6. Optometry in The Netherlands
after November 2000
Main advantages:
Diagnostic drugs allowed
Allowed to make an optometric diagnosis
7. NL Optometry early 2000s: Hospital
Use diagnostic drugs
Working as ophthalmic assistants
8. NL Optometry early 2000s: Optical
Optometrists are allowed to use diagnostic drugs
Offering optometry as a problem solver
9. NL Optometry early 2000s: Optometric
Optometric practices without optical sales ->
went broke within 3 years
10. Setting goals
WCO concept of optometry:
Optometry is a healthcare profession that is
autonomous, educated and regulated
(licensed / registered).
Graduated in Utrecht (BOptom, 2004)
Registered (KP nr 49907883787)
Private practice
11. Setting goals
WCO concept of optometry:
Optometrists are the primary healthcare
practitioners of the eye and visual system
who provide comprehensive eye and vision
care, which includes refraction and
dispensing, detection/diagnosis and
management of disease in the eye, and the
rehabilitation of conditions in the visual
system.
12. Starting an optometric practice
2004 joined a contact lens
practice
Advantages: reduced investment
Existing patient base
Disadvantages: difficult to
change a “winning team”
13. Already available Immediately necessary
Auto-refractometer 90D, 20D, gonio lenses
Retinoscope Indirect ophthalmoscope
Phoropter + trial frame Goldmann appl. tonometer
Distance + near vision tests Binocular vision tests
Slit lamp Colour vision test
Direct ophthalmoscope Amsler grid
Corneal topographer Tropicamide
Non contact tonometer Phenylephrine
Fluorescein Oxybuprocain
Lensmeter Cyclopentolate
14. Implementing optometry
Offer a comprehensive optometric exam to
everyone
Clear distinction between optical sales and
health care
Don’t offer optometry for free
15. Hard choices
Quit offering contact lens fittings and
refractions
Convince colleagues and patients of the
benefits of a comprehensive eye exam
“Forbid” my colleagues to use the
non contact tonometer
16. Different mindset
Traditionally: Product based
I want new glasses -> 10mins refraction
I want contact lenses -> contact lens fit
New: Problem based
Always start with a thorough examination of
the eyes and visual system
17. Refraction
Traditionally: History, refraction, binocular
vision, non contact tonometry.
BUT
Pts equal good tonometry to good eye health
Explain importance of tonometry, offer a
comprehensive eye exam.
18. Contact lens fit
Traditionally: History, topography, refraction,
anterior segment.
BUT
Why not adding: binocular vision, tonometry
and fundus examination?
It adds ~10 minutes
Makes people familiar with optometry
19. Collaborate with General Practitioners
Visited all local GPs
Explained optometry
Referral letters
