Safeguarding Glaucoma Care
The 2014 Judicial Review Campaign
In 2014, the Australian Society of Ophthalmologists (ASO) and the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) stood together in one of the most defining advocacy efforts in our organisation’s history — the Judicial Review of the Optometry Board of Australia’s (OBA) guidelines on glaucoma diagnosis and management.
The proposal at the time would have allowed optometrists to independently diagnose and treat glaucoma without ophthalmologist oversight. Recognising the potential risks to patient safety, the ASO led a legal challenge to ensure that every Australian diagnosed with glaucoma received appropriate medical oversight from a specialist eye doctor.
After more than 18 months of mediation and legal proceedings, the matter was successfully resolved through negotiation, with the OBA agreeing to introduce revised guidelines that mandated referral to an ophthalmologist within four months of any initial glaucoma diagnosis or treatment initiation. This outcome reaffirmed a critical principle: that patient safety and clinical collaboration must remain at the heart of eye care in Australia.
Post the review, RANZCO developed collaborative care guidelines for managing glaucoma patients to be followed by optometrists and ophthalmologists. These collaborative care guidelines can be accessed via the RANZCO website.
Today, the positive impact of this campaign continues to shape the standards of glaucoma care nationwide. The referral requirement established through this review remains a cornerstone of shared care between optometrists and ophthalmologists, ensuring early specialist involvement, improved treatment outcomes, and better protection for patients living with sight-threatening conditions.
This campaign stands as a testament to the ASO’s unwavering commitment to upholding the highest standards of ophthalmic care — advocating not for professional privilege, but for patient safety, collaboration, and quality outcomes across the eye-health sector.
FROM PREVIOUS CEO KERRY GALLAGHER ON OBA JUDCIAL REVIEW
The year 2014 will remain in our minds for a long time for the exceptional result achieved in refuting an initiative by optometrists to attempt the diagnosis and treatment of glaucoma without an ophthalmologist’s oversight.
For nearly 18 months we were engaged in a drawn-out legal process to determine the legitimacy of the Optometry Board of Australia bid to sideline ophthalmologists from many diagnoses of glaucoma.
At the outset, mediation was attempted but it was unsuccessful. The only viable remaining option was to seek a judicial review of the OBA decision.
ASO demonstrated its mettle by accepting the daunting challenge of mounting this legal defence of ophthalmology. We knew it would be complex, costly and with no certainty of being vindicated. But we persisted.
The decision by RANZCO to join us, equally, in the judicial review was a courageous step for the College but one that most Fellows felt was correct. It was certainly an important psychological boost for ASO and it has cemented a new era of closer collaboration between the two organisations.
Vindication of the move came in November when the Australian Health Practitioner Regulation Agency approached ASO-RANZCO seeking a negotiated end to the judicial hearing.
Former senator and Howard government Minister, Amanda Vanstone, chaired the talks and proved an admirable facilitator.
The agreement specified that in the event of an initial diagnosis of glaucoma, optometrists will be required to refer a patient on to an ophthalmologist within four months for confirmation of the diagnosis and to establish a management plan.
If an incident arose in which a patient experienced side effects from the initiating treatment, referral to an ophthalmologist must be immediate.
So as we conclude this year we can take heart that the fundamental principle which underpinned our efforts has been endorsed: that patient safety and wellbeing must always come first.
REFERENCES:
“Guidelines on glaucoma diagnosis and management” – Optometry Board of Australia / Australian Health Practitioner Regulation Agency (25 Nov 2014)
https://www.ahpra.gov.au/News/2014-11-25-glaucoma-diagnosis-and-management.aspx AHPRA
“Board publishes revised guidelines on glaucoma diagnosis and management” – Optometry Board of Australia (08 Dec 2014)
https://www.optometryboard.gov.au/News/2014-12-08-revised-guidelines.aspx optometryboard.gov.au
“2014 revised Guidelines for use of scheduled medicines – FAQ” – Optometry Board of Australia (FAQ page)
https://www.optometryboard.gov.au/Policies-Codes-Guidelines/FAQ/Revised-guidelines-for-use-of-scheduled-medicines-FAQ.aspx optometryboard.gov.au
“Revised glaucoma guidelines now in force” – Optometry Australia (09 Dec 2014)
https://www.optometry.org.au/workplace/revised-glaucoma-guidelines-now-in-force/ Optometry Australia
“Certainty closer with glaucoma guidelines court case” – Optometry Australia (23 Jul 2014)
https://www.optometry.org.au/workplace/certainty-closer-with-glaucoma-guidelines-court-case/ Optometry Australia
“Supreme Court of Qld hearing on glaucoma delayed until December” – Insight News (14 Aug 2014)
https://www.insightnews.com.au/supreme-court-of-qld-hearing-on-glaucoma-delayed-until-december/