Irish
College of Ophthalmologists
The Irish College of
Ophthalmologists wishes to warn the Government, the Minister of
Health & Children and other members of Dail Eireann of the
dangers inherent to some of the proposed changes to the Opticians
Act, 1956.
It is proposed in the Bill
to deregulate the sale of ‘ready readers’, to re-title
ophthalmic opticians as optometrists, to ensure the that the
registration of optometrists and dispensing opticians is in
accordance with EU requirements all of which we applaud. The
explanatory notes to the Bill also state that the purpose is ‘to
remove the absolute prohibition on treatment and prescription or
administration of drugs by optometrists’.
The Department of Health
& Children intends to issue a new Revised Regulation (Medicinal
Products Regulations) that will allow optometrists prescribe or
administer three drugs. The drugs proposed are cyclopentolate,
tropicamide and oxybuprocaine hydrochloride. The Council of the
Irish College of Ophthalmologists has grave concerns regarding the
use of these drugs which although topically applied may be
associated with significant ocular and systemic morbidity. The first
two of these drugs are anticholinergic agents and are inherently
dangerous. Of greatest concern is the fact that cyclopentolate will
be used widely in children. They are licensed for use by medical
practitioners only because of the known side effects that include
punctate keratitis, raised intraocular pressure and blinding acute
angle closure glaucoma where the loss of vision may be irreversible.
Systemic side effects include pyschotic reactions and behavioural
disturbances including ataxia, incoherent speech, restlessness and
hallucinations. Urinary retention, diminished gastrointestinal
motility, decreased secretion in salivary and sweat glands are well
described. Severe manifestations of toxicity include coma, medullary
paralysis and death
Special precautions in
administering these drugs must be taken in children, the elderly,
pregnant and lactating women and patients with cardiovascular,
respiratory, genito-urinary and other diseases. If this Bill is
passed in its proposed form the Dail will have put the lives of
those living in the State at risk
Only registered medical practitioners are qualified to assess an individual’s suitability before administering these drugs and also to deal with any unforeseen side effects that may occur. Optometrists are not qualified to administer or prescribe these agents and it is surprising that the Minister for Health & Children has been advised (ill-advised) to the contrary.
The Irish College of Ophthalmologists wishes to publicly warn the Minister, the Government and Dail Eireann that the removal of Section 48, subsection (1) of the Opticians Act 1956 will put the health of the citizens of this State in jeopardy.
21-Feb-03