{"id":3170,"date":"2026-01-02T13:27:16","date_gmt":"2026-01-02T11:27:16","guid":{"rendered":"https:\/\/optometrija.lv\/?p=3170"},"modified":"2026-01-02T13:28:59","modified_gmt":"2026-01-02T11:28:59","slug":"looa-iebildumi-nvd-izsludinataja-oftalmologijas-pakalpojumu-sniedzeju-atlases-nolikuma-projekta","status":"publish","type":"post","link":"https:\/\/optometrija.lv\/?p=3170","title":{"rendered":"LOOA iebildumi NVD izsludin\u0101taj\u0101 oftalmolo\u0123ijas pakalpojumu sniedz\u0113ju atlases nolikuma projekt\u0101"},"content":{"rendered":"\n

Nacion\u0101lais vesel\u012bbas dienests 2025. gada nogal\u0113 sabiedrisk\u0101 apsprie\u0161an\u0101 izsludin\u0101ja nolikuma projektu par oftalmolo\u0123ijas pakalpojuma sniedz\u0113ju atlases nolikumu. Nolikuma izstr\u0101d\u0113 LOOA netika uzaicin\u0101ta iesaist\u012bties. P\u0113c iepaz\u012b\u0161an\u0101s ar sagatavoto nolikuma projektu LOOA Valde sagatavoja un 22.12.2025. nos\u016bt\u012bja v\u0113stuli NVD, kur\u0101 izkl\u0101sta un pamato riskus pa\u0161reiz izstr\u0101d\u0101tajam nolikumam. \u0160eit<\/strong><\/a> pieejams NVD izstr\u0101d\u0101tais nolikuma projekts.<\/p>\n\n\n\n

Aicin\u0101m LOOA biedrus iepaz\u012bties ar nos\u016bt\u012bt\u0101s v\u0113stules tekstu:<\/p>\n\n\n

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\"\"<\/figure>\n<\/div>\n\n\n

LATVIJAS OPTOMETRISTU UN OPTI\u0136U ASOCI\u0100CIJA<\/p>\n\n\n\n

Adrese: R\u012bga, \u0136engaraga iela 8, LV-1063, Re\u0123.nr. 40008029786,<\/p>\n\n\n\n

e-pasts: looasociacija@gmail.com<\/p>\n\n\n\n

Nacion\u0101lajam vesel\u012bbas dienestam<\/strong><\/p>\n\n\n\n

C\u0113su iel\u0101 31, k-3, R\u012bg\u0101, LV-1012<\/p>\n\n\n\n

nvd@vmnvd.gov.lv<\/p>\n\n\n\n

Nr. 5\/2025<\/p>\n\n\n\n

22.12.2025.<\/p>\n\n\n\n

Par Nacion\u0101l\u0101 vesel\u012bbas dienesta izsludin\u0101to sekund\u0101r\u0101s ambulator\u0101s vesel\u012bbas apr\u016bpes pakalpojumu atlases nolikumu oftalmolo\u0123ij\u0101<\/em><\/p>\n\n\n\n

Latvijas Optometristu un opti\u0137u asoci\u0101cija (turpm\u0101k: LOOA) izsaka pamatotu pretenziju pret Nacion\u0101l\u0101 vesel\u012bbas dienesta (turpm\u0101k: NVD) izsludin\u0101to sekund\u0101r\u0101s ambulator\u0101s vesel\u012bbas apr\u016bpes pakalpojumu atlases nolikumu oftalmolo\u0123ij\u0101 (turpm\u0101k: SAVA nolikums).<\/p>\n\n\n\n

 NVD nolikums pieprasa viscie\u0161\u0101ko saikni ar nozares profesion\u0101lo organiz\u0101ciju intere\u0161u iev\u0113ro\u0161anu un viedok\u013ca uzklaus\u012b\u0161anu: 4.21. apak\u0161punkts nosaka ka NVD “apkopo un izv\u0113rt\u0113 valsts instit\u016bciju, nozares profesion\u0101lo organiz\u0101ciju, \u0101rstniec\u012bbas iest\u0101\u017eu p\u0101rskatus un speci\u0101listu ieteikumus par medic\u012bnisko tehnolo\u0123iju ievie\u0161anu un vesel\u012bbas apr\u016bpes pakalpojumu att\u012bst\u012bbu<\/em>“.<\/p>\n\n\n\n

LOOA neinform\u0113\u0161ana un nepieaicin\u0101\u0161ana SAVA nolikuma apsprie\u0161an\u0101 ir pretrun\u0101 ar NVD nolikumu, jo LOOA biedri ir tie\u0161i saist\u012bti ar nolikuma saturisko pusi. L\u016bdzam j\u016bs jaut\u0101jumos, kas skar redzes apr\u016bpes sist\u0113mu Latvij\u0101, inform\u0113t un iesaist\u012bt LOOA.<\/strong><\/p>\n\n\n\n

Ja apl\u016bko SAVA nolikuma projektu, tad LOOA ir b\u016btiski iebildumi pret t\u0101 saturisko un ekonomiski finansi\u0101lo aspektu.<\/p>\n\n\n\n

