Therapeutic Optometrists?

[PACtoDOC]

Let me ask you guys about this. As a PA and now starting MS3, I have always sent my diabetic patients for routine ophthalmological exams but recently I have seen some of them coming back with notes from these therapeutic optometrists, even after I specifically make the referral to the ophtho. I am a little concernec about it. In fact, my wife being a type I for 6 years now, she just went to one of my professors who is an ophtho and she too came back home having seen the theapeutic optometrist. Has this become a standard of acceptance and should I just go with the flow, or does the ADA really want ophtho's themselves to be doing these exams? I don't really know the complexity involved in looking for diabetic retinopathy but I think this is sort of heading in one of those anesthesiology/CRNA directions. I just wonder what you future and current ophtho's think.

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[Andrew_Doan]

Has this become a standard of acceptance and should I just go with the flow, or does the ADA really want ophtho's themselves to be doing these exams? I don't really know the complexity involved in looking for diabetic retinopathy but I think this is sort of heading in one of those anesthesiology/CRNA directions. I just wonder what you future and current ophtho's think.

Optometrists do a good job screening for diabetic retinopathy. Optometrists should refer patients to general ophthalmologists when patients develop macula edema, severe nonproliferative diabetic retinopathy, or proliferative diabetic retinopathy. I think optometrists should consult general ophthalmologists first instead of sending patients directly to a retina specialist.

 

[Richard_Hom]

I think optometrists should consult general ophthalmologists first instead of sending patients directly to a retina specialist.

Dr. Doan,

Thanks for your post. I do believe the terminology in our profession is quite confusing and can be misleading.

On the second issue, I actually agree with your recommendation. Except for complicated fibrous tractional issues or proliferative problems, most general ophthalmologists do a great job in PRP, focal or grid laser. However, I do "interview" the ophthalmologist before I do send them as general ophthalmologists have different comfort levels themselves. My case load consists of 30-50 diabetics / week of varying stages of diabetic eye disease for the past 2 years.

Richard_Hom