Optometry co-management of preoperative and postoperative cataract surgery patients.

Abstract

Purpose of review: As the prevalence of cataracts continues to rise, the increasing demand for cataract surgery may surpass the availability of ophthalmologists. This review examines the role of optometry in the co-management of patients with cataracts, including preoperative and postoperative care, and discusses the implications of expanding optometric scope-of-practice laws.

Recent findings: Collaboration between optometrists and ophthalmologists occurs through two primary models: referral-based and integrated management. Studies indicate that direct referrals from optometrists to ophthalmologists improve surgical listing rates and streamline patient care. Integrated models enhance efficiency by incorporating optometrists into ophthalmology practices, allowing ophthalmologists to focus on surgical interventions. Postoperative care co-managed by optometrists has demonstrated mostly favorable visual outcomes, with 86% of patients achieving 20/40 vision or better and low postoperative complication rates. However, legislative changes expanding optometric surgical privileges remain controversial due to concerns about training adequacy and patient safety. Sharing clinical responsibilities can lead to a "slippery slope" phenomenon encroaching on the surgeon's role and threatening patient care.

Summary: Optometry-ophthalmology co-management can enhance surgical efficiency, improve patient access, and alleviate workforce shortages. While co-management may be effective for routine cases, the expansion of optometric surgical privileges raises debate regarding clinical competency and regulatory oversight. Future efforts should focus on creating best practice guidelines for standardizing training, shared ethical responsibility, and ensuring high-quality, patient-centered care.