Proposed legislation pits optometrists against ophthalmologists in Arkansas

An ophthalmologist looks through a microscope preparing to make an incision on a patient's eye, surgery that optometrists in Arkansas are hoping a proposed bill will allow them to do as well. (Photo: KATV)

Several lawmakers have signed onto proposed legislation seeking to expand the scope of practice for optometrists in Arkansas, allowing them to perform certain surgeries that are currently only performed by ophthalmologists.

The most major difference between ophthalmologists and optometrists has to do with their formal education and training.

Optometrists have completed four years of optometry school, receiving a doctorate in optometry and have the ability to examine eyes for vision and health problems, as well as diagnose and treat certain eye diseases. Ophthalmologists, on the other hand, are medical doctors that have completed four years of medical school, in addition to a year-long internship and three years of residency.

"Things like glaucoma, eye infections, macular degeneration," said Dr. Belinda Starkey, O.D., a licensed optometrist that lives and practices in Rogers.

But Starkey said according to the Arkansas Optometry Practice Act, eye issues that require surgery must be taken care of by licensed ophthalmologists. However recently filed HB1251 attempts to change that by changing the definition of the "practice of optometry" and expands "the types of ophthalmic surgery that may be performed by optometrists."

Optometry students are being trained to do certain surgeries, like a laser procedure that helps remove a membrane that can form after cataract surgery the Arkansas Optometric Association was demonstrating at the Arkansas Capitol on Wednesday.

Right now there are four states have expanded the scope of practice to allow optometrists to perform laser and other surgical procedures legally - Oklahoma, Louisiana, Alaska and Kentucky.

"I'm in fact licensed in Oklahoma and have experience in these procedures," said Starkey. "You're looking at someone who's already done these procedures as well, and has been successful."

"The training in no way compares," said State Representative Dr. Stephen Magie, MD, Democrat from Conway.

Magie, a licensed ophthalmologist, said he and countless other ophthalmologists in Arkansas are concerned about the proposed optometry legislation because of patient safety.

While HB1251 lists several procedures optometrists will continue to be prohibited from performing in Arkansas, including any surgery that requires an incision of the iris, vitreous humor, retina and thick incision of the cornea, the bill appears to give carte blanche to optometrists to perform any surgeries that aren't listed.

"They're asking to do some things that only really only a trained surgeon can do," said Rep. Magie.

"You don't become a trained surgeon unless you've been to medical school for four years, an internship for a year and three years of residency where you participate in numerous, numerous - hundreds of procedures."

In some of the states that have allowed optometrists to perform surgery, accreditation is required, but training to obtain those credentials may be as short as a 32-hour weekend class, according to Magie. Compared to the four states that have changed the scope of practice for optometrists since Oklahoma first did in 1998, six states have rejected similar legislation within the last year.

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