Rushed eye-surgery bill endangers citizens, raises costs

Senate Bill 110, a bill that would allow an optometrist to perform dozens of surgical procedures on the eye and eyelids, is dangerous legislation. Ophthalmologists who routinely perform these procedures have attended four years of medical or osteopathic school and a one-year hospital internship and a three-year surgical residency program after medical school. Optometrists have none of this extensive training.

It is ironic that we railed upon the politicians in Washington D.C. for taking action on President's Barack Obama's health care reform because many senators and representatives had never read the entire bill. You might think we would learn.

But just last week, SB 110 was introduced Monday evening, the hearing was held and it passed out of committee on Tuesday with final Senate passage on Friday. It passed a House committee Wednesday. How many senators had the opportunity to thoroughly review this bill and understand all the patient-safety implications associated with it?

Who is pushing this legislation? Politically connected optometrists and their powerful lobbyists — not the citizens of Kentucky and not the Kentucky medical community.

Given the choice, citizens of Kentucky would prefer to have their eye surgery performed by appropriately trained surgeons. However, if SB 110 is enacted, a patient going into surgery may find later that the individual has not received the training required to ensure the quality of care citizens deserve.

Most disturbingly, this bill will create a two-tier system of surgical eye care — one world-class system that we already have and another legislated system not backed by the educational and training standards the people of Kentucky expect when they or a loved-one are required to undergo an operation.

Optometrists may be only required to take continuing education courses, some in as little as a day or a weekend, to learn these surgical procedures without any background in the fundamentals of complex surgery or even basic surgical skills.

SB 110 also will drive up costs as optometrists purchase expensive equipment, which someone will have to pay for. Under the bill, optometrists also will hand over the traditional licensing and oversight authority for eye surgery from the Kentucky Board of Medical Licensure to the Kentucky Board of Optometry. Thus, a state regulatory board that does not have one member who is a qualified surgeon will now decide how much or little training is required for its members to perform eye surgery on an unaware public. It does not make sense.

Any suggestion that because optometrists have low malpractice rates that they would perform surgery safely and responsibly is misleading. Currently, optometrists prescribe glasses and eye drops — activities that are not associated with high insurance rates. Only one other state allows laser privileges for optometrists, Oklahoma in 1999. Since that time, no other states have wanted to follow the Oklahoma example; similar legislation has been rejected in 25 other states.

SB 110 would allow optometrists to perform dozens of invasive procedures that cut or destroy tissue and can cause irreversible changes in the eye and lids.

However, surgery is more than cutting with a scalpel or blasting with a laser, it is knowing when to operate and on whom, and how to anticipate complications and solve them when they occur. And, more importantly, it is knowing what happens to the patient over several months or years after the surgery.

Is it really worth putting the eye health of Kentucky citizens at risk? Call state House members and ask them to oppose SB 110.