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Optometrists aren’t surgeons. Florida lawmakers should not let them perform eye surgery | Opinion

Thursday, April 01, 2021

All physicians take the oath to protect patients, so it’s disheartening that some Florida lawmakers support legislation that would put patients in harm’s way. The Legislature is considering Senate Bill 876 and House Bill 631, which would allow optometrists — who are not medical doctors or trained surgeons — to perform surgery on, inside and around the eye with lasers and scalpels.

Ophthalmologists are medical doctors and surgeons with more than 17,000 hours of training, specifically for eye surgery. They complete four years of medical school, followed by a one-year hospital internship, a three-year surgical residency. Most go on to complete an additional one to two years of fellowship training and almost a decade or more of post-undergraduate training to become an eye surgeon.

Optometrists, on the other hand, complete about 2,000 hours of training throughout four years of optometry school. Any surgical training consists of a 32-hour crash course that can be completed over a weekend.

Regardless of what optometrists might say, there is no such thing as “minor” eye surgery. Every eye surgery carries risk and should be approached with the utmost care and caution by experienced surgeons who have years of extensive education. Surgery should never be trivialized as a “minor procedure.”

Just ask a patient of mine who reported recurring spots in his vision to his optometrist. The optometrist told him those spots would go away on their own. But his ophthalmologist found tears in his retina. Because they were misdiagnosed, it left him with permanent vision issues in his right eye.

This patient’s case is not unique. It stems directly from a lack of education and training. According to a report published in the Journal of the American Medical Association, there is a significantly increased incidence of required follow-up surgery when certain types of glaucoma laser surgery are performed by an optometrist compared to when performed by an ophthalmologist.

Make no mistake, optometrists are valued members of the eye-care team and offer important services such as vision exams and contact-lens fittings. But they are not medical doctors or trained surgeons. And to grant them surgical privileges through legislation is irresponsible and dangerous. No surgery is ever safe to be performed by someone without the nearly decade-long clinical training and medical education that is crucial to keep patients safe.

The Florida Legislature has a chance to protect patients and their safety. But they first must listen to patients, physicians and the science behind the safety requirements that are in place, despite the misinformation and clever attempts at bill-drafting that would grant surgical privileges to those who are not sufficiently trained.

Training, education and clinical experience protect those we serve, and Florida law is carefully designed to do so. It doesn’t need to be changed to create two separate standards of surgical safety. The Florida Legislature must stand firm against SB 876 and HB 631.

Sarah Wellik, M.D. is president of the Florida Society of Ophthalmology; and professor of clinical ophthalmology and director of Glaucoma Service at UHealth Plantation, Bascom Palmer Eye Institute and University of Miami School of Medicine.

Read in the Miami Herald.

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