NC considers allowing optometrists to perform some eye surgeries

Who should be able to perform eye surgeries? Right now, that's the job of an ophthalmologist; however, a bill moving through Raleigh proposes letting optometrists perform some procedures.

The bill says it would improve access to and affordability of eye care, especially in rural areas. Several local representatives are sponsoring the bill.

Mitchell County offers views as far as the eye can see, but you won't spot an ophthalmologist. The county doesn't have one full-time.

If you're looking for eye care, many end up in Spruce Pine at Appalachian Eye Associates. If you think optometrists just prescribe lenses, Dr. Marvin Walker estimates 80 percent of what he does is medical eye care. He wants to provide more.

"It really is an access to care issue, in my opinion, that we're trying to provide better access to these rural areas," Dr. Walker said.

Many patients who need a procedure for glaucoma or cataracts see their way to Asheville. At Asheville Eye Associates, News 13 found Charles Hunt, who came from Yancey County for a laser surgery called trabeculoplasty.

"I have glaucoma, and as I've gotten older the pressure in my eye has increased," he described.

If legislators pass the bill, an optometrist could have performed the surgery. News 13 spoke with Hunt minutes after he had the surgery.

"To get a procedure that you know is gonna be good? I would drive 300 miles," Hunt said, happy with the care he received 42-miles from home.

Oklahoma has had a similar law on the books for years. The head of the state's Board of Optometry said it has not received one complaint about a laser trabeculoplasty procedure, and he said optometrists have been performing the procedure for several years.

Over the course of five years, the Journal of the American Medical Association found patients in Oklahoma who received a laser trabeculoplasty from an optometrist needed a second procedure 35.9 percent of the time -- compared to 15.1 percent of the time when an ophthalmologist performed the procedure.

Dr. Marvin Walker hadn't seen the study.

"I'm not sure that a single study is as important as knowing the difference in the training between an ophthalmologist and an optometrist," said Dr. William Haynes, of Asheville Eye Associates, the ophthalmologist who performed Hunt's surgery.

So, what is the difference? Ophthalmologists are medical doctors who receive years of more education and surgical training. Rather than improve health care, Haynes says the proposal threatens patients' safety.

"I feel like surgery should be done by ophthalmologists. Surgical anatomy is something, particularly like glaucoma, is not a simple thing," Dr. Haynes said.

Walker said he has seen people's vision decrease because of a wait to see an ophthalmologist.

"As far as difficulty, it's a matter of accurately pointing a laser, and then being able to handle the complications afterwards," Dr. Walker said.

"The lasers seem to be very quick, very easy, point and shoot kind of devices, but they're not so simple, and knowing the anatomy of an eyeball is very very important," Dr. Haynes said.

Next, the legislature will put the issue under its scope.

Wednesday the House Health Committee will be discussing the bill. The committee won't be voting Wednesday, but the members are expected to vote soon.

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