Pirmk\u0101rt: SAVA nolikums ignor\u0113 optometrista profesijas juridisko statusu, k\u0101 rezult\u0101t\u0101 ir ierobe\u017eots optometrista k\u0101 autonomas \u0101rstniec\u012bbas personas statuss.<\/p>\n\n\n\n

Saska\u0146\u0101 ar \u0100rstniec\u012bbas likumu kop\u0161 2020. gada 1. janv\u0101ra optometrists ir atz\u012bts par funkcion\u0101lo speci\u0101listu \u2013 \u0101rstniec\u012bbas personu ar augst\u0101ko medic\u012bnisko izgl\u012bt\u012bbu. Likums nosaka, ka funkcion\u0101lais speci\u0101lists sav\u0101 specialit\u0101t\u0113 ir ties\u012bgs patst\u0101v\u012bgi veikt diagnostiku, funkciju nov\u0113rt\u0113\u0161anu un dot atzinumus. Pa\u0161reiz\u0113jais SAVA nolikums optometristu k\u013c\u016bdaini defin\u0113 tikai k\u0101 oftalmologa atbalsta person\u0101lu vai piel\u012bdzina m\u0101s\u0101m vai \u0101rsta pal\u012bgiem. NVD r\u012bc\u012bba, izsl\u0113dzot LOOA no SAVA nolikuma izstr\u0101des, ir aizsk\u0101rusi optometrista k\u0101 neatkar\u012bga speci\u0101lista statusu, t\u0101dej\u0101di degrad\u0113jot t\u0101 profesiju. LOOA uzskata, ka optometristam ir j\u0101saglab\u0101 patst\u0101v\u012bba jaut\u0101jumos, kas ir aprakst\u012bti optometrista profesijas standart\u0101. Diem\u017e\u0113l l\u012bdz\u0161in\u0113j\u0101 praks\u0113 bie\u017ei ir nov\u0113rots, ka tie LOOA biedri, kuri str\u0101d\u0101 slimn\u012bc\u0101s vai polikl\u012bnik\u0101s, patst\u0101v\u012bgi veic faktisko darbu, kas saist\u012bts ar redzes funkciju nov\u0113rt\u0113\u0161anu, bet optometrista veikt\u0101s manipul\u0101cijas tiek noform\u0113tas k\u0101 oftalmologa sniegts pakalpojums. LOOA uzskata, ka ir nepiecie\u0161ams main\u012bt MK noteikumus Nr. 555, ievie\u0161ot tajos ar optometrista darbu saist\u012bt\u0101s manipul\u0101cijas un optometrista ambulator\u0101s viz\u012btes tarifu.<\/strong><\/p>\n\n\n\n

SAVA nolikum\u0101 min\u0113to pakalpojumu pieejam\u012bbas un ekonomisk\u0101s efektivit\u0101tes anal\u012bze<\/strong><\/p>\n\n\n\n

LOOA uzskata, ka SAVA nolikuma projekt\u0101 nav \u0146emta v\u0113r\u0101 NVD nolikum\u0101 min\u0113t\u0101 labas prakses principu iev\u0113ro\u0161ana:<\/p>\n\n\n\n

Dienestam ir pien\u0101kums nodro\u0161in\u0101t pakalpojumu kvalit\u0101ti un pieejam\u012bbu atbilsto\u0161i starptautiski atz\u012bt\u0101m kl\u012bniskaj\u0101m vadl\u012bnij\u0101m un<\/strong> valsts starptautiskaj\u0101m saist\u012bb\u0101m. LOOA uzman\u012bgi seko pasaules tendenc\u0113m un rekomend\u0101cij\u0101m, kas saist\u012btas ar redzes apr\u016bpi. Viens no jaun\u0101kajiem starptautisko organiz\u0101ciju dokumentiem, kas velt\u012bts \u0161ai tematikai ir Pasaules Vesel\u012bbas organiz\u0101cijas rekomend\u0101cijas par redzes apr\u016bpes sist\u0113mas izveidi (<\/strong>https:\/\/www.who.int\/publications\/i\/item\/9789240048959<\/strong><\/a>). <\/strong>Redzes apr\u016bpes interven\u010du pakete (package of eye care interventions<\/em> – PECI) nodro\u0161ina uz pier\u0101d\u012bjumiem balst\u012btu redzes apr\u016bpes interven\u010du kopumu vis\u0101 apr\u016bpes nep\u0101rtraukt\u012bb\u0101 un ievie\u0161anai nepiecie\u0161amos materi\u0101los resursus. PECI kalpo, lai pal\u012bdz\u0113tu politikas veidot\u0101jiem un tehnisko l\u0113mumu pie\u0146\u0113m\u0113jiem valst\u012bs ar zemiem un vid\u0113jiem ien\u0101kumiem integr\u0113t redzes apr\u016bpi savu vesel\u012bbas pakalpojumu paket\u0113s un politik\u0101. Pakalpojumu sniedz\u0113ji var izmantot PECI, lai pl\u0101notu un ieviestu redzes apr\u016bpes intervences sav\u0101s pakalpojumu programm\u0101s.<\/p>\n\n\n\n

