(Release) Opthalmologists: What You Need to Know About Eye Surgery regarding HB 1099

What You Need to Know About Eye Surgery
HB 1099 would compromise safety for eye surgery in South Dakota.

On Thursday, Feb. 1, the South Dakota House Health and Human Services Committee will consider HB 1099, a bill that would reduce the training required to provide surgical eye care by adding laser and scalpel surgery to optometry’s scope of practice. It can be difficult to discern accurate information on this issue. Let’s set the record straight:

CLAIM #1: SD Ophthalmologists are “scaremongering” the public over eye surgery standards.

FACT #1: There are no shortcuts to surgical safety in eye care. In states where similar laws have been unfortunately enacted, patients have been severely hurt and visually impaired due to optometrists performing some of the same procedures as authorized in HB 1099. This is bigger than a piece of legislation. These are the safeguards for our families and communities. As Denise Hanisch, MD, President of the SD State Medical Association stated: “We cannot forget the patient as we debate who should be able to perform these surgeries. Our first priority must be to patients and their protection. This bill makes compromises regarding surgical safety.”

CLAIM #2: Optometrists are medical doctors and should be able to perform eye surgery.

FACT #2: Ophthalmologists and optometrists play critical roles in a patient’s eye care. Optometrists provide basic vision care through regular check-ups, diagnose proper prescriptive lenses, and treat certain eye diseases. But they are not medical doctors or trained surgeons. The American Society of Cataract and Refractive Surgery sent a letter to legislators explaining why this is problematic: “This dangerous legislation places South Dakotans at risk and threatens the high quality of eye care and surgical safety standards currently available to patients throughout the state.”

CLAIM #3: Optometrists are fully trained to perform the eye surgeries outlined in HB 1099.

FACT #3: Optometrists are not medical doctors or trained surgeons. Even in ostensibly straightforward procedures, eye tissues are extremely fragile, with narrow margins of safety. Surgical errors are challenging – if not impossible – to correct.

When it comes to the procedures outlined in the bill, optometrists’ “surgical training” consists of a 32-hour course containing lectures and practice on non-human models. This is shockingly low compared to the 15,000+ training hours ophthalmologists undergo in addition to 8-10 years of highly supervised medical and surgical training during medical school, internship, ophthalmology residency, and fellowship. Ophthalmologists complete medical school with a keen sense of judgment to ensure surgical therapies are offered only when necessary and are prepared to manage surgical complications if they arrive.

To note, 22 of the nation’s 24 optometry schools are in states where optometrists are not permitted to perform laser eye surgery, making it unrealistic at 91% of these programs for students to properly train in performing these procedures. This represents roughly 95% of U.S. optometry students. An optometrist who has completed the equivalent of a long weekend of training should never be permitted to perform laser surgery on someone’s eyes or inject anesthesia with a needle into someone’s eyelid to surgically treat patient’s eye or perform surgeries to treat skin conditions of the eyelid.

CLAIM #4: Expanding optometrists’ scope of practice will increase access for rural communities. HB 1099 proponents write: “If you live in a rural area, would it be better to be treated that day, or to need a referral to an ophthalmology clinic for an evaluation, and then a separate visit for the procedure?”

FACT #4: Medical research shows there is no significant increase in accessibility to eye care in states that allow optometrists to perform eye surgery. Living in a rural area must never be a prescription for unsafe eye surgery.