reported ODOB in a statement at the end of last year. The statement said ODOB board members had met with the then health minister (Andrew Little) in March 2021 to discuss intravitreal injections and the availability of optometrists to assist in meeting the population’s eye health needs, in light of the healthcare workforce crisis. “This discussion was well received and the board later received a letter from the minister acknowledging that Avastin injections are underserved across the (then) district health boards due to the limited ophthalmology workforce and nurse injectors working with ophthalmologists who currently deliver injections.”

Hadyn Treanor

Since then, the ODOB has been working with the Ministry of Health to draft guidelines for possible training requirements and a proposed training programme, all of which has now been handed to NZAO, which will present back to ODOB when completed. It is still very early days in the process, however, stressed Treanor. “NZAO is still in discussion as to how best to pursue this option.”

ONZ confirmed it had made a submission to the ODOB on the potential scope change, but would not be drawn on where it stood on the matter. ONZ’s mission is to improve the working environment and outcome for New Zealand’s ophthalmologists and their patients, said Dr Dean Corbett, ONZ chair. “We have made our thoughts known to (the ODOB) as an independent body.”

Dr Dean Corbett

Despite experienced hospital optometrists’ scope being legally extended in 2022 to include minor laser procedures such as YAG (and welcomed by many of the country’s public-hospital ophthalmologists when questioned by NZ Optics), RANZCO wrote to its fellows advising them not to train optometrists in laser. Asked if ONZ’s position on optometrists now performing intravitreal injections is informed by RANZCO’s stance, Dr Corbett said, “ONZ and RANZCO are separate and form their own actions and opinions.”