LOOA valde, balstoties uz nolikuma projekt\u0101 sniegt\u0101s inform\u0101cijas b\u0101zi, ir izanaliz\u0113jusi t\u0101 atbilst\u012bbu \u0161\u012bm Pasaules Vesel\u012bbas organiz\u0101cijas rekomend\u0101cij\u0101m.<\/p>\n\n\n\n

Sal\u012bdzinot NVD izveidoto SAVA nolikumu 2026. gadam ar Pasaules Vesel\u012bbas organiz\u0101cijas (PVO) izstr\u0101d\u0101to PECI paketi, ir v\u0113rojama augsta tehnisk\u0101 un medic\u012bnisk\u0101 atbilst\u012bba<\/strong>, tom\u0113r past\u0101v at\u0161\u0137ir\u012bbas pakalpojumu groza tv\u0113rum\u0101. SAVA nolikums ir \u013coti prec\u012bzs un progres\u012bvs attiec\u012bb\u0101 uz medic\u012bnisko tehnolo\u0123iju un \u0101rstniec\u012bbas meto\u017eu atbilst\u012bbu<\/strong> PVO standartiem. Tom\u0113r, lai piln\u012bb\u0101 sasniegtu PVO m\u0113r\u0137i par univers\u0101lu vesel\u012bbas aptveri, valsts sist\u0113m\u0101 b\u016btu nepiecie\u0161ams nep\u0101rprotami atdal\u012bt prim\u0101ro un sekund\u0101ro redzes apr\u016bpi, iek\u013caujot optometrista veikto prim\u0101ro redzes apr\u016bpes pakalpojumu valsts sist\u0113m\u0101.<\/strong><\/p>\n\n\n\n

Optometristu nepietiekama integr\u0101cija vai ierobe\u017eot\u0101 loma SAVA nolikum\u0101 rada vair\u0101kus riskus un v\u0101jos punktus, raugoties gan no NVD m\u0113r\u0137iem, gan no PVO rekomend\u0101cij\u0101m. Optometristu neintegr\u0113\u0161ana k\u0101 patst\u0101v\u012bgu pakalpojumu sniedz\u0113ju kav\u0113 NVD m\u0113r\u0137i sasniegt maksim\u0101lu vesel\u012bbas apr\u016bpes pieejam\u012bbu un ir pretrun\u0101 ar PVO strat\u0113\u0123iju par darba uzdevumu sadali\/p\u0101rnesi (task-shifting<\/em>), k\u0101 rezult\u0101t\u0101 sist\u0113ma k\u013c\u016bst d\u0101rg\u0101ka un maz\u0101k pieejama pacientam. Redzes korekcijas l\u012bdzek\u013cu recept\u0113m ir j\u0101b\u016bt pakalpojuma groz\u0101 k\u0101 priorit\u0101ram pakalpojumam. To neiek\u013cau\u0161ana vai nepietiekama prioritiz\u0101cija ir pretrun\u0101 ar PVO m\u0113r\u0137i palielin\u0101t redzes korekcijas aptveri par 40% un NVD uzdevumu nodro\u0161in\u0101t efekt\u012bvu un pieejamu apr\u016bpi.<\/p>\n\n\n\n

Lai pl\u0101notu resursus, ir nepiecie\u0161ama sapratne par redzes apr\u016bpes pakalpojumu strukt\u016bru. Balstoties uz PVO datiem un Latvijas demogr\u0101fisko ainu, var ieg\u016bt \u0161\u0101du redzes ambulator\u0101s apr\u016bpes pakalpojumu kopainu:<\/p>\n\n\n\n

Vajadz\u012bbas veids<\/td>Ambulatoro gad\u012bjumu skaits gad\u0101<\/td>%<\/td><\/tr>
Refrakcijas probl\u0113mas<\/td>186,057<\/td>50%<\/td><\/tr>
Acu slim\u012bbu epizodes<\/td> 46,514<\/td>13%<\/td><\/tr>
Diab\u0113ta skr\u012bnings<\/td> 51,739<\/td>14%<\/td><\/tr>
Hronisku slim\u012bbu uzraudz\u012bba<\/td> 46,514<\/td>13%<\/td><\/tr>
Miopo b\u0113rnu uzraudz\u012bba<\/td> 38,233<\/td>10%<\/td><\/tr>
Kop\u0101<\/td>369,057<\/td>100%<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

