Eye surgery demands serious training. Don’t let Missouri lawmakers loosen standards | Opinion

A tide of dangerous legislation has swept across the Midwest, and it’s now reached Missouri. As the General Assembly contemplates Senate Bill 956 and House Bill 1963, a critical decision looms over the future of eye care in our state. This legislation threatens to relax the standards that currently safeguard the well-being of patients and could expose many Missourians to substantial risks by allowing completely unqualified people — without even a medical degree — to perform laser eye surgery. Our leaders in Jefferson City must reject this unnecessary and potentially harmful legislation to preserve the high standards of eye care that current law protects.

Lobbyists for the state’s optometric industry are pushing for the passage of S.B. 956 and H.B. 1963, seeking a significant change in state laws to allow optometrists to perform critical and highly sensitive surgical eye procedures they are not trained to carry out. Under current Missouri law, and most state laws nationwide, only ophthalmologists are permitted to perform invasive eye surgeries, whether with a laser or a scalpel.

There’s a good reason for this — in fact, there are 17,280 of them. That’s roughly the number of hours ophthalmologists spend gaining clinical experience across medical school, internships and residency.

While optometrists play a critical role in the delivery of routine eye care — including performing eye exams and vision tests, prescribing eyeglasses and contact lenses, and diagnosing, treating and managing certain eye problems — they are not medical doctors and do not have nearly enough training or expertise to perform laser eye surgeries. Yet, if these bills pass, optometrists would be able to utilize lasers on Missourians eyes after a 32-hour class.

Needless to say, letting unqualified people perform these delicate surgeries would expose patients to substandard care. As an ophthalmologist with four years of medical school, four years of residency and an additional year in cornea and external disease training, this legislation not only trivializes the years of medical education, surgical training and hard work it takes to be an ophthalmologist — it also poses a direct threat to the health and safety of my patients.

Unfortunately, this push by optometrists to gain surgical privileges by rewriting state law is not limited to Missouri. A growing number of states, including our neighbor, Kansas, are now considering similar legislation that would allow optometrists to perform laser eye surgeries. Proponents of these misguided bills are attempting to claim that such a move is necessary to address an eye care access crisis, when a crisis simply does not exist. Lawmakers must recognize this is not an isolated issue, but part of a broader trend that demands collaborative action to safeguard the standards of eye care across the region.

According to U.S. Census data, nearly 86% of Kansans and more than 89% of Missourians live within a 30-minute drive of an ophthalmologist, numbers that jump to almost 100% when looking at a drive time of 60 minutes or less. Not only that, but a study published in the Journal of the American Medical Association found that expanding optometrists’ scope of practice to include surgical procedures would not improve access or decrease driving time for patients.

Our lawmakers should learn from the mistakes of Oklahoma, one of the few states where optometrists have been allowed to perform laser surgery. After state legislators expanded optometrists’ scope of practice to perform laser trabeculoplasty, patients in that state who received the procedure from an optometrist experienced a 189% increased risk of needing additional surgeries in the same eye, when compared to patients who had the procedure performed by an ophthalmologist. This suggests a serious spike in avoidable complications, and it’s why eye surgery should be left to trained surgeons.

Passing S.B. 956 and H.B. 1963 would subject patients to surgical eye procedures performed by optometrists who lack comprehensive clinical training and education. Changing the law doesn’t change their experience level. Our lawmakers must wholeheartedly reject this bill to maintain the high standards of care that currently protect Missourians and their eyes.

Jonathan Schell is a board-certified ophthalmologist and the president-elect of the 501(c)(6) nonprofit Missouri Society of Eye Physicians and Surgeons.