Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
To determine how orthoptic-led clinics can deliver safe, patient-centred care for the management of stable eye conditions while reducing wait times and alleviating demand on specialist ophthalmology services.
Dates: February 2025 - August 2025
Implementation sites: Caloundra Hospital
Aim
To reduce appointment waiting times for both new and review ophthalmology patients by implementing safe and sustainable orthoptic-led care pathways.
Outcomes
- In our orthoptic led glaucoma pilot clinic, nearly 80% of stable patients seen in the orthoptic clinic were rebooked in the orthoptic for their next follow up.
- In our Idiopathic intracranial hypertension (IIH) pilot clinic, 60% were rebooked in the orthoptic clinic, 23% were discharged, and only 17% required an ophthalmologist review.
- Overall, 76 patients were assessed in this pilot clinic, freeing up 76 ophthalmology appointments for new and complex cases.
Patients were surveyed to capture their thought on the orthoptic led clinics:
- 93% Questions and concerns addressed by orthoptist
- 100%: Acceptable waiting times
- 100%: Appreciated not waiting for in-person doctor review
- 100%: Confident results reviewed by ophthalmologist
- 96.5%: Overall satisfaction (very satisfied)
Background
The Sunshine Coast is Queensland's fastest-growing region, and our ophthalmology services are under pressure. In May 2025, 91% (over 1,100 patients) Category 2 patients were waiting longer than the recommended three months for an appointment. Appointment delays can lead to permanent vision loss, falls and reduced quality of life. We needed a solution.
Methods
We designed and introduced orthoptic-led pilot clinics for Glaucoma, and Idiopathic Intracranial Hypertension. These are two eye conditions that in the past required long term follow up and regular appointments with an ophthalmologist.
In these orthoptic led pilot clinics experienced orthoptists assessed stable review patients and carried out all of the required tests and imaging.
After each orthoptic assessment, an ophthalmologist carried out a virtual chart review of the findings at a later date and provided a follow-up plan.
Any new concerning findings identified by the orthoptist during the assessment were escalated to an ophthalmologist immediately.
This model of care allows specialist ophthalmologists to focus on new and complex cases while our service is able to deliver safe, high-quality eye care to more patients.
Discussion
Strengths/Benefits of the project:
- Reduced waiting times: Orthoptists can provide alternative care pathways to review stable and early-stage eye conditions.
- Cost-efficient workforce utilisation: Orthoptists working to their full scope of practice.
- Optimised specialised resources: Our ophthalmologists and optometrist can focus on new patients and complex cases.
Next steps:
- Orthoptic staff training: provide any upskilling and supervision required for more orthoptists to practice in these clinics.
- With structured training as well as formal clinical pathways and protocols this approach could be adopted across other hospitals or health services.
- Develop/refine clinical protocols, pathways and policies for orthoptic led clinics.
References
Previous studies show orthoptic led glaucoma and diabetic clinics are safe and effective (1,2)
1. Koklanis K, Thorburn D. Orthoptist-led glaucoma monitoring: A pilot quality assurance audit of the reliability of orthoptists in glaucoma management decisions, Aust orthoptic J, 2021 Vol 53.
2. Crameri A, Koklanis K Investigating the effectiveness of an orthoptic-led diabetic retinopathy screening clinic. Aust orthoptic J, 2016 Vol48
Key contact
Lisa Saunders
Senior Orthoptist
Sunshine Coast Hospital and Health Service