Idaho’s ophthalmologists are asking lawmakers to vote no on HB 317, a bill that would expand the scope of practice of optometrists allowing them to perform eye surgery with lasers and scalpels. 

Optometrists are providers of basic eye care services such as vision exams and contact lens fittings, but they are not medical doctors or trained surgeons.  Ophthalmologists, medical doctors and surgeons with a minimum of eight years of post-college medical and surgical training, are concerned that this legislation increases patient safety risks and lowers the standard of quality surgical care.

“There are no shortcuts for learning how to safely perform eye surgery and there is no such thing as minor or simple eye surgery,” said Dr. Brent Betts, Intermountain Eye Centers in Boise. “If the procedure requires human tissue to be cut with a scalpel, laser, or other modality, it is invasive and should be taken seriously. Lasers are surgical instruments which cut as deeply and sharply as any scalpel.  An error of even one millimeter can lead to bleeding, infection, and permanent blindness.”

Proponents of the legislation falsely claim that the bill increases access to eye care, a misleading characterization.  Enactment of HB 317 would decrease patient safety by allowing those without sufficient training and education to perform surgery on your eyes.  For any type of surgery, convenience should never trump safety or quality care. 

In fact, 95-percent of residents live in areas where they would have a comparable or shorter drive-time to an ophthalmologist than to the closest Walmart.  Idahoans are willing to drive to ensure their surgery is performed safely and effectively by a qualified surgeon.  There is no shortage of medical ophthalmologists – eye physicians and surgeons - to meet the surgical needs of Idaho patients. Surely a drive to an ophthalmologist with the appropriate surgical training is not an inconvenience when it comes to protecting your eyes. 

“Would you want your heart surgeon or the orthopedic surgeon performing your hip replacement to have skipped medical school and surgical residency?  Of course not.  That is the same reason that you do not want an optometrist to perform surgery on your eyes.  Yet, some optometrists believe they can learn to perform eye surgery by just completing a 32-hour weekend course.  

Optometrists have an important and valuable role to play in health care and the eye care team, but they are not medical doctors and surgeons,” said Dr. James Earl, Retina Specialists of Idaho. “This bill poses an incredible risk to Idahoans and ignores the importance of medical education and training to perform surgery.”

Additional differences between Ophthalmologists and Optometrists include:

Ophthalmologists                                                                       

  • Medical doctors
  • Trained to perform surgery on living people
  • 4-years medical school (8-year post-undergraduate), 1-year hospital internship, mandatory 3-year surgical residency in ophthalmology
  • 17,000 hours of clinical training before they are allowed to treat patients on their own
  • Education and standards heavily regulated across the nation by the Accreditation Council for Graduate Medical Education
  • Mostly see unhealthy or diseased eyes

Optometrists

  • Not medical doctors
  • Never required to practice surgery on living people
  • 4-year optometry school program focusing on basic eye care services such as eye exams and contact lens fitting
  • 2,500 hours of clinical training, about 20% complete a one-year residency, which does not include performing surgery on people
  • Curriculums, training, and requirements vary among schools
  • Mostly see healthy eyes

“If an optometrist wants to perform surgery, they have the right to go back to medical school to receive the required medical education and surgical training to perform eye surgery.  The ocular system is far too complex and fragile to allow surgery based on a piece of legislation,” said Dr. Betts.