Guest Column: Protect Eye Surgery in South Dakota 

Protect Eye Surgery in South Dakota
By Dr. Ryan Geraets and Barbara Smith

Tomorrow, the South Dakota Health and Human Services Committee will consider a bill (SB 87) that seeks to expand the scope of practice for the profession of optometry to include surgery on and around the eye with instruments such as scalpels and lasers. As leaders in the South Dakota medical community, we adamantly oppose this legislation. Expanding the scope of practice to allow non-surgically trained optometrists to perform surgical procedures puts South Dakota patients at risk.

The average patient may not know the difference between optometrists and ophthalmologists—but there is a big difference. Ophthalmologists are medical doctors and trained eye surgeons—optometrists are not. Optometrists are valued members of the eye care team and undertake a four-year training program focusing on eye examination and disease identification. But they do not properly train in performing surgery. They learn about specific, minor procedures but do not undergo the necessary education and training to perform the surgeries included in the proposed bill.

Ophthalmologists, on the other hand, are medical doctors and trained eye surgeons. They undergo at least 10,000 more hours of training than optometrists and attend four additional years of residency, where they must complete hundreds of hands-on, supervised surgical procedures.

As South Dakota doctors who perform eyelid surgery and laser surgery inside the eye, we can attest that these are not minor surgeries. Among surgeons, eye surgery ranks as one of the most risky, invasive surgeries for a patient. We cannot forget the patient as we debate who should be able to perform these surgeries. Our first priority should be our patients and their vision.

Today, South Dakota is rightfully in line with an overwhelming majority of states that exclusively allow ophthalmologists to perform laser eye surgeries on patients, but SB 87 seeks to dilute our quality of care. This bill is part of a larger national agenda by the optometry profession stemming from an aggressive and well-funded optometry lobby. Advocates incorrectly claim that allowing optometrists to perform eye surgery would improve availability and access to eye care. Medical research, however, shows there is no significant increase in accessibility to eye care in states that allow optometrists to perform eye surgery.

In states that have enacted similar legislation, patients have been hurt. A few years after the Louisiana legislature mistakenly expanded optometrists’ scope of practice to allow them to perform surgery, a Texas resident named Charlotte was told by a local optometrist that she required laser surgery. The state of Texas rightfully prohibits optometrists from performing surgery, but instead of referring her to one of many ophthalmologists near her home who would have been happy to treat her, Charlotte’s optometrist convinced her to drive six hours to have laser eye surgery performed by one of his optometry colleagues in Louisiana.

Surgery that would have taken an ophthalmologist less than 10 minutes lasted more than two hours, and Charlotte woke up to swollen eyes, extreme pain, and discomfort. As a result of the optometrist’s laser surgery, Charlotte suffered irreversible eye damage to both of her lenses.

We cannot let this happen in South Dakota. The surgical expansions in SB 87 are dangerous and would dramatically reduce the quality of eye care in our state, potentially hurting people and causing irreversible damage. As leaders in our state’s medical community, we urge the members of the House Health and Human Services Committee to vote no on SB 87. There are no shortcuts to safe surgery.


Ryan Geraets, MD, is an ophthalmologist in Sioux Falls and serves as President of the South Dakota Academy of Ophthalmology. Barb Smith is CEO of the South Dakota State Medical Association.

26 thoughts on “Guest Column: Protect Eye Surgery in South Dakota ”

  1. That sounds very reasonable and logical. However most South Dakota legislators seem frightened of reason and logic…

  2. It’s a shame these are the same people who told us lockdowns and masking was efficacious and vaccines were safe for everyone and more effective than natural immunity.

    Betrayal of trust for money makes everything you say suspect.

    1. Its a shame you actually believe the liberal-Hollywood conspiracy that vaccines aren’t safe.

      1. Um, it’s ultra-right wing nuts like Republican Marjorie Taylor Green and Lora Hubbel touting those conspiracies.

        1. Ann:

          Actually, it is science studies that now shows there was no statistical evidence lockdowns (yet had significant economic impact disproportionately born by the poor and single parent households) or masks (now being increasingly being blamed for toddlers with speech deficit and significant retardation of social development skills of pre teens, teens and young adults leading to suicide, dysfunction, depression, etc)) made a difference in deaths.

          We now have our own government admitting it is likely that the virus came from a lab leak and natural immunity was better at preventing spread and generating less lethal and virile strains. And, the list of people now being told by their doctor to not take the vaccine (the young and fit or those with certain cardio vascular risks like stroke, high blood pressure, and plaque buildup) might be half the nation.

