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The delivery of ophthalmic care: the practitioner, community ophthalmic teams, and contract ophthalmology
  1. ROLF BLACH
  1. Henley on Thames, UK

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    It is generally accepted that the delivery of ophthalmic care, both nationally and internationally, is limited by lack of resources. However, present resources could be used more effectively for the treatment and prevention of eye disease by the better coordination of existing services.

    On a national level, the coordination of the work of “eye care professionals” would focus ophthalmic activity without threatening the standing of individual practitioners. On an international level, the coordination of agencies involved in the delivery of eye care—governments, international bodies, charities, medical personnel, carers—would create the opportunities for total ophthalmic care to communities. Many isolated examples of such coordination already exist.

    How might this work?

    On a national level

    In the United Kingdom, total ophthalmic care in a community, involving treatment and prevention, is an ideal that cannot be achieved by the existing complement of ophthalmologists. However, ophthalmology comprising nearly 800 consultants, about 1400 subconsultant grades and trainees, and others more peripherally involved (nurse practitioners, general practitioners, school medical officers, charitable workers), also includes more than 8000 optometrists and 1100 orthoptists.

    Society expects the ophthalmic services to …

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