Senate panel offers lukewarm support to optometrist scope-of-practice expansion

Stock image via Adobe.

The Senate Health Policy Committee advanced a bill that would give optometrists prescribing authority and allow them to perform certain surgical procedures despite most senators expressing concern the bill oversteps.

SB 876, sponsored by Sen. Manny Diaz, revives the long-running “Eyeball Wars.” Similar legislation has been introduced in past Legislative Sessions, with optometrists largely in support and ophthalmologists staunchly opposed.

The division stems from the pathways to similar-sounding, but not identical, careers.

Optometrists are primary eye care providers. They are licensed to prescribe corrective lenses and have limited prescription powers, mostly for topical medications such as eye drops. They hold doctorates in optometry.

Ophthalmologists, meanwhile, are medical doctors who specialize in eye care. Though they commonly perform vision tests and prescribe lenses, they also diagnose and treat complex eye maladies such as glaucoma.

The MDs argue optometrists do not have the education and training needed to perform surgery or prescribe certain controlled substances, such as opioid painkillers.

Senators of both parties offered the Hialeah Republican’s bill tenuous, conditional support, with most saying they would not support the bill in its next committee or on the chamber floor without significant revisions.

The major sticking point is the list of procedures optometrists would be able to perform.

The bill does not directly provide surgical authority, but would allow the state Board of Optometry to develop rules for and authorize a list of “laser and non-laser ophthalmic procedures and therapies” and set requirements for optometrists to become certified to perform them.

Senate Democratic Leader Gary Farmer of Fort Lauderdale said the language could potentially allow optometrists to perform surgical procedures that are beyond their grasp. Miami Republican Sen. Ileana Garcia had the same concern.

“I can’t see myself supporting this bill going forward, especially with a procedure that clearly is invasive to relieve the pressure on the eye. I think that should be left to ophthalmologists,” she said.

Tampa Democratic Sen. Janet Cruz opposed the bill citing her first-hand knowledge of the professions both as an optician and the wife of a physician. And Sen. Shevrin Jones also voted against the bill, citing poor vision care his father received.

“My father over the years went to optometrists, and he had visited two or three optometrists, and none of them were able to catch what was wrong, why his eyesight was leaving, until he went to the fourth optometrist who made it clear that he needed to go see an ophthalmologist,” the West Park Democrat said.

“[The ophthalmologist] is who told him that he had glaucoma and that he had to get surgery. It had become so far along that they had to do corrective eye surgery. It is because of the ophthalmologist that my dad now has partial sight. But if we would have known that in the beginning — if the optometrist would have caught that earlier — his predicament would probably be different.”

Diaz, who chairs the Health Policy Committee, recognized “there is a lot of work to do on this” especially in regard to the authorized procedure list. He couched concerns on prescribing authority — a constant criticism from ophthalmology groups — by noting optometrists would only be able write scripts for 72 hours of medication.

With the affirmative vote, the bill now moves to the Appropriations Subcommittee on Health and Human Services. The House companion, HB 631 by Hialeah Republican Rep. Alex Rizo, has not yet made a committee agenda.