Ophthalmologists criticize lack of specificity in proposed eye-surgery regulations

Critics cite Risks, lack of training specifics

bmusgrave@herald-leader.comJuly 20, 2011 

FRANKFORT — Ophthalmologists say proposed regulations that would allow optometrists to perform some surgeries do not go far enough to protect patients.

The new regulations, which would allow optometrists to do some minor surgeries, are being considered Thursday at the Kentucky Board of Optometric Examiners.

Ophthalmologists, who attend medical school and have years of advanced training, say the proposed regulations do not spell out how many hours of training optometrists must have or how many procedures they must perform before being certified.

"The document fails to protect the residents of Kentucky because it's vague, non-specific and puts patients at risk because of these shortcomings," said Dr. Woodford Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons and a member of the University of Kentucky medical faculty.

Dr. Michael Karpf, executive vice president of University of Kentucky health affairs, said Tuesday that if the regulations are not changed, no optometrist would be allowed to perform any of the expanded surgical duties at the UK.

"There is no chance we would grant privileges to optometrists to either use a laser or use a scalpel," Karpf said. "That would not happen with our institution."

Optometrists counter that the new regulations are more stringent and detailed than most regulations for new medical procedures.

"Most of the health care boards do not require any credentialing when there is a new procedure," said Dr. Joe Ellis, a Benton optometrist and past president of the American Optometric Association.

Ophthalmologists opposed passage of Senate Bill 110, which allowed optometrists to expand therapeutic duties to include some laser surgeries, the limited use of injections and the use of scalpels for some procedures involving the eyes.

The new law does not allow optometrists to perform Lasik corrective surgery or any other procedure requiring general anesthesia.

After the bill flew through the legislature in 12 days, Gov. Steve Beshear signed it in February, despite strong opposition from many in the medical community.

After the law was signed, it was sent to the Kentucky Board of Optometric Examiners, which drafted the regulations. The board will hear public comments at its meeting Thursday.

Optometrists, who do not attend medical school but receive four years of training post-college, argued that the bill would improve access to high-quality eye care in Kentucky. The majority of Kentuckians do not live near an ophthalmologist.

Oklahoma passed a similar bill in 1998, and there have been no problems, optometrists say.

But Van Meter and the ophthalmologists say that 26 other states have considered similar bills and have opted not to pass them. Passing the bill in haste has given Kentucky a black eye, eye surgeons say.

"The public wants surgery to be performed by surgeons," Van Meter said.

Dr. Ken Weaver, a Lexington ophthalmologist, said the proposed regulations require that optometrists receive training from an optometry school or medical school, and that training must include a host of procedures.

"It doesn't say how many hours" are required, Weaver said. "Could it be done over a weekend?"

But Ellis said most optometrists have been doing minor procedures on the eye for decades.

"We have a great track record already with these procedures for a number of years," Ellis said. "Malpractice rates are very, very low in Kentucky and low in Oklahoma. If people were having issues, you would see those rates go up."

After the Kentucky Board of Optometric Examiners votes on the proposed regulation, the regulations will go to the Administrative Regulations Review subcommittee, which is made up of legislators.

Even if the subcommittee votes against the measure, Beshear can override the committee's decision.

Lexington Herald-Leader is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service