Optometrists win rights to broaden services

Optometrist services

Optometrist services

Optometrists have recently lobbied to expand their scope of practice in 18 states. Here's what happened:



 

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Optometrists, ophthalmologists fight over eye care rights

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Tulsa area resident Pam Odum hoped to ditch her glasses when she saw an optometrist for laser surgery. Instead, her vision got worse, and she now requires a stronger prescription. Photo by Jen Hoppa
Tulsa area resident Pam Odum hoped to ditch her glasses when she saw an optometrist for laser surgery. Instead, her vision got worse, and she now requires a stronger prescription. Photo by Jen Hoppa

Optometrists battle ophthalmologists as line blurs between levels of care

Comments

I am an OD. In my experience (Residency trained and most of my career in a hospital facility) the patients best interest is served when ophthalmology sticks to surgical procedures and clinical time that is directed to surgery. Optometry's role is to maintain primary eye care and focus on treating vision and ocular health concerns. Glaucoma, infections, dry eye, amblyopia, and all refractive and visual therapy are optometry. Surgery is ophthalmology. I send patients to an ophthalmologist when a surgical procedure is needed and only to an ophthalmologist that spends his time doing surgery. I don't want to do surgery as i don't have time to be really good at everything. Neither does any ophthalmologist. If an ophthalmologist is not doing surgery (or surgery focused clinic) 80% of the time she/he is probably not a very good eye doctor. One last thought. How many md graduates can use a direct ophthalmoscope out of medical school? I was shocked at the lack of ability when I started training ophthalmology interested fourth year med students and fp/peds/Im residents. The shock has left now, I politely and humbly smile at the lack of eye training or preparation that is received in medical school. Then I teach them how to examine an optic nerve.

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I had cataract operation a few months ago. I had an eye infection in the left eye prior to the operation,3 month weeks my last check up with the eye doctor,he said I had 20/20 vision and I do NOT. mg vision i'd still blurred and I can only see with reading glasses and that i'd not do good. I have complained to the office and they are telling me that it takes a few months to fully recovery. I get flashing lights in my eyes which he did check and said the retina is good. also, have floating black dots said I have to get use to that ??? guess I am going to have to see a different eye doctor .makes me do mad.

While its true that there are well trained optometrists who could & can do superficial procedures & prescribe meds, the best trained of these have a one year post training & work in an MD eye clinic or closely with Opthalmologist. There is a huge drop off in abilities between ODs. Certainly any increase in privileges (which is usually touted as a convenience issue for rural areas to legislatures) should be strongly worded to include the nessecity for those ODs who expand there scope to have passed written & oral knowledge tests in these fields & re certify periodically just as board certified ophthalmologist do. Also they should have had a residency & be associated with an eye MD as a Physician Assistant is. Furthermore they should have oversight by the same Board of Medicine in their state that watches & regulates the activities of MD eye doctors if the Particular OD wants to have an expanded scope of Medical Practice. In short it's NOT in anyone's best interests to just legislate all ODs to expand their scope of medical practice without agreeing to follow these guidelines to separate themselves.

Both eye doctors no difference

optometry school--6yrs--medical--seven yrs[ after med school the doctor to be an ophthalmologist-3-4yrs hands on t raining. in an hospital under other ophthalmologists. Optometry now has the same hands on training in optometry controlled clinics where they get such training by ophthalmologists who are training optometrist for the same procedures. I started the first of these clinics in Atlanta;there are several now across the country serving all the schools of Optometry just as medicine does their boys.

This lawyer would not trust an optometrist to do surgery nor to prescribe meds. The difference in training is huge between optometrists & ophthalmologists, although optometrists like to call themselves "Dr's". Ophthalmologists are trained for years & years to handle defects, injuries & medical conditions of the eye. That's a LOT more than a few years of optometry school & concentrating on improving vision with glasses & contacts!

This comment about Optometrists shows the lack of research and understanding of reality that is prevalent is SOME lawyers. As an Optometrist, I have many lawyer friends and patients who would never make an unfounded statement such as the statement from Brenda. Optometrists have 4 years of undergraduate work and 4 years of strictly eye training. Plus many take another year of residency. We have mandatory continuing education requirements and we are considered physicians under Medicare. We treat most eye disease that requires medication and refer for surgery when indicated. When I refer for surgery, I send the patient to someone who does eye surgery ONLY, not some who do eye surgery part time. Finally, people like Brenda give lawyers a bad name as we know that public perception of lawyers is not positive. However, my experience with lawyers is very positive and I recognize that there are a few bad apples like Brenda in the bunch.

This doctor would not trust a lawyer that makes public comments on situtations that they know don't understand. Your comment about "concentrating on improving vision with glasses and contacts," shows your ignorance about the profession of optometry and what they are trained, qualified and certified to do. Be socially responsible, if you are as educated as you claim to be, do a little research before your post such nonsence. Optometrist are not trained to be surgeons...PERIOD! IF you need eye surgery go to a MD. Optometrist do however prescribe meds and treat eye diseases with no more complications than their M.D. counterparts. The American Optometric Association webpage can be a great resource to find more "factual" information about optometry.

I think the only thing CLEAR hear on reading these comments is that there is a lot of misperception out there and this needs to be discussed more. To begin with, mention is made of MD's, "real doctors". Let us not forget (or do we know?) of DO's, Doctors of Osteopathic Medicine, who are also "real doctors" and become ophthalmologists (BTW, that word has two h's in it) in all 50 States and territories after receiving the same surgical/medical training that allopathic (MD) physicians have. So one misperception right there. Could there not be another misperception? Secondly, I am a "real" physician who works in a rural area, and there ARE NO ophthalmologists anywhere close. I have on multiple occasions consulted or referred patients to local optometrists for both medical and trauma situations, and they have done a bang-up job of helping out. If it is beyond their capability, they refer to ophthalmology. Consideration needs to be taken of the relative lack of availability of ophthalmology in rural areas.

I use an optometrist who is constantly getting new training. I definitely trust him to prescribe meds for my eyes when needed & if he gets advanced training to do surgery I would trust him for that. BTW, even opthemologists make mistakes.

I have worked in the medical field for many years. The only medical professional that should be licensed to perform surgery is an MD whose residency rotation included surgery training and experience.

Watch out!!! Big groups refer within their group just for business which is a big mistake.

A friend had an optomotrist perform surgery on her eye and lost her sight in that eye. It took an ophthalmologist - a real eye doctor - to get her back most of her sight. The optometrist may be very nice, but CLEARLY does not have the medical knowledge or skill that an eye surgeon - who has studied eye surgery for many more years before going into the market place - has.

I think you may have been given some incorrect information. I don't know of any state that allows optometrists to perform actual surgery. I attended optometry school which is the same length of time as medical school or dental school, four years. A one year residency is optional for us. An ophthalmologist is an eye surgeon and has a longer mandatory residency and many continue into a sub-specialty field by completing an additional fellowship. We are not surgeons but we are "real" eye doctors and can prescribe medication, perform minor procedures like removing foriegn bodies and of course, prescribe glasses and contact lenses. I am also on staff at a hospital and work closely with a large ophthalmology group. I hope that clears things up for you and others that may read your comment.

I think surgery and prescriptions should be left to Optomologists / MD's - not folks trained to test eyes.

I just performed surgery this AM on a patient. Now his eye is free of the foreign body and he is taking two prescriptions. We are doctors and deserve respect. I do not think we should ever do lasik, but optometrists are trained in surgical procedures. -An O.D. at a retail chain.

Although removing a foreign body has a surgical code, claiming you "preformed surgery" gives the public the wrong impression and just adds fuel to the fire.

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