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Review
. 2025 Sep;32(6):1900-1910.
doi: 10.1177/09697330251317670. Epub 2025 Mar 12.

Innovative care models: Expanding nurses' and optometrists' roles in ophthalmology

Luke Yu Xuan Yeo  1 , Collin Yip Ming Tan  1 , Jemima W Allen  2 , Charmaine Chai  3 , Khadijah Binte Othman  4 , Yih Chung Tham  5 , Victor Teck Chang Koh  6 , Julian Savulescu  7
Affiliations
Review

Innovative care models: Expanding nurses' and optometrists' roles in ophthalmology

Luke Yu Xuan Yeo et al. Nurs Ethics. 2025 Sep.

Abstract

The expanding demands of healthcare necessitate novel methods of increasing the supply of trained professionals to enhance the delivery of care services. One means of doing so is to expand allied health professionals' scope of practice. This paper explores the ethics of two examples of such expansion in ophthalmology, comparing the widely accepted practice of nurses administering intravitreal injections and the relatively less prevalent optometrists functioning as physician extenders. We conducted a literature review of empirical research into both practices and conclude that nurses administering intravitreal injections are ethically justified. With adequate standardized training, optometrists can also function as primary eye care providers to improve accessibility to eye care. We provide an algorithm for the ethical introduction of innovative expanded allied healthcare.

Keywords: Ophthalmology; allied health; nursing; optometry; physician extenders.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JS is a Bioethics Committee consultant for Bayer. JS is a Bioethics Advisor to the Hevolution Foundation. The other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article

Figures

Figure 1.
Figure 1.
Overview of risks and benefits of nurse and optometrist-led ophthalmological care.
Figure 2.
Figure 2.
Papers reviewed for the purpose of this study.
Figure 3.
Figure 3.
Innovative Care Algorithm for allied healthcare [adapted from Savulescu and Wilkinson, 2017].
See this image and copyright information in PMC

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