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Clinical Care and Practice Advancement

Optometric Co-Management of Vision Therapy

The co-management of optometric patients presents opportunities to provide a full range of optometric services. Patients benefit by receiving expanded services for visual problems identified by their primary care optometrist. Primary care optometrists benefit by satisfying patient needs through services not provided in their practice. The referring doctor retains primary authority for the patient’s eye, vision, and optical needs. The consulting doctor benefits by having additional opportunities to provide care.

With the expanded scope of optometric responsibilities, it is challenging for individual optometrists to provide the full range of eye and vision care services in their offices. Increasingly, optometrists are finding it beneficial to collaborate with colleagues on a variety of clinical issues such as specialty contact lenses, low vision rehabilitation, glaucoma, infant’s eye and vision care, and vision therapy. This is a well-accepted practice to provide patients with optimal care. In select cases, the recommendations of other specialists such as a neurologist, pediatric ophthalmologist, occupational therapist, or learning specialist may be indicated based on the consultation between the primary care optometrist and the optometric consultant. Co-management is facilitated by a collegial relationship between the referring and consulting doctors, characterized by mutual respect and ongoing communication. It is vital to establish protocols and guidelines to assist co-management.

The patient should be aware of the nature of this relationship and the respective role of each provider. The primary care doctor should provide the consulting doctor with the reasons for referral. The consulting doctor should provide a written report summarizing the recommendations and rationale. The referring doctor should receive periodic updates of the patient’s progress, particularly when the complexity of the case requires extensive therapy. As both visual problems and visual demands increase, optometric co-management enables patients to receive the highest level of the full-scope of optometric care. As our knowledge about the treatment of visual problems increases, optometric co-management will enable patients to continue receiving the highest level of full-scope optometric care.

This publication was formulated by the American Optometric Association’s Binocular Vision Working Group. The following individuals are acknowledged for their contributions:

Gary J. Williams, O.D., Chair
Gregory Kitchener, O.D.
Leonard J. Press, O.D.
Glen T. Steele, O.D.

Approved by: American Optometric Association, April 2004