Some University students will have their eyes on the prize today as a bill goes to the House floor for debate regarding whether optometrists will be allowed to perform certain surgeries without going to medical school.

If passed, the bill known as House Bill 527 would allow optometrists to perform certain surgical eye procedures on patients that currently only ophthalmologists are allowed to do. The bill would allow optometrists to bypass years of extra schooling.

“There is a great deal of medical background that optometrists are never exposed to,” said Brad Black, a Baton Rouge pediatric ophthalmologist who has been practicing for 31 years.

Ophthalmologists, who are medical doctors, must obtain an undergraduate degree, attend four years of medical school, complete at least two years of residency and then undergo between four and five more years of ophthalmologic training.

Optometrists are certified doctors of optometry, trained through a four-year college of optometry to obtain their degree.

Jaime Wang, biology sophomore and secretary of the LSU Pre-Optometry Association, said she respects ophthalmologists’ dedication to their profession and believes that if the bill passes, it should require students of optometry go through more schooling to learn the proper procedures.

James Sandefur, executive director of the Optometry Association of Louisiana, said further training is specified in the bill and nothing would be “grandfathered in.”

“For the three laser procedures included in the bill, optometrists wishing to perform those procedures would be certified by one of the colleges of optometry that do provide training for the procedures,” Sandefur said.

Leanne Gilder, biology junior and president of the Pre-Optometry Association, said she sent an email to the organization upon hearing about the bill and encouraged members to voice their support.

“We are being educated in a medical field, just not to the extent of medical school.” Gilder said. “If I wasn’t trained, I wouldn’t want to perform a surgery.”

However, Black said the structure to train optometrists to perform the surgeries specified in the bill — like using certain laser technologies, removing lesions around the eye or performing certain injections — is not in place at the optometry schools where students from Louisiana typically attend.

Black said the real problem with allowing optometrists to perform surgery is that they lack the experience needed to take care of a patient.

“The real expertise is making the right decisions before and responding if there are more complications,” Black said. “The surgery is probably the easiest part of the process.”

Gilder said the bill could be good for patients who visit optometrists and end up needing superficial injections of the eye or similar minor procedures, like the use of laser technologies.

“Flu shots are given at Wal-Mart, so why can’t trained optometrists have the same right?” Gilder said.

However, Black said although the bill specifically excludes some procedures, reserving them for ophthalmologists, it trivializes certain types of surgery.

Pam Williams, a pediatric ophthalmologist working in Baton Rouge said the bill prevents optometrists from performing 18 of more than 300 ophthalmic procedures, therefore giving the Louisiana State Board of Optometry Examiners the “full reign to include surgery that is not excluded.”

“This bill is confusing to the public and shows a lack of understanding on the part of optometrists about taking care of a patient,” Black said. “Before anything else, we need to be advocates for the people we are taking care of.”

John Green, a student at LSU School of Medicine in New Orleans, is about to graduate and begin his four-year residency specializing in ophthalmology in Mississippi, where a similar bill was voted down.

“My stance is that I’m going to Mississippi to train in ophthalmology, and I might have decided to move back to Louisiana, but if the bill is passed here I won’t be moving back,” Green said.

The bill makes a poor environment for ophthalmologists, he said.

“This bill is discouraging to anyone thinking about going into ophthalmology because their specialty is being watered down,” Green said.

Williams said this is an unintended consequence of the bill, because blurring the definition of physicians will not only hurt ophthalmologists but also make Louisiana a hostile environment for physicians looking to practice.

“This bill is confusing to the public and shows a lack of understanding on the part of optometrists about taking care of a patient. Before anything else, we need to be advocates for the people we are taking care of.”
From the Louisiana State Medical Society: Southern Media & Opinion Research, a Baton Rouge based survey research firm, interviewed 500 frequent voters April 12 and 13, 2013. The poll was commissioned by the Louisiana State Medical Society in response to House Bill 527 which would amend current state law relative to eye health care.
83% of the voters interviewed oppose allowing optometrists to call themselves “physicians”.
89% oppose allowing persons who are not licensed by the Louisiana State Medical Board to perform eye surgery.
87% do not want the state legislature to weaken the authority of the Louisiana State Medical Board.
According to the poll, voters are quite familiar with eye healthcare. Eyeglass or contact lenses are used by someone in 84% of the families represented by the voters who were interviewed. Of the voters interviewed:
• 89% say that the eye care they need is available to them;
• 82% have gone to an optometrist;
• 57% have gone to an ophthalmologist; and
• 68% maintain there is a distinction between optometrists and ophthalmologists.