          The “Conspiracy theories” prove to have more truth than the “science” of “Mr. Science” himself.

          1. With all due respect, the “science studies” you allude to are far from conclusive concerning lives saved through mitigation efforts. There is no consensus yet that doing nothing would have been better than the path taken.

          2. The fact that you can’t even sign your name to this idiocy tells it all! Optometrist are trained to fit us with glasses and contacts NOT eye surgery.

    2. I wish your same skepticism was prevalent among the fools who believe gender reassignment treatments actually achieve the desired results

    1. Well hell then…why don’t we just consider it fine and dandy to let chiropractors perform orthopedic surgery?

    2. Many folks are not educated in the difference between an Ophthalmologist and Optometrist. Optometrists are NOT medical doctors.
      An Ophthalmologist graduates from 4 years of undergraduate school, with honors, + 4 years of medical school, + a minimum of 4 years training in an internship and residency. 2 additional years of Fellowship training is required for specialities such as Retina, Cornea/refractive/anterior segment, Glaucoma, Pediatrics, Oculoplastics, Neuro-ophthalmology, etc. An Ophthalmologist has 12-14 years of education & training in eye surgical procedures besides conducting vision tests & prescribing corrective lens. An Optometrist is trained in conducting vision tests & prescribing corrective lens, not surgical procedures.
      Both serve a purpose for their communities, in their realm of training. We just need to be educated in what their training is before coming at us for surgery. Most definitely do not want a bill allowing Optometrists to operate on us when that is not their training.

      1. Coming at us? Who’s coming at you? The bill’s purpose as I understand it, was to help serve the patients across SD with better access to health care. These words you are using justify the “turf” you clearly are trying to protect. Optometrists ARE trained and educated to perform these procedures. Please stop spreading lies to South Dakotans and do your homework.

  3. I’m all for Optholmologists protecting their turf. Heart surgeons and orthopedic surgeons as well.

  4. READ the bill! These aren’t surgeries in an operating room. They are in-office procedures that optometrists are trained to do and ophthalmologists know this. Do MD’s ever actually try to work with other professions to help expand patient care?

  5. Sounds like optometrists can already perform these procedures in many other states, so this article about not being properly trained is bogus. My cousin is an optometrist in Oklahoma and has performed hundreds (maybe more) of these procedures without any harm. I’m sure her patients are thankful they don’t have to drive hours to find a busy ophthalmologist that’s booked out 4+ months.

    1. I’ll drive hours to seek a highly trained MD to touch my eyes. Let’s face it many folks don’t know the difference between an M.D. & an Optometrist. If an Optometrist wants to do surgery, let’s invite them to go to medical school and do a full residency to become fully trained, not partly trained.

      1. nobody is stopping you from driving hours. Oh, I just realized, you are smarter than the rubes like me who might make a different decision. I’m so glad for smart people like you. I don’t know how I’d survive.

        You are making the same argument referenced by the person below regarding nurse practitioners and physicians assistants. Thankfully, we disregarded the Doctor’s Grifters and Income Security Association, I mean South Dakota Medical Association, then too.

        To be believable, they’d be specific on what Optometrists don’t have in training and experience and the risks. Instead, like they did with Covid, they just say trust me, I’m the expert. Sorry, that ship has sailed.

  6. Nurse practitioners and physician assistants in SD adequately perform these non-invasive procedures and are not trained surgeons, nor do they possess the training optometrists do as all optometry schools teach these procedures. This bill would require optometrists to be certified on these procedures and be observed performing such on 5 patients before passing certification. Optometrists are adequately trained to perform these and should have the opportunity to possess the certification to perform them if they choose.

    1. Absurd! Let’s not lessen the medical training, in any field, on the public. We deserve the highest trained care.

      1. Just because there’s a fancy “MD” behind a name, doesn’t mean they are the highest trained. Cmon. Get with the times, we aren’t living in the dark ages. Even the testifying MD said he admits he wasn’t competent in these skills. So you’d rather see an incompetent MD than a fully trained optometrist based solely on their credentials? And if so, even with the passage of this bill, guess what, you’d still get the choice. A nice freedom to have. But until then, no choices in SD.

    2. “Nurse practitioners and physician assistants in SD adequately perform these non-invasive procedures and are not trained surgeons”

      But only under the guidance/authority of a Medical Doctor.

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