Doctors on Thursday debated the amount of training needed for optometrists to perform some minor eye surgeries allowed under legislation approved in February by the Kentucky General Assembly.
Senate Bill 110 raised eyebrows for the short time it took both chambers to pass the bill - 10 days - and the Kentucky Optometric Association's political action committee giving more than $400,000 in campaign contributions to lawmakers and the gubernatorial campaigns of Gov. Steve Beshear and Senate President David Williams in the past two years.
The bill will allow optometrists to do some procedures previously reserved only for ophthalmologists. Kentucky becomes the second state to allow optometrists to perform these types of surgeries, behind Oklahoma.
The Kentucky Board of Optometric Examiners held a public forum Thursday in Lexington on regulations that would set the standards of certification for optometrists to perform these procedures, which include the use of lasers for some conditions involved with cataract surgery and the injection with a needle of certain medications. It would not allow optometrists to perform LASIK surgery.
The current proposed regulations would require optometrists to complete courses approved by the Board of Optometric Examiners.
Optometrists said the need is there so they can provide services to rural areas in the state where there aren't ophthalmologists.
James Sawyer, an optometrist from Wayne County in southeastern Kentucky, testified Thursday that many residents in that county don't have the option to go to an ophthalmologist.
"It is medically underserved," Sawyer said. "Wayne County has a high number of Medicaid recipients and many elderly residents. Getting our folks to travel to another county to get health care is a challenge. Many cannot afford gas and cannot drive."
Ophthalmologists Thursday urged for the revamping of the requirements, which they said puts patients at risk. They criticized a flyer advertising a 16-hour weekend course in September to grant surgical privileges to optometrists.
The regulations don't specify the teacher credentials or length of training and are vague in many areas, said Woodford Van Meter, chief of ophthalmology at Central Baptist Hospital in Lexington and president of the Kentucky Academy of Eye Physicians and Surgeons. He said Senate Bill 110 is an "abysmal failure" to protect patients.
"One cannot become an eye surgeon in 16 hours," Van Meter said.
It stands in contrast to the extensive training and education ophthalmologists go through to become medical doctors, said William Richardson, an ophthalmologist from Georgetown.
"It is at this point, eight years, 17,000 hours, 1,200 hours in operating room, 626 hours of lab instruction, a minimum of 3,000 patients and board certification when we are considered qualified to safely perform surgery on our own," Richardson said.
Ophthalmologists are medical doctors who specialize in eye care.
Optometrists are licensed to provide primary eye care services such as conducting exams, diagnosing diseases, prescribing glasses and performing minor procedures of the eye. This requires an undergraduate degree and four years of education in a college of optometry.
Senate Bill 110 is similar to when optometrists in Kentucky faced opposition but successfully lobbied the General Assembly for the right to dilate eyes with eye drops, said Darlene Eakin, executive director of the Kentucky Optometric Association.
"History shows that optometrists exercise this privilege frequently to the benefit of thousands of Kentuckians," Eakin said.
This law allows optometrists to do in office procedures without general anesthesia and doesn't allow major procedures, she said. The more labor-intensive procedures allowed under the bill we require more than a weekend course, she said.
"That course has some areas covered, but that's not everything they would have to have," Eakin said.
Florence optometrist and councilwoman Julie Metzger Aubuchon testified in support of Senate Bill 110 and said optometrists will be just as qualified for these procedures as ophthalmologists.
"Many references have been made to a weekend course," Aubuchon said. "I submit to you that many ophthalmologists that testified here today did not learn the current procedures in medical school. They had to go back. They had to learn those things in a course."
The way the bill passed through the General Assembly concerned local ophthalmologist James Sanitato, who practices in ophthalmology in Cincinnati and Crestview Hills.
"It is not in the purview of the legislature to redefine surgery in bills that were rushed through," Sanitato said.
The Kentucky Board of Examiners before Aug. 15 will send proposed regulations to the General Assembly. If approved by a sub-committee, they could go into effect by November. The public can send written comments until Aug. 1 to the Kentucky Board of Optometric Examiners, 163 W. Short St., Suite 550, Lexington, KY 40507.
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