Lasik by optometrists???

**hcjilson** · 11-02-2004, 01:02 PM

Stopper,
I have done some futher research.First I carefully checked my posts in this thread to reassure myself that I never said OD's were doing Lasik.I never did. I did say laser surgery however.

Chapter 59-581 of the OK statutes as provided by the OK public legal research system sponsored by the OK atty gen's office.
From paragraph A. which is the definition of optometry.
I quote:

"A. The practice of optimetry is defined to be the science and art of examining the human eye and measurement of the powers of vision by the employment of any means, including the use or furnishinng of any self-testing device, the use of any compterized or automatic refracting device, the use of pharmaceutical agents, the diagnosis of conditions of the human eye, and the correcting and relief of ocular abnormalities by means including but not limited to prescribing and adaptation of lenses, contact lenses, spectacles, eyeglasses, prisms and the employment of vision therapy or orthoptics for the aid thereof, low vision rehabilitation, laser surgery procedures, excluding retina, laser in-situ keratomileusis (lasik), and cosmetic lid surgery."

Why the concern?, you may ask. A careful reading of the above paragraph would indicate that use of an argon laser is approved.It would appear that a YAG laser is also approved for doing capsulotomies.It would also appear that SLT's are approved.

A further clarification of the VA situation. You do need an OK license to practice laser surgery in a VA hospital outside the state. When you practice in a VA hospital, you can practice under OK rules, not the home state's. I was incorrect in stating the federal guidelines supercede the state's. There are no federal guidelines for the practice of Optometry. Hope this clears up what I said above.
best from hj

PS I didn't mean for the colored print to be that big! no time to fix!

**hcjilson** · 11-02-2004, 02:40 PM

This email was just forwarded to me as a result of a noontime request for more info. It comes from the exec administrator of the state society.I have deleted her name as well as tha addressee's.

ent: Friday, October 29, 2004 10:01 AM

Subject: Urgent message from

Oklahoma’s future belongs to all of us – make your voice heard TODAY
The Oklahoma Board of Examiners in Optometry has adopted a regulation that will allow optometrists to perform surgery with a scalpel.

The governor now has until Nov. 19 to accept or reject it. Your response will make an impact. The governor’s office is now tallying the number of calls and faxes received on the issue. Fax the governor at 405.521.3902 and tell him how this disastrous decision will likely harm patient safety. It will only take a few minutes of your time, but the result may influence your entire career.

**Stopper** · 11-02-2004, 04:02 PM

hcjilson,
I never said that ODs weren't doing laser procedures (surgery) What I said is that I know of no state where they are doing LASIK.(Which is the topic of the thread) Your last post even states that LAsik is excluded if I read it correctly. So I stand by my statement that ODs doing lasik is an "Optical Legend". As far as other laser procedures, That has been going on for years. why all the fuss now? I have my thoughts but to keep to your request about dialoge not bashing(which I agree with) I will keep my thoughts to myself for now.

No problem with the large print. This is always a conversation and discussion among peers, even if people disagree

**hcjilson** · 11-02-2004, 06:48 PM

Sorry stopper, I really meant to change that and got sidetracked.Did you by any chance go to the thread I originally posted "whats going on in OK"? I think the implications of that are clear evidence that the OD's (In OK anyway) found a chink in the armor and took advantage of that? Then when it appeared that the regulation was so loosely worded, took advantage of that too. I think this is bad mojo. The way to increase the scope of practice is to be up front with it. This is definitely a back door attemp and not worthy of the profession. My opinion only.

hj

PS was sucessful in reducing size of red letters......and surgery is still surgery any way you slice it (pun unintentional but not bad for an amature.

**hcjilson** · 11-02-2004, 08:15 PM

PPS to the above,

How long has this "laser" surgery been going on? What medical school trains the ODs for these procedures, and how long are these courses? Are you indicating to us that the OK optometrist should be the primary source of glaucoma treatment? With all due respect I cannot believe the public is being well served here. This is not an "Optical Legend" it is a fact.Lets not get hung up on Lasik-lasek, this is a rule that will allow OD's to practice medicine, and without the proper training (ie medical school) it is dangerous to the public. Now if you disagree with that statement kindly enlighten us with the reasoning behind your postition.

hj

**NC-OD** · 11-02-2004, 08:20 PM

http://www.revoptom.com/index.asp?page=2_1194.htm

http://arapaho.nsuok.edu/%7Eoptometry/

**hcjilson** · 11-02-2004, 08:32 PM

Hi NC, long time no talk.....
The law as written is quoted above. What troubles (I think!) the ophthalmologists is the loose wording of the law. You can clearly see what is not allowed but the sin of omission is what is not mentioned, which is what I referenced a couple of posts ago.I have no ax to grind either way. I don't practice optometry in VA hospitals or in OK. What troubles me is the backdoor incursion into medicine. I think we had a similar exchange a few years back. I think the scope of practice should be enlarged for all practices, with proper training, however, it is difficult to back optometry in their quest while they are standing on our necks while we try to enlarge ours.

