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I read with interest the article by Kern et al: Implementation of a cloud-based referral platform in ophthalmology making telemedicine services a reality in eye care. I agree entirely that this is a way forward in ophthalmology, and increasing cooperation between optometrists and ophthalmologists is vital and in the best interests of the patient as well as the NHS.
However, there is an important sentence in the introduction which is incorrect:
'The Opticians Act 1989 obligates UK optometrists to refer any incidental eye abnormality detected during an NHS eye test to a Hospital Eye Services (HES) unless they provide a sufficient disease description including medical advice to the patient.7 '
The obligation on an optometrist to refer a person who appears to be suffering from an injury or disease of the eye applied to any consultation, whether NHS or private. However, this was removed on 1 January 2000 when the General Optical Council’s Rules relating to Injury or Disease of the Eye (1999) came into force. Optometrists now have discretion as to whether or not to refer patients, and indeed many such patients are successfully managed in primary care as a result.