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Dr. Linda Schumacher-Feero is the past president of the Maine Society of Eye Physicians & Surgeons.
Close your eyes and imagine that you needed eye surgery, and you had the choice between someone who was a medical doctor and trained eye surgeon, and someone who was neither.
Now ask yourself: Who would you trust to perform the surgery?
If you’re like most people, the choice is clear — you wouldn’t want anyone other than a trained medical doctor and surgeon in charge. That’s why LD 1803 is so worrying to me.
If passed, this bill would authorize optometrists — who are not medical doctors or trained surgeons — to perform surgery on and around the eyes using lasers, scalpels and needles, placing patients at risk of complications due to optometrists’ incomplete training and underdeveloped surgical skills.
While both play important roles in care, the difference in training between ophthalmologists and optometrists is vast. Ophthalmologists like me have gained the privilege to perform cataract, laser eye, and glaucoma surgeries through rigorous medical education and the nationally standardized requisite level of clinical training.
The moment a patient regains their vision is a magical experience — and a direct result of over 17,000 hours of medical school, internship, and a four-year residency training performing eye surgery under the direct supervision of experienced faculty. Optometrists, meanwhile, graduate from optometry school where they master skills to perform primary eye care like vision testing and correction, but not surgery.
Passing legislation to grant optometrists the license to perform surgery raises significant safety concerns, as evidenced by the handful of states that have passed bills similar to LD 1803. A number of patients have reported permanent vision loss from surgery by optometrists. There is simply no substitute for many years of rigorous surgical training. There are recent stories of patients’ eyesight being put at risk by state boards of optometry getting caught exceeding their authority and bending the rules. I’m very worried the same thing could happen in Maine.
Because of the risks involved in any eye surgery, the vast majority of Maine voters oppose LD 1803. In fact, a recent survey found that 86% of Mainers trust ophthalmologists to perform eye surgery safely, while only 4% would trust optometrists more.
This is not to say that optometrists are not essential caregivers in our health system. Their skills are crucial when it comes to routine eye exams, diagnosing and treating eye disease with medication. Could some optometrists take on an expanded role for certain medical services? Yes, but with more rigorous training than the 32-hour Advanced Procedures Course and eight-hour proctored session with no requirement to ever perform even a single surgery on a living human eye as proposed. T
I believe the expansion proposed in LD 1803 goes way too far and creates serious risks for Mainers.
While optometrists argue that expanding their scope of practice is necessary to improve access to eye care, recent data says otherwise. In fact, a recent study published in the Journal of the American Medical Association found that fewer than 20 optometry practices across the entire country are truly isolated from a nearby ophthalmology practice, and the average driving distance between optometry and ophthalmology practices is just 11 miles. Since most of the proposed eye surgeries are not emergencies, there is no reason for optometrists to perform surgeries they are not medically qualified to perform, especially when the proposed training consists of a 32-hour lecture course and practice on model eyes with no requirement to ever do a single surgery on a real eye.
Improving access to care is a top priority for ophthalmologists across Maine, but I believe increasing optometrists’ surgical permissions will only introduce unnecessary risks without solving underlying geographic or systemic barriers to quality healthcare.
Patients deserve the best medical care they can get. We must protect them from unnecessary harm.
I urge our state Legislature to listen to the 70% of Maine voters who say they stand against LD 1803. Our leaders must ensure that any Mainer who undergoes surgery on or around their eyes can trust their surgeon’s level of expertise and continue waking up each day with clear and reliable vision.
