Last Modified: Sunday, April 21, 2013 7:51 PM
A battle royal is shaping up in the state Legislature that’s “worth keeping an eye on.”
House Bill 527, authored by state Rep. Frank Hoffman, R-West Monroe, would allow optometrists to perform certain eye procedures and write prescriptions for drugs that heretofore were reserved only for ophthalmologists.
What’s the difference between the two?
An ophthalmologist is an M.D. — a doctor of medicine. They are trained through four years of medical school, a year of internship and three years of hospital-based residency. By their education, as affirmed by current state law, they are entrusted to perform delicate surgeries and other procedures and to exercise medical judgment in prescribing drugs that include narcotics.
An optometrist is an O.D. — a doctor of optometry. They are trained through a four-year college of optometry. They diagnose eye diseases and visual conditions and provide such services as examinations, eyeglass prescriptions and contact lens fittings.
The Hoffman bill would allow optometrists to wield scalpels, lasers and other instruments to perform a number of surgical eyelid procedures such as photorefractive keratectomy, better known as LASEK, and treat such conditions as lesions, cysts and glaucoma. They would have expanded authority to prescribe certain drugs and give needle injections into the eye and use local or regional anesthetics in performing surgery — and, if desired, bring in an anesthesiologist for certain procedures, It would also give the State Optometry Board newfound authority to define an optometrist’s scope of practice, including surgery.
Hoffman says there is a need to expand services to optometrists in many rural areas of the state where there are no practicing ophthalmologists.
Optometrists in Oklahoma and Kentucky can perform some surgeries. Other states are considering legislation that would give optometrists the ability to perform procedures that have been the domain of opthalmologists.
Ophthalmologists counter that their rigor and length of training prepare them better for surgical procedures and to properly dispense drugs that include narcotics.
In opposing the bill, the American Academy of Ophthalmology has said, “Surgery involves more than performing procedures; it includes deciding who does and does not need to have a procedure done, involves patient education and requires the ability to identify and manage complications.”
The academy says the bill substitutes an optometry school program ... ‘‘for current physician-training standards requiring thousands of hours of medical education, clinical and surgical experience and other training.”
Ophthalmologists also believe their oversight board, the Louisiana State Board of Medical Examiners, is better equipped to handle issues than the State Optometry Board.
The House Committee for Health and Welfare approved the bill 12-7 last week. It is scheduled for debate on the House floor Tuesday.
While both optometrists and ophthalmologists have already button-holed their state legislators and employed lobbyists to make their points, it’s likely consumers have yet to weigh in. They now have a little more than 24 hours to contact their state representatives to let their feelings be known.
Eyesight, arguably, is the greatest sense for humans. Very few of us go through life without having to have some sort of correction for this precious gift.
We believe the best fate for HB 527 is for it to be tabled and the issue be given greater study by a reputable, neutral party before such a dramatic sea-change in who performs certain eye procedures in Louisiana takes place.
This editorial was written by a member of the American Press Editorial Board. Its content reflects the collaborative opinion of the Board, whose members include Bobby Dower, Jim Beam, Crystal Stevenson and Donna Price.
Posted By: Glynn K. Maxwell On: 4/25/2013
Be like letting the man who has done nothing but change the oil in my car overhaul my transmission.
Posted By: Thomas On: 4/24/2013
Title: Opthalmology vs Optometry
This is a very scary bill that should never have been allowed on the legislative floor. If there is a question of need for optometrists to prescribe medications and perform surgeries (which this bill seems to be about), everyone would be better served allowing some medical board such as the AMA to decide, not politicians.
Posted By: Douglas Walsworth On: 4/23/2013
We already allow nurses to prescribe drugs and with the coming doctor shortage caused by Obamacare, it won't be long before the Ladies Auxiliary will be doing surgery.