Devil's advocate: OD-performed surgery dangerous, but could be legal

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Zack Oakey, MD, an ophthalmology resident at the University of California, Irvine. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Advanstar.

 

On April 19, I received an e-mail from the American Academy of Ophthalmology. It expressed concern with a recent proposed change to the policy of the California Professions and Economic Development Committee regarding scope of practice for-among other professionals-optometrists.

In the e-mail I read that “state Sen. Ed Hernandez (D-West Covina), a practicing optometrist” has sponsored SB 622 that would allow optometrists to perform eyelid procedures, glaucoma laser surgery, inject medicines (including intravitreal), give vaccines, and use antimetabolites. I am also informed that the above would require “minimal education and training” and that I ought to “send an urgent message to [my] state senator, committee member, and staff” because “patient safety is at risk.”

More from Dr. Oakey

I have read SB 622, and I’ve found that the details are more revealing than the headlines. Much of what I’ve heard from my colleagues surrounding this new law seems to relay the latter. For a full reading, see the link provided below.¹

Here are a couple pertinent portions: 

For eyelid procedures, optometrists will be allowed to perform "removal, destruction, or drainage of lesions of the eyelid and adnexa clinically evaluated by the optometrist to be noncancerous, not involving the eyelid margin, lacrimal supply or drainage systems, no deeper than the orbicularis muscle, and smaller than five millimeters in diameter . . . local anesthesia techniques and complications . . . treatment of anaphylaxis . . . radiofrequency surgery . . . [and] postoperative wound care.”

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