Sarah Wellik: When it comes to eye surgery, let’s put patient safety first

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We cannot allow patients to be placed at risk by watering down surgical safety standards in Florida.

Ophthalmologists are medical doctors that specialize in creating better vision in their patients. One of their specialties is surgery, on and around the eye, a major procedure that must be done with expertise and care.

Take, for instance, the removal of a what appears to be a benign (noncancerous) skin lesion on the eyelid.

There are some who would minimize the severity of this as a “minor procedure” to treat a “lump or bump.” But like all surgeries involving the eye and surrounding areas, it requires extreme care and experience and can be devastating if not performed correctly. No one can ever be sure whether a lesion is cancerous without first sending a sample off for a biopsy.

Improperly cutting or injecting a cancerous lesion can be tremendously harmful to the patient and result in a threat of the cancer spreading to other parts of the body.

It does not sound very “simple,” does it?

Now, imagine having that “minor procedure” performed by someone who never went to medical school and lacks the necessary clinical experience because they never went through extensive surgical residency training.

That is exactly what the Florida legislature is proposing with SB 876 and HB 631.

This dangerous legislation would greatly expand the scope of practice for optometrists — who are not medical doctors or trained surgeons — and would allow them to perform this type of surgery.

Additionally, it would allow optometrists to perform laser surgery on and inside the globe of the eye itself. Proponents of the measure claim that the surgeries are “noninvasive.”

But anytime a surgical instrument is used to operate on human tissue — especially inside the eye — it is invasive and serious and should never be taken lightly.

Optometrists are valued members of the eye care team. Their role is important in performing eye exams and vision tests, prescribing corrective lenses and detecting certain eye abnormalities. They can even prescribe a limited number of oral drugs for eye care such as antibiotics and glaucoma medications, in consultation with an ophthalmologist.

Optometrists often help point out red flags in vision and are key to helping patients see well. But they are not medical doctors or trained surgeons.

Optometrists do not have the medical education, clinical training, and surgical experience necessary to safely perform delicate eye surgery or to decide when surgery is even the right treatment for the patient’s conditions.

Ophthalmologists, on the other hand, attend four years of medical school, followed by a one-year hospital internship and a three-year surgical residency in ophthalmology. Many ophthalmologists then continue on and complete a 1-2 years of subspecialty fellowship training.

In total, ophthalmologists undergo at least eight-to-10 years of postgraduate education and clinical training totaling over 17,000 hours before they can independently operate on a patient’s eyes.

Eyes are home to tissue that does not regenerate on its own. Even a surgical error of just one millimeter resulting from a lack of experience can be irreparable and can create a lifetime of harm to a patient.

This is precisely why only properly trained medical doctors and surgeons are the only ones who can and should independently operate on the eyes in Florida.

Despite what some proponents of SB 876 and HB 631 have been telling lawmakers, non-physician providers such as physician assistants and nurse practitioners do not have the authority to independently perform eye surgery and they are not “supplanting” optometrists as eye primary care providers in Florida. This misinformation does no one any good.

We cannot allow patients to be placed at risk by watering down surgical safety standards in Florida.

Granting optometrists surgical privileges through legislation versus medical school and residency is dangerous and poses a huge risk to the quality of care that Floridians expect and deserve.

Our elected representatives in the Florida Legislature must not succumb to organized misinformation and manipulative bill drafting, but instead should do what is in the best interest for the citizens of Florida by soundly rejecting SB 876 and HB 631.

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Sarah Wellik M.D. is president of the Florida Society of Ophthalmology.

Guest Author



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