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Scope-of-practice battles reignite in US

Ophthalmologists in Florida are vehemently opposing “dangerous legislation” that would allow optometrists to perform certain types of eye surgery and prescribe medications.

According to reports, current Florida law states optometrists are licensed to prescribe corrective lenses and have limited prescription powers, which mostly involve topical medications.

Dr Sarah Wellik.

Under the proposed legislation – a pair of bills filed in the Florida Senate earlier this year – the state Board of Optometry would determine parameters for optometrists to become licensed to conduct surgeries.

If passed, optometrists would be allowed to perform eyelid and tear duct surgery, as well as a host of procedures that require incisions. The bills also propose allowing optometrists to prescribe more medication, including opioids.

According to Florida Politics, proponents have argued that expanding optometrists’ scope-of-practice would give people better access to eyecare. But ophthalmologists argue optometrists do not have the education and training to perform surgery or prescribe certain controlled substances.

The Florida Society of Ophthalmology released a statement in opposition to the bills, claiming it would “drastically expand the scope of optometric practice in Florida and threaten patient safety” if certified.

Dr Sarah Wellik, president of the association, described the legislation as dangerous and harmful.

“This legislation is a misguided attempt that would grant broad and unprecedented surgical privileges to optometrists, who have not completed medical school and are not medical doctors. Ophthalmologists, on the other hand, are medical doctors who spend over a decade receiving extensive clinical education and surgical training,” Wellik said.

“The idea that an optometrist could become licensed to perform surgery through legislation, instead of completing medical school and residency training, is a dangerous threat to patient safety. With Florida being the epicentre of the opioid epidemic, it would be catastrophic for the Legislature to expand optometry’s prescribing authority to over 4,000 non-medical professionals,” she said.

The two eyecare professions have battled over scope-of-practice for many years.

In 2013, optometrists successfully lobbied for legislation that allowed them to prescribe a limited number of oral medications. It also stipulated optometrists must complete 20 hours of added training, pass an examination, and carry medical malpractice coverage at the same level as medical doctors.

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