T\u0101 k\u0101 oftalmologs ir tie\u0161\u0101s pieejam\u012bbas \u0101rsts, tad, balstoties uz tabul\u0101 min\u0113to redzes ambulator\u0101s apr\u016bpes pakalpojumu kopainu, katrs otrais oftalmologa pacients b\u016bs ar refrakcijas problem\u0101tiku. T\u0101 rezult\u0101t\u0101 oftalmologu resurss joproj\u0101m tiks izmantots nelietder\u012bgi, uzliekot tiem pien\u0101kumu veikt rut\u012bnas refrakcijas noteik\u0161anu un redzes korekcijas l\u012bdzek\u013cu izrakst\u012b\u0161anu, liedzot savlaic\u012bgu piek\u013cuvi pakalpojumiem pacientiem ar da\u017e\u0101d\u0101m, tai skait\u0101 smag\u0101m acu patolo\u0123ij\u0101m. Uzturot \u0161\u0101du sist\u0113mu, SAVA nolikum\u0101 pied\u0101v\u0101t\u0101s 220 941 ambulator\u0101s viz\u012btes ir tikai 60\u00a0% no vajadz\u012bbas, k\u0101 rezult\u0101t\u0101 joproj\u0101m saglab\u0101sies oftalmologa pakalpojuma pieejam\u012bbas probl\u0113ma.<\/p>\n\n\n\n

PVO strat\u0113\u0123ija “Integrated people-centered eye care<\/em>” (IPEC) uzsver nepiecie\u0161am\u012bbu veicin\u0101t uzdevumu p\u0101rvirz\u012b\u0161anu speci\u0101li apm\u0101c\u012btam person\u0101lam, lai uzlabotu apr\u016bpes pieejam\u012bbu. Anal\u012bze r\u0101da, ka oftalmologa apr\u016bpes epizode pa\u0161laik oblig\u0101ti ietver refrakcijas noteik\u0161anu, redzes funkciju nov\u0113rt\u0113\u0161anu un redzes korekciju, kas atbilsto\u0161i optometrista profesijas standartam ir tie\u0161i optometrista darba pien\u0101kumi. Vid\u0113ji \u0161\u012bs darb\u012bbas aiz\u0146em 15\u201320 min\u016btes no viz\u012btes, kas noz\u012bm\u0113, ka oftalmologs zaud\u0113 30\u201350 % sava laika, veicot optometrista darbu. Sist\u0113mas l\u012bmen\u012b pat 60\u201370 % no vis\u0101m ambulatoraj\u0101m konsult\u0101cij\u0101m var\u0113tu tikt novirz\u012btas optometristiem k\u0101 neatkar\u012bgiem speci\u0101listiem. NVD pl\u0101not\u0101s oftalmologa konsult\u0101cijas 2026. gadam nesedz iedz\u012bvot\u0101ju vajadz\u012bbas, ja speci\u0101listiem j\u0101nodarbojas ar masveida redzes korekcijas izrakst\u012b\u0161anu. No\u0146emot refrakcijas noteik\u0161anu no oftalmologu pleciem, oftalmologi var\u0113tu vair\u0101k fokus\u0113ties uz dienas stacion\u0101ra \u0137irur\u0123iju un sare\u017e\u0123\u012btu patolo\u0123iju \u0101rst\u0113\u0161anu.<\/p>\n\n\n\n

LOOA pied\u0101v\u0101 ieviest divu l\u012bme\u0146u sist\u0113mu, kur optometrists kalpo k\u0101 “v\u0101rtu sargs” prim\u0101raj\u0101 apr\u016bp\u0113, nofiltr\u0113jot rut\u012bnas gad\u012bjumus un pie oftalmologa nos\u016btot tikai pacientus ar acu patolo\u0123ij\u0101m.<\/strong><\/p>\n\n\n\n

1. L\u012aMENIS (optometrists): Veic masveida refrakcijas noteik\u0161anu, redzes korekcijas l\u012bdzek\u013cu izrakst\u012b\u0161anu, b\u0113rnu profilaktisk\u0101s redzes p\u0101rbaudes un prim\u0101ro patolo\u0123iju monitoringu (piem\u0113ram, ar digit\u0101laj\u0101m fundus kamer\u0101m). Optometrists nofiltr\u0113 rut\u012bnas gad\u012bjumus (aptuveni 60\u201370 % no vis\u0101m ambulatoraj\u0101m epizod\u0113m), uz otro l\u012bmeni nos\u016btot tikai tos pacientus, kuriem konstat\u0113tas indik\u0101cijas oftalmologa konsult\u0101cijai (piem\u0113ram, konstat\u0113tas k\u0101das acu patolo\u0123ijas kl\u012bnisk\u0101s paz\u012bmes vai nepiecie\u0161ama specifiska \u0101rst\u0113\u0161ana).<\/p>\n\n\n\n

2. L\u012aMENIS (oftalmologs): Piln\u012bb\u0101 fokus\u0113jas uz sekund\u0101ro un terci\u0101ro redzes apr\u016bpi – \u00a0operat\u012bvo \u0137irur\u0123iju, sare\u017e\u0123\u012btu hronisku slim\u012bbu vad\u012bbu un ak\u016bto acu situ\u0101ciju \u0101rst\u0113\u0161anu.<\/p>\n\n\n\n

