ECOO finds progress in scope of practice across Europe

The European Council of Optometry and Optics found that, while there are still areas to grow, “significant progress has been achieved” in developing the scope of optometry in countries across Europe

frames in practice
Pexels/Karolina Grabowska

The European Council of Optometry and Optics (ECOO) has published the fourth edition of its Blue Book, which gathers data on the optometry and optics professions across Europe.

The report suggested that there has been a steady progress in developing the scope of practice across Europe, though there are still areas for improvement.

The Blue Book contains data on the number and size of the profession in each country, its status and education, the scope of practice, as well as its role in public health. The data is gathered through surveys of 31 countries.

Observing the data, ECOO has found that the scope of practice is evolving, with professionals able to use diagnostic drugs in some countries (approximately 12), while countries are also moving towards developing a therapeutic scope of practice, the report found.

Cindy Tromans, ECOO president, commented: “Despite significant progress achieved, there is still some way to go to ensure the roles of opticians and optometrists are firmly established as primary care givers across all of Europe.”

Looking at the scope of practice in specific examples, the Blue Book reveals that myopia management is permitted in 20 countries, practiced in seven and prohibited in three, while testing drivers’ sight is permitted in 12 countries, practised in three and prohibited in 15.



For the first time, the Blue Book also included data on whether professionals can test vision and prescribe spectacles to children in countries across Europe, finding that 18 responding countries said no, seven said yes - a special qualification was needed, and five said it was not permitted.

ECOO suggested that the standard eye examination is similar across Europe and mainly regulated through professional guidelines. Variations include the fact that in 12% of responding countries, professionals are not permitted to determine the follow-up time scale. In 77% of countries professionals can test ocular mobility, while in 48% of countries professionals are allowed to carry out a posterior eye assessment.

Reflecting on the data, Ms Tromans noted that with COVID-19 there was a recognition that optometry and optics could contribute to reducing some of the pressure on health systems, while ensuring continuity of eye care.

She added: “The only way forward is to invest in a well-educated and skilled workforce that can ensure timely diagnosis of eye conditions and access to care, and opticians and optometrists are eager to play their full role.”

The report revealed a steady number of students graduating each year into various optical qualifications. It is anticipated that, per year, more than 6500 students complete their qualification in optics, and 4630 students complete their qualification in optometry.

ECOO observed that educational recognition is often more advanced than legislative recognition.

ECOO secretary-general, Fabienne Eckert, explained that the organisation hopes to assist policy-makers with the data, providing a picture of the demands on eye care, and the status of the profession.