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Optometry is a relatively new profession that has evolved differently in different countries around the world. Currently, Optometrists around the world work in health care as the primary eye care physicians. They face incredible challenges and contribute towards the global eye health needs.
The current scenario shows the natural need of Optometrists to contribute in the public health issue of visual impairment in 123 million population with uncorrected refractive error and 517 million people with near vision impairment.2 In addition, there are other conditions of public health concern such as diabetic retinopathy, glaucoma, epidemic myopia and binocular vision problems where Optometrists can contribute.
Optometrists, now have the opportunities to expand their practice to public health Optometry. A very good example of this is the eye nurse and ophthalmologists training programme the Fred Hollows Foundation New Zealand (FHFNZ) has developed and successfully tested in Papua New Guinea (PNG) and other Pacific Island Countries (PICs). I was very fortunate to have contributed to this exemplary programme.
A part of the programme included training of local nurses to be eye nurses in public sector. As a result the public have universal access to eye care. Most of the one year postgraduate diploma in eye care training for eye nurses was developed by a team of Optometrists and solely delivered by Optometrists. In such countries with no or a handful of eye professionals, the eye nurses with skills in diagnosing and treating most common eye conditions, refraction and prescribing spectacles, assisting in eye operating theatre, and organizing community eye programmes have contributed a lot. A majority of these eye nurses work in the public sector with ministries of health. Thus, integrating primary eye care into the primary health care of respective countries.
In terms of the quality of the training, it has been accredited by the International Joint Commission for Allied Health Personnel in Ophthalmology (IJCAHPO) and the certification exam pass rate for the graduates has so far remained at 100%. There is a study that provides evidence of good access of equipment for refraction and ocular health assessment by these eye nurses. Also, the levels of access and comfort of use for most common ophthalmic medications is found to be in the higher range.3
The Optometry skills have now been transferred to the eye nurse graduates and training is moving towards localization.