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Naples Daily News: Commentary: Eye surgery should be by trained doctors

Wednesday, April 19, 2017

By Stacey Kruger, Vice president of Outreach, Florida Society of Ophthalmology

As a medical doctor and board-certified ophthalmologist, I was surprised to read the recent op-ed written by April Jasper, O.D., published in the Naples Daily News.

Jasper is president of the Florida Optometric Association (FOA), a group pushing legislation in the Florida Legislature (House Bill 1037) that would allow optometrists — who are not medical doctors and have never completed medical school or any type of surgical residency — to perform surgery on the human eye using scalpels and lasers.

To sell this legislation to the public, the FOA president makes three outrageous claims that have no basis in fact.

First, Jasper claims optometrists only want to cut on the eye using scalpels and lasers to do “minor procedures.” It is absurd to consider any type of eye surgery “minor.” Unlike other parts of the human tissue, the tissue of the human eye does not regenerate. One miscalculation with a scalpel or laser can irreparably damage one’s eyesight and even lead to blindness. Optometrists have no business cutting on the human eye.

Second, Jasper claims that optometrists should perform eye surgery so patients have better access to eye health care. Studies show that no patient in Florida is more than a 25-minute drive from an ophthalmologist — a medical eye surgeon fully trained to treat all aspects of a patient’s eye health. State of Florida data shows some 1,161 ophthalmologists who are active Medicaid providers.

 In West Palm Beach, where Jasper resides, there are 88 active ophthalmologists who accept and treat Medicaid patients. It is disingenuous for her to suggest that Floridians don’t have adequate access to eye health care.

Third, Jasper claims that optometrists should be able to perform surgery because physician assistants (PAs) perform ocular surgery. That’s simply not true. PAs do not independently perform surgery in Florida. PAs assist surgeons in certain surgeries but only do so under the close supervision of the surgeon.

The chair emeritus of the physician assistant training program at the University of Florida has formally stated that it would be “inappropriate” for PAs to even assist an ophthalmologist in performing ocular surgery.

Jasper also fails to tell the readers that HB 1037 would do much more than allow nonmedical doctors to cut the eye. The bill would permit optometrists to prescribe virtually all oral medications, including some of the most addictive narcotics like hydrocodone (Vicodin) and oxycodone (OxyContin).

Florida is the epicenter of America’s opioid addiction epidemic. In the past 12 months, the opioid epidemic has killed more than 600 Palm Beach County residents, prompting that county to ask Gov. Rick Scott to declare a public health emergency.

The epidemic is costing Florida’s health care system billions of dollars. The Palm Beach Post reports that the opioid epidemic cost Florida hospitals more than $1.1 billion for the first nine months of 2015. To combat this public health crisis, the last thing the state should do is issue new prescribing pads to 4,000 nonmedical professionals, but that’s precisely what Jasper and her group are advocating.

The public should see through this ruse. I fully understand that the optometrists have funneled millions of dollars into the legislative process, but I am hopeful that our elected officials will not be blinded by that amount of money.

I urge them to protect the safety of patients by rejecting the legislation that Jasper and her special-interest group are so aggressively pursuing.

Kruger, of Miami, is vice president of outreach for the Florida Society of Ophthalmology.

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