Pa\u0161reiz\u0113jie MK noteikumi Nr. 555 paredz, ka oblig\u0101t\u0101s b\u0113rnu redzes profilaktisk\u0101s p\u0101rbaudes (1,3 un 6-7 gadu vecum\u0101) veic tikai oftalmologs. Tas rada papildu slodzi aptuveni 55 000\u201360 000 viz\u012b\u0161u apm\u0113r\u0101 gad\u0101.<\/p>\n\n\n\n

Optometrists k\u0101 funkcion\u0101lais speci\u0101lists ir pilnties\u012bgi kvalific\u0113ts veikt \u0161o diagnostiku un funkciju nov\u0113rt\u0113\u0161anu ar\u012b b\u0113rniem. PVO vadl\u012bnijas (IPEC modelis) skaidri nor\u0101da, ka \u0161\u0101das p\u0101rbaudes efekt\u012bvi var veikt apm\u0101c\u012bts person\u0101ls, izmantojot standartiz\u0113tus protokolus.<\/p>\n\n\n\n

SAVA nolikum\u0101 un eso\u0161aj\u0101 praks\u0113 bie\u017ei tiek uztur\u0113ta pras\u012bba p\u0113c oblig\u0101tas refrakcijas nov\u0113rt\u0113\u0161anas ciklopl\u0113\u0123ij\u0101 b\u0113rnu redzes profilaktisk\u0101s p\u0101rbaudes ietvaros, pat ja nav kl\u012bnisku indik\u0101ciju (piem\u0113ram, \u0161\u0137iel\u0113\u0161anas vai augstas pak\u0101pes refrakcijas k\u013c\u016bdu riska). Pasaules prakse r\u0101da, ka refrakcijas nov\u0113rt\u0113\u0161ana bez ciklopl\u0113\u0123ijas kop\u0101 ar detaliz\u0113tu redzes funkciju izv\u0113rt\u0113\u0161anu ir pietiekama savlaic\u012bgai redzes un acu vesel\u012bbas trauc\u0113jumu atkl\u0101\u0161anai, kas ir galvenais redzes profilaktisk\u0101s p\u0101rbaudes m\u0113r\u0137is. Oblig\u0101ta ciklopl\u0113\u0123ija katr\u0101 redzes profilaktisk\u0101s p\u0101rbaud\u0113 bez vajadz\u012bbas pagarina apskates laiku un prasa tie\u0161u oftalmologa iesaisti, t\u0101d\u0113j\u0101di pagarinot rindas un sad\u0101rdzinot min\u0113to pakalpojumu. Nepamatota ciklopl\u0113\u0123ijas pielieto\u0161ana papildus rada lieku diskomfortu b\u0113rnam un vec\u0101kiem. Optometrists, veicot prim\u0101ro redzes apr\u016bpi (tai skait\u0101 redzes profilaktisko p\u0101rbaudi), var identific\u0113t tos gad\u012bjumus, kuros ciklopl\u0113\u0123ija ir medic\u012bniski nepiecie\u0161ama, un tikai tad nos\u016bt\u012bt b\u0113rnu pie oftalmologa specializ\u0113tai redzes un acu vesel\u012bbas izmekl\u0113\u0161anai.<\/p>\n\n\n\n

Ar\u012b \u0161eit LOOA pied\u0101v\u0101 ieviest divu l\u012bme\u0146u sist\u0113mu, kur optometrists ir pirmais speci\u0101lists, kur\u0161 veic prim\u0101ro redzes apr\u016bpi (tai skait\u0101 redzes profilaktisko p\u0101rbaudi), redzes funkciju nov\u0113rt\u0113\u0161anu un refrakcijas noteik\u0161anu. Oftalmologs iesaist\u0101s tikai gad\u012bjumos, kad atkl\u0101ta patolo\u0123ija vai nepiecie\u0161ama specifiska \u0101rst\u0113\u0161ana, kur\u0101 ietilpst ar\u012b pamatota medic\u012bnisk\u0101 manipul\u0101cija ar ciklopl\u0113\u0123ijas pielieto\u0161anu.<\/p>\n\n\n\n

Nov\u0113rt\u0113jot no pieejamajiem datiem, optometrista pakalpojuma ievie\u0161ana MK noteikumos Nr. 555 dod ietaup\u012bjuma efektu 2,77 miljonu EUR apm\u0113r\u0101, sal\u012bdzinot ar patreiz\u0113jo SAVA nolikumu, kas balst\u012bts tikai uz oftalmologa pakalpojumu.<\/p>\n\n\n\n

Parametrs<\/td>Pa\u0161reiz\u0113jais modelis<\/td>Modelis ar optometristu<\/td>Starp\u012bba<\/td><\/tr>
Ambulator\u0101s epizodes<\/td>10 658 193 \u20ac<\/td>8 420 277 \u20ac<\/td>-2,23 milj. \u20ac<\/td><\/tr>
B\u0113rnu skr\u012bnings<\/td>1 792 200 \u20ac<\/td>1 254 600 \u20ac<\/td>-0,53 milj. \u20ac<\/td><\/tr>
Kop\u0113j\u0101s izmaksas<\/td>14 769 669 \u20ac<\/td>11 994 153 \u20ac<\/td>-2,77 milj. \u20ac<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Lai preciz\u0113tu iesp\u0113jamo valsts bud\u017eeta l\u012bdzek\u013cu ietaup\u012bjumu, NVD nepiecie\u0161ams izanaliz\u0113t inform\u0101ciju par 2023., 2024. un 2025. gad\u0101 apmaks\u0101taj\u0101m oftalmologu manipul\u0101cij\u0101m, to skaitu un samaks\u0101to naudas summu un izv\u0113rt\u0113t, kuras no min\u0113taj\u0101m manipul\u0101cij\u0101m var\u0113tu sniegt optometrists par zem\u0101ku samaksu atbilsto\u0161i optometrista kompetencei.<\/p>\n\n\n\n

