The provision of training is variable with most nurses and Aboriginal Health Workers developing their eye care skills on the job. Medical Officers report the need for additional training particularly for conditions that are rarely seen in urban Australia such as trachoma and trichiasis. There is a need to develop clinical practice guidelines for primary eye care and for them to be disseminated and updated regularly. Regular in-service training would assist in the implementation of these guidelines. Disease registers are essential for the proper management of chronic diseases especially for diabetes.
Most health services lack adequate registers or information systems.
Commercially available, computer-based systems now exist and health services should be actively encouraged to use these for patient recall and management. Governments should provide incentives for services to acquire and use computer-based, patient management and recall systems. The capacity of different primary health care professionals to deal with eye problems depends on their level of training. This was found to vary considerably and was exacerbated by high levels of staff turnover in many rural and remote locations. Most AHW and registered nurses stated that they received little or no formal training about primary eye care and developed their eye care skills on the job.