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Optometrist Dr. Belinda R. Starkey (seated at the center) speaks to legislators in favor of House Bill 1251, which would allow optometrists to perform certain types of surgery. Bill sponsor state Rep. Jon S. Eubanks, R-Paris, (seated from left) and supporter Dr. David Cockrell listen to her.

US state passes law to broaden optometry scope of practice

Arkansas is the latest US state to pass a controversial law that expands the optometry scope of practice, allowing primary eyecare professionals to perform several surgical procedures, including the use of ophthalmic lasers.

The state’s governor Ms Asa Hutchison recently signed the contentious HB1251 bill into law, granting the state’s doctors of optometry permission to perform selective laser trabeculoplasty and Nd:YAG laser procedures, injections (excluding intravenous and intraocular), removal of lid lesions and chalazion incisions and curettage.

The decision sees Arkansas become the fourth US state – after Oklahoma, Kentucky and Louisiana – to lift restrictions on optometrists to conduct laser procedures, while Alaskan legislators are currently working to develop regulations for laser use.

Dr Belinda Starkey, who is president of the Arkansas Optometric Association, said the bill’s “bipartisan support is a testament to the importance primary eye doctors deliver”.

“The most exciting aspect of the progress made is that families across the state are just one step away from having much greater access to comprehensive eye health and vision care, with doctors of optometry being authorised to practice near the fullest extent of our training,” she said, according to the Review of Optometry website.

Expansion of the optometry scope of practice is a highly politicised and controversial issue, particularly in the in the US where policymakers are increasingly relaxing laws that American ophthalmologists believe compromises patient safety. Frequently cited problems include inadequate training for surgical procedures, and issues with laser trabeculoplasty procedures.

The trend comes in the wake of advice from a joint report issued by the federal departments of Health and Human Services, Labor and Treasury, which advocated for reduced regulations for health providers without a medical degree, including optometrists.

As such, the decision has reportedly been met with disapproval from the Arkansas Medical Society, which encouraged its members to lobby against what it called the “optometrists eye surgery bill”.

In response, Starkey wrote an article for a local newspaper rebutting the medical society’s claims, and stated opponents incorrectly claim optometrists don’t have the background to perform “these basic procedures”.

“That’s simply not the case. Optometry students receive intensive hands-on clinical training during their four years of optometry school. We must pass a rigorous national board examination (written and hands-on) before receiving a license to practice in Arkansas,” she said.

The HB1251 bill was initially voted down, however, following amendments, lawmakers approved it.

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