Mary Henry (Independent)

The drugs that optometrists want to prescribe are mainly local anaesthetics for the eye, as well as drugs that affect accommodation. The only reason for using drugs that affect accommodation is to examine the fundus of the eye. If one is examining the fundus of the eye, one is surely trying to diagnose the medical condition. Diabetes is one of the most important problems regarding disease of the eye.

I have no doubt that optometrists will refer people to medical practitioners as they have done, but if people visiting optometrists are given the impression they are getting a full examination of the eye, they will have a sense of security that their retina has been looked at and any disease has been picked up. I would like to know more about why it is desirable that opticians should be in a position to examine the fundus and perhaps diagnose retinal diseases.

These practitioners are also putting themselves in a situation where they are far more liable to litigation. Who will be held responsible if, after using drugs that affect accommodation, a disease of the retina is found? Will they be liable? They do not have medical training so they could not be expected to recognise these diseases but, having given the impression they are conducting more than an examination required for glasses, will they be liable under this Act if they miss any diseases present? I would like some guidance on that.

The Minister said we will have to update the Medical Products (Prescription and Control of Supply) Regulations 1996 to allow these drugs to be used and I want to know the view of the Irish Medicines Board and if it has been consulted.

Optometrists are taking great responsibility upon themselves which I hope has been properly thought through. Even when using local anaesthetics on the eye one must be careful about warning people when they leave the examination not to get dust in their eye because they will not feel it. If they do not give these warnings, will they be liable for any damage done to the cornea? I hope these aspects have been carefully considered.

While it might be a plus to allow people to prescribe for diagnostic purposes, people may think they have had a whole examination of their eye and any diagnosis of disease which may be systemic but which manifests itself in the eye, such as with diabetes, may be overlooked. I hate to sound like a doubting Thomas, but I see problems with patients perceiving they are getting a more extensive examination than they in fact are.