**NC-OD** · 11-02-2004, 08:40 PM

Hcjilson,

For Opticians to move forward, they will have to put forth an academic curriculum.......with an AA, BS or MS degree. It won't happen with OTJ training, I don't think. Of course, I don't speak for any organization-- Only my personal opinion.

If you look at the OK school of Optometry curriculum (and others), while not being medical school, is a quite intense, 4-year immersion into eye and vision care (after 4 years of undergrad).
:cheers:

**hcjilson** · 11-02-2004, 08:53 PM

I agree completely with the need for an academic curriculum as a precursor to enlarging the scope of practice, but wonder why with Optician students it is called OJT and with Optometry students, its called clinical instruction.I point out the difference in semantics ,to illustrate a certain bias on the part of Optometry and not as a put down to my friend in North Carolina.
best wishes from harry j
PS whats going on down there?CNN reports Bush is ahead!!!

**NC-OD** · 11-02-2004, 10:29 PM

[QUOTE=hcjilson]I agree completely with the need for an academic curriculum as a precursor to enlarging the scope of practice, but wonder why with Optician students it is called OJT and with Optometry students, its called clinical instruction.[QUOTE]

Huh? One is instruction through an institution of higher education with clinical and didactic training with prerequisites in science, math etc....required for admission to study.
The other, well, is not. Nothing wrong with OTJ........but I don't make the rules, you know. Ideally, you get the best outcome with both, I suppose.

I understand there are very good schools of opticianary but they are few and far in between. (We have one here at Durham Tech, NC). I might be wrong, but I understand that many, if not most opticansare not university or comm. college trained. Again, I might be wrong. Are there any statistics on this?

I just think your comparison between Optometry's expansion of scope and Opticianary is night and day. Some make it sound as if Optometry just paid off a few legislatures and we were able to do anything we want. I had 9 years of post-high school education and it cost me $150,000 in school debt. It was/is education first and then legislation second (and only because of fierce opposition). And the fact that there are not dead people lining the street from ODs dilating eyes, treating with topical/oral medications (27 years now in NC) and now OK ODs doing laser eye procedures for the past 8-10 yrs with NO (read that ZERO) adverse reactions, blind or dead people, seems to say we are doing something right.

Properly (officially, university-trained as a rule) educated opticians would have a great advantage when seeking expanding scope.

Hey, I believe about anybody can be an eye doctor. You could take a semi-sane plumber and teach him to do refractions or cataract surgery. None of it's rocket science.

But again, I don't make the rules and there is alot of money and egos at play. What'cha gonna do? As least North Carolina had the sense to pick BUSH. Still waiting for the rest of the U.S. to catch up.;)

**Laurie** · 11-03-2004, 12:21 PM

Hey NC-OD, long time...nice to see you here.

I'll jump in here, as I am an opticianry educator and can answer some of the questions in regard to data.

There are approx. 25 - 30 accredited opticianry programs in our country. They are found in universities, community college, and military schools. We actually are pretty close to optometry numbers in regard to programs nation-wide.

Unfortunately, though, completing an AS in opticianry is optional as a prerequisite to licensure. Therefore, only a small percentage of opticians take advantage of educational opportunities.

We absolutely agree on one thing: educate, THEN legislate. Our curriculum is 72 credits in length, includes general education, and advanced optical concepts as well as CL fitting and Refractometry. I have no doubt that our grads are capable of performing refractions (with higher quality than we see out there now) as they have such a strong optical base going in.

Opticianry is a little slow to embrace the concept of mandated formal education, but we are making progress. Here at Hillsborough Community College in Tampa we are over capacity in enrollment, and our Dean has asked us to cap our enrollment in the future. This has nothing to do with our ability to place grads in career opportunities, but is a community college/state funding issue. We are considering expanding our program around the state and licensing our materials to other colleges.

It certainly is an interesting ride.

: )

Laurie

**Stopper** · 11-04-2004, 03:37 PM

Hcjilson,

I did look at your original thread. I think if you have looked at the link that NC-OD posted it gives a different perspective on the situation in OK. The sky isn’t falling and ODs are not running around blinding everyone. (exaggeration to make a point) there are always two sides and the truth is usually somewhere in between. Where, depends on one’s perspective and bias.

I don’t think anything is being done through the back door. Doctors are doing what they are trained and capable of doing and what is permitted by Law. Why should ODs have to have everything specificly listed that they are “allowed” to do. The MDs don’t have this constraint. An ophthalmologists could legally do brain surgery. But they don’t because they are not trained to do it. (Again exaggeration) And ODs are not doing things they are not trained to do.

Where is it written that you have to go to medical school to have knowledge, skill and training?

Many MD’s and ODs learn quite a lot after they graduate from school. Are we going to restrict an MD from doing a new procedure or surgery because he/she didn’t learn it in medical school? I think not. And we shouldn’t restrict others either. As long as they are licensed and trained. Now the sticky part is who determines who is licensed and trained. That is why we have a Board of Opticianry, a Board of Optometry and a Board of Medicine and the laws that govern them.

I don’t believe I ever said anything about ODs being the primary source for treating glaucoma but since you bring it up, I do think ODs can be a primary source for treating glaucoma. I do it every day and have for years. So do many ODs. And the public is being well served.

Best regards,