Shared care for chronic eye diseases: perspectives of ophthalmologists, optometrists and patients

Patricia M O’Connor, C Alex Harper, Cathy L Brunton, Sandra J Clews, Sharon A Haymes and Jill E Keeffe
Med J Aust 2012; 196 (10): 646-650. || doi: 10.5694/mja11.10856


Objective: To report the perspectives of optometrists, ophthalmologists and patients on a model of shared care for patients with chronic eye diseases.

Design, setting and participants: Qualitative study of a model of shared care between optometrists and ophthalmologists for patients with stable age-related macular degeneration, diabetic retinopathy and glaucoma, trialled by the Royal Victorian Eye and Ear Hospital in Melbourne during 2007–2009. Semi-structured interviews were conducted with optometrists, ophthalmologists and patients at completion of the project to obtain their perspectives on this model.

Results: Seventeen optometrists submitted expressions of interest to participate, and 12 completed web-based training modules and clinical observerships and adhered to specified examination and reporting protocols. All five participating ophthalmologists and 11 of the optometrists were interviewed. Ninety-eight patients participated and 37 were interviewed. Optometrists not only met ophthalmologists’ expectations but exceeded them, appropriately detecting and referring patients with additional, previously undetected conditions. Patients reported savings in travel time and were satisfied with the quality of care they received. Optometrists, ophthalmologists and patients indicated a general acceptance of shared care arrangements, although there were some issues relating to interprofessional trust.

Conclusions: Shared care between local optometrists and hospital-based ophthalmologists can help to reduce patient waiting time for review and offers an opportunity for these two groups of eye care professionals to collaborate in providing localised care for the benefit of patients. However, trust and relationship building need to be further developed.

  • Patricia M O’Connor1,2
  • C Alex Harper1,2
  • Cathy L Brunton2
  • Sandra J Clews2
  • Sharon A Haymes1,2
  • Jill E Keeffe1,2

  • 1 Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC.
  • 2 Royal Victorian Eye and Ear Hospital, Melbourne, VIC.



This 2-year National Eye Health Demonstration Project was funded by the Australian Government Department of Health and Ageing, with additional funds from the Victorian Department of Health. This research was supported by the Royal Victorian Eye and Ear Hospital. The Centre for Eye Research Australia receives operational infrastructure support from the Victorian Government. We acknowledge the support and cooperation of all the ophthalmologists, optometrists, support staff and patients involved, and the contribution of the project manager, Bich Thai.

Competing interests:

No relevant disclosures.

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