ACBO was recently contacted by Insight News magazine to respond to accusations by a few ophthalmologists concerning optometrists providing unnecessary vision screenings in schools, charging Medicare for the screenings, and prescribing glasses which should not, in the eye surgeons’ opinions, be prescribed. ACBO responded to the factually incorrect, unjustified and malicious assertions, and the Insight News article can be seen here
Although ACBO submitted a thorough rebuttal, this was heavily edited in the published Insight News article. We now want to set the record straight by publishing our original response in its full form. Please read on...
Submitted 26 July 2018 to Insight News
School screenings are not arranged by and are not associated directly with the Australasian College of Behavioural Optometrists (ACBO). ACBO provides education and continuing professional development for optometrists. School screenings and vision examinations are routine optometry services provided by registered and qualified optometrists in the relevant circumstances. Behavioural vision care is not a consideration.
ACBO strongly supports the provision of screenings and vision examinations for all children as defined in recognised standards as an important part of caring for the health of our community.
1. Why should behavioural optometrists be contracted to carry out eyecare programs at schools?
Behavioural optometrists specifically are not contracted to provide eye examinations at schools.
Optometrists are qualified and do conduct vision screenings at schools. Optometrists who identify as behavioural optometrists are registered and qualified to practice optometry. They can and do conduct school visual screenings as is their right as registered Optometrists. It is important to distinguish between vision screenings, a routine optometry examination and a more detailed children’s vision examination.
School vision screenings are a common community service provided by many optometrists. Indicative tests are completed in the screening to see if there is potentially a vision problem. If there is suspicion, the child is referred to the appropriate practitioner for further investigation. Optometrists do not get paid for conducting the student screening and can be accompanied by optometry students from teaching colleges such as Melbourne University and The University of New South Wales, to give the students practical experience.
Sometimes an optometrist may, as a part of their practice, visit a school and conduct a regular eye examination for students. A thorough eye examination can be completed on site in the school, with the parent’s consent, and this is funded by Medicare as are all vision tests. This is not behavioural optometry and is not a function of ACBO.
Optometrists generally have the equipment and experience and may undertake more extensive examinations to identify both common and more complex vision conditions in children. This is also a part of standard optometric practice.
There is clear evidence that there are a significant number of children with both identified and undetected vision problems. A recent studyi showed that 30% of the children screened by optometrists had vision issues of concern, and that the NAPLAN Scores of those children was significantly less than their unaffected peers. It not only makes sense, but it is specifically recommended by leading authorities (including ophthalmologists) that school age children have regular eye
2. Ophthalmologists have said optometrists, in particular behavioural optometrists, shouldn’t facilitate these programs due to a perceived conflict of interest (i.e. financial incentive to recommend glasses and further treatments) and also questions related to the evidence behind behavioural optometry. How would ACBO respond?
All health professionals consult and diagnose patients and offer therapy or treatment and are paid for the consultation and therapy/treatment. This is not a conflict of interest. School screenings are provided by optometrists as an unpaid
community service and are a part of accepted standards for general optometry practice.
If the ophthalmologists referred to in this story have examples of any optometrists who have behaved inappropriately or unprofessionally, they should present this evidence to AHPRA for investigation or refrain from inappropriate public comment.
The question of evidence for behavioural optometry is extensive and needs to be much more specific. To suggest that behavioural optometry lacks evidence is false.
There is a vast body of evidence for the many concepts and principles that make up the extensive scope of practice referred to as “behavioural optometry”. Some is without question. Other evidence is significant and is under discussion. A few areas
of practice are evolving, and evidence is accumulating. ACBO supports and mandates Evidence Based Practice principles and Informed Consent for Members.
i White, Sonia L.J., Wood, Joanne M., Black, Alex A., & Hopkins, Shelley (2017)
Vision screening outcomes of Grade 3 children in Australia: Differences in academic achievement. International Journal
of Educational Research, 83, pp. 154-159.