L\u016bdzam Nacion\u0101lo vesel\u012bbas dienestu sniegt sekojo\u0161us skaidrojumus:<\/strong><\/p>\n\n\n\n

    \n
  1. L\u016bdzam skaidrot, k\u0101das Eiropas Savien\u012bbas, Pasaules Vesel\u012bbas organiz\u0101cijas vai citu starptautisku instit\u016bciju rekomend\u0101cijas, kl\u012bnisk\u0101s vadl\u012bnijas vai sal\u012bdzin\u0101mie mode\u013ci ir \u0146emti v\u0113r\u0101, izstr\u0101d\u0101jot sekund\u0101r\u0101s ambulator\u0101s vesel\u012bbas apr\u016bpes pakalpojumu atlases nolikumu oftalmolo\u0123ij\u0101, \u012bpa\u0161i attiec\u012bb\u0101 uz \u0101rstniec\u012bbas personu kompeten\u010du sadal\u012bjumu<\/strong>, un k\u0101d\u0113\u013c, \u0146emot v\u0113r\u0101 min\u0113t\u0101s vadl\u012bnijas, optometrista k\u0101 funkcion\u0101l\u0101 speci\u0101lista pakalpojums nav paredz\u0113ts k\u0101 patst\u0101v\u012bgs un valsts apmaks\u0101ts pakalpojums redzes apr\u016bpes sist\u0113m\u0101.<\/li>\n\n\n\n
  2. L\u016bdzam sniegt inform\u0101ciju, vai sekund\u0101r\u0101s ambulator\u0101s vesel\u012bbas apr\u016bpes pakalpojumu atlases nolikuma oftalmolo\u0123ij\u0101 izstr\u0101des proces\u0101 ir veikts izv\u0113rt\u0113jums par divu l\u012bme\u0146u redzes apr\u016bpes sist\u0113mas ievie\u0161anu, \u0146emot v\u0113r\u0101 starptautisk\u0101s vadl\u012bnijas un lab\u0101s prakses piem\u0113rus, paredzot optometristu k\u0101 prim\u0101r\u0101 l\u012bme\u0146a pakalpojumu sniedz\u0113ju ar valsts apmaks\u0101tu pakalpojumu<\/strong>, un oftalmologu k\u0101 sekund\u0101r\u0101 l\u012bme\u0146a pakalpojumu speci\u0101listu, k\u0101 ar\u012b nor\u0101d\u012bt tiesiskos, medic\u012bniskos un ekonomiskos apsv\u0113rumus, kuru d\u0113\u013c \u0161\u0101ds modelis nav ticis ietverts \u0161aj\u0101 nolikum\u0101.<\/li>\n\n\n\n
  3. L\u016bdzam skaidrot, k\u0101d\u0101 apjom\u0101, izstr\u0101d\u0101jot sekund\u0101r\u0101s ambulator\u0101s vesel\u012bbas apr\u016bpes pakalpojumu atlases nolikumu oftalmolo\u0123ij\u0101 un piem\u0113rojot sp\u0113k\u0101 eso\u0161o regul\u0113jumu, ir \u0146emtas v\u0113r\u0101 starptautisk\u0101s kl\u012bnisk\u0101s vadl\u012bnijas un rekomend\u0101cijas b\u0113rnu redzes profilaktisko p\u0101rbau\u017eu jom\u0101, un k\u0101d\u0113\u013c optometrista k\u0101 funkcion\u0101l\u0101 speci\u0101lista<\/strong> veikt\u0101s b\u0113rnu redzes profilaktisk\u0101s p\u0101rbaudes nav paredz\u0113tas k\u0101 valsts apmaks\u0101ts pakalpojums<\/strong>, to starp prim\u0101r\u0101s redzes apr\u016bpes ietvaros.<\/li>\n\n\n\n
  4. Atk\u0101rtoti l\u016bdzam Nacion\u0101lo vesel\u012bbas dienestu rosin\u0101t iek\u013caut optometrista pakalpojumu valsts apmaks\u0101to pakalpojumu groz\u0101, veicot MK noteikuma Nr. 555 punktu un to saist\u012bto pielikumu groz\u012bjumus saska\u0146\u0101 ar pielikum\u0101 Nr. 1 formul\u0113to pied\u0101v\u0101jumu.<\/li>\n<\/ol>\n\n\n\n

