ON FEBRUARY 24, Kentucky Governor Steve Beshear signed a bill increasing the scope of optometric practice in his state. While bills expanding optometric practice have become common over the last couple of decades, this one raises a lot of questions because it brings optometrists into the realm of surgery.

According to a February 24th article in the Louisville Courier-Journal, “The measure will allow optometrists to perform certain treatments and surgical procedures—including a laser procedure sometimes needed after cataract surgery—that now must be done by ophthalmologists.” Although 25 other states defeated similar measures, this bill was introduced, passed, and signed in only 12 days. As you might suspect, ophthalmologists were stunned and disappointed at the outcome.

While it’s easy to takes sides with one of the three O’s on this issue, the question really is, “What does this mean to the eyecare and eyewear marketplace in general?”

It is my opinion that optometrists will eventually resemble osteopaths. An osteopath approaches medicine holistically while a physician approaches it from a drug and surgery point of view. They both have the same treating and prescribing authority but their method is different.

If optometrists become indistinguishable from medical doctors, what are the ramifications? In the short term, the impending burden on the American health care system will be enormous and the number of qualified medical professionals required will be inadequate. Surgical therapeutic eyecare will experience this dilemma too. More medical personnel (ODs) could relieve some of this.

Many optometric friends have shared their anxiety saying, “We can’t do everything.” Optometrists will have to specialize, just like ophthalmologists do today. Board certification seems to make sense.

What does this mean for opticianry? There’s opportunity for opticianry to move into the voids that optometry will vacate. It’s impossible for an optometrist to be a specialist in everything. One thing ophthalmologists do well is delegate to others on their practice’s team. Optometry hasn’t learned to do this well, but if optometrists continue to become more medically oriented, they will have to in order to provide the quality care expected of them.

Opticianry should fill these voids by creating educational programs and additional certifications and/or licensing that develop competent allied health professionals that optometrists (and ophthalmologists) can incorporate into their teams. These new personnel would be qualified to perform a host of skills not part of the current opticianry skill set, and in this way, expand the scope of practice of opticianry. This kind of optician is in the best interest of the entire ophthalmic industry.

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