Recent data from Canadian paediatric ophthalmology services shows that diagnostic accuracy rates are lower among family physicians and paediatricians, and substantially higher among optometrists; at the same time, fewer of these referrals are made by optometrists.
Enabling optometrists to make referrals would reduce the volume of both referrals and false positives to secondary or tertiary ophthalmology services. Most importantly, patients will receive more timely care due to improved detection, and waiting times for patients will no doubt be shorter.
Specifically in the context of Hong Kong, multiple optometrist service experiments were conducted more than a decade ago.
An optometrist-led service was set up at Tsan Yuk Hospital, and patients with eye symptoms were referred to the optometry service instead of secondary or tertiary ophthalmology services. Overall, only 22 out of 176 patients were referred for specialist attention after feedback from optometrists.
An adjacent study showed that after implementation of the optometrist service, the referral rate to ophthalmologists significantly decreased from 36.2 per cent to 23.5 per cent.
At another assessment service, diagnoses made by optometrists were compared with those made by ophthalmologists. In 80 per cent of the cases, the two sets of diagnoses completely agreed, which was comparable to overseas findings.
The Hong Kong findings were presented at Hospital Authority conferences. They indicate that optometrists can aid physicians in enhancing the accuracy of diagnoses of eye conditions, reduce the number of referrals to secondary or tertiary care, and provide enhanced eye care at the primary care level.
Currently, private hospitals accept referrals made by optometrists to no detriment. There are also some isolated cases of optometrist referrals being directly endorsed by family physicians who trust in the optometrists’ expertise and judgment, and of these referrals being accepted by the Hospital Authority.
This demonstrates the feasibility and reliability of optometrist referrals, and makes the adoption of direct optometrist referrals by the Hospital Authority a reasonable step, for which there are precedents.
Ultimately, allowing optometrists to make direct referrals to the Hospital Authority shortens queues for treatment, thus helping to achieve the goals of ensuring timely treatment for patients and reducing the burden on Hospital Authority facilities.
I urge the immediate implementation of this measure so better eye care can be provided to the public.
George Woo, emeritus professor, School of Optometry, Hong Kong Polytechnic University
Good reasons for Hong Kong to go smoke-free
As lawmakers in Hong Kong consider more rigorous measures to curb tobacco use among citizens, they have the opportunity to take bold action and create our city’s first smoke-free generation. To curtail smoking prevalence among our youth, a policy could prohibit the sale of tobacco products to people after a certain age, for instance, those born after 2009, with the legal minimum age then being raised annually.
An urgent response is needed to lower these figures, and the passing of smoke-free legislation would put Hong Kong at the forefront of global efforts to eradicate the scourge of smoking and ensure the well-being of future generations.
The impact of such legislation would be profound not only on public health but also on the economy and the future prosperity of Hong Kong. Fewer cases of smoking-related diseases would alleviate the pressure on our public healthcare system, allowing resources to be allocated elsewhere.
Additionally, being smoke-free may make Hong Kong more attractive to business and talent, thus consolidating our position as an international financial and commercial centre.
Sennett Shi, Tung Chung
Can Israel be taken seriously on ceasefire talks?
On August 10, an Israeli air strike on a school building sheltering displaced Palestinians in Gaza City killed at least 90 people.
It seems Israel is the tail wagging the US dog.
Christian Rogers, Wan Chai
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