    \u0145emot v\u0113r\u0101 iepriek\u0161 izkl\u0101st\u012bto, l\u016bdzam Nacion\u0101lo vesel\u012bbas dienestu sniegt motiv\u0113tu atbildi p\u0113c b\u016bt\u012bbas uz nor\u0101d\u012btajiem jaut\u0101jumiem un l\u016bgumiem, k\u0101 ar\u012b inform\u0113t par turpm\u0101kaj\u0101m pl\u0101notaj\u0101m darb\u012bb\u0101m normat\u012bv\u0101 regul\u0113juma p\u0101rskat\u012b\u0161anas uzs\u0101k\u0161anai<\/strong>. Vienlaikus v\u0113r\u0161am uzman\u012bbu uz nepiecie\u0161am\u012bbu nodro\u0161in\u0101t nozares profesion\u0101l\u0101s organiz\u0101cijas – Latvijas Optometristu un opti\u0137u asoci\u0101cijas savlaic\u012bgu un pilnv\u0113rt\u012bgu iesaisti visos ar redzes apr\u016bpes pakalpojumu regul\u0113jumu saist\u012btajos l\u0113mumu pie\u0146em\u0161anas procesos, iev\u0113rojot labas p\u0101rvald\u012bbas, sam\u0113r\u012bguma un tiesisk\u0101s pa\u013c\u0101v\u012bbas principus.<\/p>\n\n\n\n

    Latvijas Optometristu un opti\u0137u asoci\u0101cijas v\u0101rd\u0101<\/p>\n\n\n\n

    Valdes priek\u0161s\u0113d\u0113t\u0101ja Krist\u012bne Detkova<\/p>\n\n\n\n

    <\/p>\n\n\n\n

    Pielikums Nr. 1<\/h2>\n\n\n\n

    Sal\u012bdzino\u0161\u0101 tabula
    MK noteikumi Nr. 555<\/h4>\n\n\n\n
    Normas vien\u012bba<\/td>Sp\u0113k\u0101 eso\u0161\u0101 redakcija<\/td>Pied\u0101v\u0101t\u0101 redakcija<\/td><\/tr>
    56.2.8. apak\u0161punkts<\/td>pie oftalmologa (redzes p\u0101rbaudei);<\/td>pie oftalmologa vai optometrista (redzes funkciju nov\u0113rt\u0113\u0161anai, refrakcijas noteik\u0161anai un redzes korekcijai);<\/td><\/tr>
    Jauns punkts (56.6.)<\/td>Nav regul\u0113juma par optometrista kompetenci valsts apmaks\u0101tajos pakalpojumos.<\/td>Redzes apr\u016bpes pakalpojumus valsts apmaks\u0101t\u0101s vesel\u012bbas apr\u016bpes ietvaros sniedz oftalmologs vai optometrists atbilsto\u0161i katra speci\u0101lista profesion\u0101lajai kompetencei.<\/td><\/tr>
    4.3.4.\u00b9 punkts<\/td>Optometrista pakalpojums nav paredz\u0113ts.<\/td>Optometrists k\u0101 funkcion\u0101lais speci\u0101lists sniedz valsts apmaks\u0101tus prim\u0101r\u0101s redzes apr\u016bpes pakalpojumus, tostarp redzes korekcijas l\u012bdzek\u013cu recep\u0161u izrakst\u012b\u0161anu un b\u0113rnu redzes profilaktisko p\u0101rbaudi.<\/td><\/tr>
    1. pielikuma 2. piez\u012bme<\/td>B\u0113rnu redzes p\u0101rbaudes veic oftalmologs.<\/td>B\u0113rnu redzes p\u0101rbaudes veic oftalmologs vai optometrists atbilsto\u0161i katra speci\u0101lista profesion\u0101lajai kompetencei.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    MK noteikumu Nr. 555 pielikumu groz\u012bjumi (BIJA \/ IR)<\/h4>\n\n\n\n

    1. Pielikums \u2013 Profilaktisk\u0101s apskates (b\u0113rni)<\/h4>\n\n\n\n
    Normas vien\u012bba<\/td>Sp\u0113k\u0101 eso\u0161\u0101 redakcija<\/td>Pied\u0101v\u0101t\u0101 redakcija<\/td><\/tr>
    1. pielikuma 2. piez\u012bme<\/td>Min\u0113t\u0101s redzes p\u0101rbaudes veic oftalmologs.<\/td>Min\u0113t\u0101s redzes p\u0101rbaudes veic oftalmologs vai optometrists. Ja redzes profilaktisk\u0101s p\u0101rbaudes laik\u0101 tiek konstat\u0113tas patolo\u0123iskas novirzes vai nepiecie\u0161ami papildu izmekl\u0113jumi, optometrists pacientu nos\u016bta pie oftalmologa.<\/td><\/tr>
    Jauna piez\u012bme<\/td>Nav noteikta.<\/td>Prim\u0101ro b\u0113rnu redzes profilaktisko p\u0101rbaudi veic optometrists vai oftalmologs. Ciklopl\u0113\u0123ija tiek veikta tikai gad\u012bjumos, ja profilaktisk\u0101s p\u0101rbaudes laik\u0101 konstat\u0113tas medic\u012bniskas indik\u0101cijas.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    4. Pielikums \u2013 Apr\u016bpes epizodes un to tarifi<\/h4>\n\n\n\n
    Normas vien\u012bba<\/td>Sp\u0113k\u0101 eso\u0161\u0101 redakcija<\/td>Pied\u0101v\u0101t\u0101 redakcija<\/td><\/tr>
    Optometrista apr\u016bpes epizode<\/td>Optometrista apr\u016bpes epizode nav paredz\u0113ta.<\/td>5.xx. Optometrista apr\u016bpes epizode \u2013 redzes funkciju nov\u0113rt\u0113\u0161ana, refrakcijas noteik\u0161ana, redzes korekcijas l\u012bdzek\u013cu receptes izrakst\u012b\u0161ana, profilaktisk\u0101 redzes p\u0101rbaude pieaugu\u0161iem un b\u0113rniem. Tarifs \u2013 30,00 EUR.<\/td><\/tr>
    B\u0113rnu redzes profilaktisk\u0101 p\u0101rbaude (optometrists)<\/td>Nav paredz\u0113ts k\u0101 atsevi\u0161\u0137a apr\u016bpes epizode.<\/td>5.xy. B\u0113rnu redzes profilaktisk\u0101 p\u0101rbaude (optometrists) \u2013 vecumam atbilsto\u0161s prim\u0101r\u0101 redzes profilaktisk\u0101 p\u0101rbaude (bez oblig\u0101tas ciklopl\u0113\u0123ijas), acu patolo\u0123iju prim\u0101r\u0101 atlase un, nepiecie\u0161am\u012bbas gad\u012bjum\u0101, nos\u016bt\u012b\u0161ana pie oftalmologa. Tarifs \u2013 17,00 EUR.<\/td><\/tr>
    Piez\u012bme par kompetenci<\/td>Nav noteikta.<\/td>Optometrista apr\u016bpes epizode un b\u0113rnu redzes profilaktisk\u0101 p\u0101rbaude neietver acu slim\u012bbu diagnostiku, \u0101rst\u0113\u0161anu vai \u0137irur\u0123isku iejauk\u0161anos, kas ir oftalmologa kompetenc\u0113.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    3. Pielikums \u2013 Pakalpojumu sniedz\u0113ji<\/h4>\n\n\n\n
    Normas vien\u012bba<\/td>Sp\u0113k\u0101 eso\u0161\u0101 redakcija<\/td>Pied\u0101v\u0101t\u0101 redakcija<\/td><\/tr>
    Pakalpojuma sniedz\u0113js<\/td>Optometrists nav skaidri noteikts k\u0101 patst\u0101v\u012bgs valsts apmaks\u0101ta pakalpojuma sniedz\u0113js.<\/td>Valsts apmaks\u0101tus prim\u0101r\u0101s redzes apr\u016bpes pakalpojumus ir ties\u012bgs sniegt ar\u012b sertific\u0113ts optometrists k\u0101 funkcion\u0101lais speci\u0101lists, kas re\u0123istr\u0113ts \u0100rstniec\u012bbas personu re\u0123istr\u0101.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    P\u0101rejas noteikumi<\/h4>\n\n\n\n
    Normas vien\u012bba<\/td>Sp\u0113k\u0101 eso\u0161\u0101 redakcija<\/td>Pied\u0101v\u0101t\u0101 redakcija<\/td><\/tr>
    Ievie\u0161anas k\u0101rt\u012bba<\/td>Nav noteikta.<\/td>Nacion\u0101lais vesel\u012bbas dienests l\u012bdz 2026. gada 1. j\u016blijam nodro\u0161ina optometrista pakalpojuma ievie\u0161anai nepiecie\u0161amo l\u012bgumu sl\u0113g\u0161anas, uzskaites un samaksas k\u0101rt\u012bbu.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

    Nacion\u0101lais vesel\u012bbas dienests 2025. gada nogal\u0113 sabiedrisk\u0101 apsprie\u0161an\u0101 izsludin\u0101ja nolikuma projektu par oftalmolo\u0123ijas pakalpojuma sniedz\u0113ju atlases nolikumu. Nolikuma izstr\u0101d\u0113 LOOA netika uzaicin\u0101ta iesaist\u012bties. P\u0113c iepaz\u012b\u0161an\u0101s ar sagatavoto nolikuma projektu LOOA …<\/p>\n","protected":false},"author":4,"featured_media":2268,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3170","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/posts\/3170","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/optometrija.lv\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3170"}],"version-history":[{"count":2,"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/posts\/3170\/revisions"}],"predecessor-version":[{"id":3174,"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/posts\/3170\/revisions\/3174"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/optometrija.lv\/index.php?rest_route=\/wp\/v2\/media\/2268"}],"wp:attachment":[{"href":"https:\/\/optometrija.lv\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3170"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/optometrija.lv\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3170"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/optometrija.lv\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3170"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}